health systems analysis

8/8/2019 Health Systems Analysis

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Ajay PAjay PMBA (Healthcare & Hospital Management)MBA (Healthcare & Hospital Management)

09MBMH1309MBMH13

School of Management StudiesSchool of Management Studies


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Health systems is the sum total of allHealth systems is the sum total of allorganizations, institutions and resources whoseorganizations, institutions and resources whose

primary purpose is to improve health.primary purpose is to improve health.


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SOCIOECONOMICENVIRONMENT

HEALTH SYSTEM


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It is required to make the decisions in order toIt is required to make the decisions in order to

improve the health conditions of the People.improve the health conditions of the People.

To make the policies in order to eradicate theTo make the policies in order to eradicate theprevailing diseases from the society.prevailing diseases from the society.

It helps us to make changes in the presentIt helps us to make changes in the present

systems and enlightens us to reach the diseasesystems and enlightens us to reach the diseasefree India.free India.


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As a Health system includes all activities with aAs a Health system includes all activities with a

primary purpose of protecting, promoting restoringprimary purpose of protecting, promoting restoring

or maintaining health the fundamental objectivesor maintaining health the fundamental objectiveswill be:will be:

Protect people against threats of ill health andProtect people against threats of ill health and

injury.injury.

Provide financial protections against costs of illProvide financial protections against costs of ill

health.health.

It needs to provide services that are responsive andIt needs to provide services that are responsive and

financially fair and treating people decently.financially fair and treating people decently.


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Total population : 1027 mTotal population : 1027 m

Sex ratioSex ratio : 933f/1000m: 933f/1000m

LiteracyLiteracy : 65.3: 65.3 Pop. density : 324/sq.kmPop. density : 324/sq.km

Districts : 593Districts : 593

TownsTowns : 5161: 5161

BlocksBlocks : 5564: 5564

Villages : 5,80,781Villages : 5,80,781


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Urban populationUrban population : 29%: 29%

Population under 15Population under 15 : 35.6%: 35.6%

Population 65+Population 65+ : 4.1%: 4.1% Population belowPopulation below

Poverty line (


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Villages servicesVillages services : 1000 (pop): 1000 (pop)

SubSub--centrescentres : 5000 (pop): 5000 (pop)

Primary health centrePrimary health centre : 30000 (pop): 30000 (pop)

Community health centreCommunity health centre : 1,00,000 (pop): 1,00,000 (pop)

SubSub--divisional (taluk) leveldivisional (taluk) level : 5,00,000 (pop): 5,00,000 (pop) District level centreDistrict level centre : 20: 20 --25lakh(pop)25lakh(pop)

State levelState level


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Medical careMedical care

Control ofCDsControl ofCDs

MCHMCH-- Maternal Child HealthMaternal Child Health

FWFW-- Family WelfareFamily Welfare

NutritionNutrition

ESES-- Environmental SanitationEnvironmental Sanitation Vital statisticsVital statistics

School HealthSchool Health


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HOSPITALSHOSPITALS : 18218: 18218 BEDSBEDS : 811000: 811000

CHCsCHCs : 3043: 3043

PHCsPHCs : 22842: 22842 MEDICAL COLLEGESMEDICAL COLLEGES : 271: 271


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DoctorsDoctors : 6,68,131: 6,68,131

NursesNurses : 7,37,000: 7,37,000

DentistsDentists : 10751: 10751


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Trained attn. during pregTrained attn. during preg : 65%: 65%

Skilled attn. during dely.Skilled attn. during dely. : 33.5%: 33.5%

Women using FP method : 48%Women using FP method : 48% Children fully immunised : 49%Children fully immunised : 49%

Children with lbwChildren with lbw : 23%: 23%

Malnutrition(


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People with HIVPeople with HIV : 4 m: 4 m

MalariaMalaria : 2.3 m: 2.3 m

FilariaFilaria : 420 m: 420 mJapanese encephalitisJapanese encephalitis : 24 states: 24 states

PoliomyelitisPoliomyelitis : 142: 142

Dengue h. feverDengue h. fever : URBAN: URBAN


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TuberculosisTuberculosis : 207/lakh: 207/lakh

LeprosyLeprosy : 5,60,000: 5,60,000

MeaslesMeasles : 3,30,000: 3,30,000 DiarrhoeaDiarrhoea : 8,40,000: 8,40,000


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DiabetesDiabetes :31.8 m:31.8 m

HypertensionHypertension : not known: not known

CardioCardio--vascular vascular : not known: not known CancerCancer :2.5m:2.5m

50% mortality50% mortality

BlindnessBlindness :1.1%:1.1%


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PhysicalPhysical -- 1717

VisualVisual -- 4545 HearingHearing -- 2727

SpeechSpeech -- 1010

LocomotorLocomotor -- 105105(Population in lakhs)(Population in lakhs)


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PolicyPolicy FinancingFinancing

Human resourcesHuman resources

Supply systemsSupply systems Service managementService management

Information and monitoring systemsInformation and monitoring systems


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GEOGRAPHICANDCLIMATICALGEOGRAPHICANDCLIMATICAL

POLITICAL FACTORSPOLITICAL FACTORS

SOCIOCULTURAL FACTORSSOCIOCULTURAL FACTORS

ECONOMIC FACTORSECONOMIC FACTORS

ORGANISATIONAL FACTORSORGANISATIONAL FACTORS

ADMINISTRATIVE FACTORSADMINISTRATIVE FACTORS

TECHNICAL FACTORSTECHNICAL FACTORS

MANPOWERFACTORSMANPOWERFACTORS

COMMUNITYFACTORSCOMMUNITYFACTORS


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Health is central to global agenda on povertyHealth is central to global agenda on povertyreduction.reduction.

Severe human resources shortage or lack ofSevere human resources shortage or lack of

sustainable financing represent a key obstacle insustainable financing represent a key obstacle inscaling of disease control initiatives.scaling of disease control initiatives.

Health should be a priority within the overallHealth should be a priority within the overalldevelopment and economic policies.development and economic policies.

Inversely social, political, and economic initiativesInversely social, political, and economic initiativescan improve health system functioning if they makecan improve health system functioning if they makethese systems a priority.these systems a priority.


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A sound health information system is the strongestA sound health information system is the strongestfoundation for the health system development.foundation for the health system development.

Answerability, resource allocation, programmeAnswerability, resource allocation, programme

improvement, and management decisions relyimprovement, and management decisions relyheavily on Health information.heavily on Health information.

Two types of health information systems:Two types of health information systems:

a.a. population basedpopulation based: census; vital statistics: census; vital statistics

b.b. Health facility basedHealth facility based: surveillance; health: surveillance; healthstatus data; monitoring data regarding humanstatus data; monitoring data regarding humanresource;resource; financing etc.financing etc.

Different types of information neededDifferent types of information needed

for different levels.for different levels.


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Health information could be:Health information could be:

Area basedArea based

Disease basedDisease based Gender basedGender based

Age group basedAge group based

Out put basedOut put based

Detailed reports based on epidemiologicalDetailed reports based on epidemiologicalinformation obtained from studies.information obtained from studies.


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Drinking water availability: 78%Drinking water availability: 78% Sanitary facilities : 36%Sanitary facilities : 36%

There are 3000 villages without any water sourceThere are 3000 villages without any water source

and 1.5 lakh villages with difficult to reachand 1.5 lakh villages with difficult to reachsource.source.


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Currently only 10 per cent of the IndianCurrently only 10 per cent of the Indianpopulation has health insurance, which meanspopulation has health insurance, which meansthat there is tremendous scope for growth inthat there is tremendous scope for growth in

this area.this area. The Indian health insurance business is growingThe Indian health insurance business is growing

at 50 per cent.at 50 per cent.

Aarogyasri is one of the health insuranceAarogyasri is one of the health insuranceimplemented by the Government of Andhraimplemented by the Government of AndhraPradesh by Late Dr. Y.S. Rajasekhar Reddy.Pradesh by Late Dr. Y.S. Rajasekhar Reddy.


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In 2007, India treated 450,000 foreign patients rankingIn 2007, India treated 450,000 foreign patients rankingit second in medical tourism.it second in medical tourism.

It is estimated that medical tourism is growing at 25It is estimated that medical tourism is growing at 25--3030per cent annually.per cent annually.

The key selling points of the medical tourism industryThe key selling points of the medical tourism industryare its cost effectiveness and its combination with theare its cost effectiveness and its combination with theattractions of tourism. Treatment cost is lowest in Indiaattractions of tourism. Treatment cost is lowest in India 20 per cent of the average cost incurred in the US,20 per cent of the average cost incurred in the US,Singapore,

Thailand and

South Africa.

Singapore,

Thailand and

South Africa.

Besides world class medical facilities, India is also tryingBesides world class medical facilities, India is also tryingto promote its traditional medicine such as ayurveda.to promote its traditional medicine such as ayurveda.


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Enhanced national capacity on health policyEnhanced national capacity on health policyplanning and management for the provision ofplanning and management for the provision ofeffective and efficient health services that areeffective and efficient health services that areresponsible to communitys needs, particularlyresponsible to communitys needs, particularlythose of the poor and vulnerable groups.those of the poor and vulnerable groups.

Strengthened national capacity for health sectorStrengthened national capacity for health sectorreform to effectively manage reforms that leadreform to effectively manage reforms that leadto equity, effectiveness and efficiency in healthto equity, effectiveness and efficiency in healthcare in the countries of the region.care in the countries of the region.

Adequate strategies, methods, guidelines andAdequate strategies, methods, guidelines andtools developed to enable countries to improvetools developed to enable countries to improvethe delivery and quality of health services tothe delivery and quality of health services toindividuals and populations.individuals and populations.


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Building up and strengthening health systems isBuilding up and strengthening health systems isvital if more progress is to be made towards thevital if more progress is to be made towards themillennium development goals.millennium development goals.

Unless urgent investments are made in healthUnless urgent investments are made in health

systems current rates of progress will not besystems current rates of progress will not besufficient to meet most of the goals.sufficient to meet most of the goals.

Building strong health systems requiresBuilding strong health systems requiresimprovements across governmentsimprovements across governments in publicin publicfinancial management, manpower planning, roadsfinancial management, manpower planning, roadsand infrastructure and many other areas.and infrastructure and many other areas.

Health systems requires not only urgent investmentHealth systems requires not only urgent investmentbut also commitments from developing countries tobut also commitments from developing countries toincrease accountability and prioritise health inincrease accountability and prioritise health in

national and poverty reduction plans.national and poverty reduction plans.


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The approaches are many and varied:The approaches are many and varied:

I

ncreasing cost effectiveness.I

ncreasing cost effectiveness. Improving efficiency through reorganisedImproving efficiency through reorganised

services.services.

Decentralising health systems.Decentralising health systems.

Allocation of appropriate resources to betterAllocation of appropriate resources to betteraddress the needs of the population.address the needs of the population.


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Optimal Health(e.g., holistic and personalised

health and wellness)

Health enhancements(e.g., cosmetic and LASIKsurgeries)

MedicallyNecessary needs(e.g., acute care for sickness or injury)

Basic Healthcare needs(e.g., immunizaations and preventive screenings)

Environmental Health needs(e.g.., clean water, adequate sanitation and clean air)


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Focus on value:Focus on value:

Consumers, providers and payers should agree upon theConsumers, providers and payers should agree upon thedefinition and measures of healthcare value and thendefinition and measures of healthcare value and thendirect healthcare purchasing, healthcare services deliverydirect healthcare purchasing, healthcare services delivery

and reimburse accordingly.and reimburse accordingly. Develop better consumers:Develop better consumers:

Consumers need to make more sound lifestyle choicesConsumers need to make more sound lifestyle choicesand become more astute purchasers of healthcare services.and become more astute purchasers of healthcare services.

Create better options for promoting health and providing care:

Create better options for promoting health and providing care:

Consumers, payers, providers should seek out moreConsumers, payers, providers should seek out moreconvenient, effective and efficient means, channels andconvenient, effective and efficient means, channels andsettings for health promotion and care delivery.settings for health promotion and care delivery.


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TransformingConsumer

Responsibility

TransformingCare

Delivery

Transforming

Value


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All round commitment.All round commitment.

Evidence based decision making.Evidence based decision making.

Health viewed as a priority.Health viewed as a priority. Increased allocations.Increased allocations.

Leadership and management strengthening at allLeadership and management strengthening at alllevels.levels.

Continuous health systems research.Continuous health systems research.

health systems analysis

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