Health Issues

Part I: Description of your country’s health (4-5 pages)

Based on key health metrics and data, present an overall picture of the current state of health in your selected country. Strong papers will correctly use available metrics in a way that is meaningful and that tells an organized story of health – this is about turning data into words and stories, and correctly interpreting that data. You may choose any metrics you want, but we strongly suggest including material

On: maternal and infant mortality rates, life expectancy, leading causes of death, and a sophisticated  discussion of DALYs (don’t forget about the very important YLD portion of this metric),key health risk factors, etc. You might also consider how these metrics have changed over time, how they differ by different populations or geographic area, etc. Finally, your analysis should consider different categories of disease (NCDs, diseases of extreme poverty, accidents/injury, etc.).

 

In addition, Part I should:

1. a) Place the current state of health in your country in a historical context (i.e. what has changed in terms of health in the last 20-100years; how did the colonial period or period just after independence affect the health picture? What major historical events or processes have had the most significant impact on public health in your country?)Do NOT write along chronology of political events in your country. Instead, think about Chapter 3 in RGH, “Colonial Medicine and its Legacies.”
2. b) Place this overall picture in​regional context. How does your country compare to other countries in its region and/or of similar economic ranking?
3. c) Qualify your findings, if necessary, by commenting on the quality of available health data (see Suggested Resources below).
4. d) Briefly (in 1-2 paragraphs), consider one subgroup of the population that has substantially worse health outcomes than the national averages

​ (E.g. women, adolescents, elderly, ethnic minority, urban populations, etc.). Consider the historical, political and/or economic issues in the country that might have resulted in worse health outcomes for this group, and what specific impacts this has had on their health outcomes.

 

You may organize Part I in whatever way you want (e.g. discussing health metrics in historical context, or separating those two sections), but don’t forget that​your paper needs an introduction and must cover each of the areas identified above.

 

Part II: Determinants impacting a specific health issue (2-3 pages)

 

Pick one top health issue in your country. The issue you select does not have to be the leading cause of deaths or DALYs, but you must explain why it is one of the most concerning health issues in the country (example: the disease is among the top 5 causes of death and the top 5 DALYs and prevalence is increasing annually). Present a comprehensive picture of how a variety of determinants of health impact that health issue.

 

Tips for this section:

• Be specific, e.g. discuss​specific physical determinants (such as crowded urban housing or road infrastructure). This section asks you to demonstrate that you have a solid understanding of the course concepts from the first few weeks of lectures and readings, so we will be looking for a nuanced analysis that demonstrates an application of the early course material.
• Once you have described the specific determinant(e.g. Hand washing as a behavioral determinant, or earthquakes as a physical determinant),​think past it to consider how other issues/factors such as vulnerabilityimpactthatissue.e.g.personalchoiceorlivinginanearthquakezonedonotfully explain why some people are sick/injured and others are not.
• Research risk factors for your specific health issue and discuss how the determinants impact those risk factors. For example, risk factors for heart disease include diets high in saturated fats and smoking, so discuss determinants that impact each of those risks, rather than just those that impact diet. If you only discuss determinants that impact one risk factor, your argument won’t be                as strong.

 

Part III: Description and analysis of the health system (3-4 pages)

In this section you begin by describing the overall health system (including organization, financing, coverage and model). Tip: don’t just copy phrases that you read. If you’re not able to put it into your own words, you probably don’t understand the system. After you’ve given an overview, then you’ll analyze the key sector issues. You’ll need to be concise as you will only have about a paragraph or less for each of the key sector issues.

• Organization: Is it a coordinated system run by the Ministry of Health or is it more fragmented and relies primarily on market forces or NGOs? Is there a linked system of primary care, hospital                 care, and tertiary care (specialist care like neurology, cardiology, etc.)
• Financing: Is it publicly funded, privately funded, supported by foreign donors, oramix? Is the funding level sufficient to meet the needs of the population? If it has public funding, is it from taxes or insurance premiums? What % of healthcare costs are paid by the government?
• Coverage:​Is there insurance? How does insurance work (who pays for it, what %of people are insured)? What costs are incurred by citizens (insurance premiums/cost of care)? Any recent             significant changes in the system?
• Key Sector Issues:​Analyze​the ability of your country’s health system to tackle its health issues by researching and describing each of the following issues discussed in class: demographic and epidemiologic changes, health workforce concerns (referred to as human resources in Skolnik),            and access and equity. The key sector issues are described in detail in the assigned Skolnik article (posted in D2L readings).