Health Systems ContextHealth Systems Context

Institutional Arrangement for Completion of Institutional Arrangement for Completion of Economics Trends AnalysisEconomics Trends Analysis

Multisectoral /Intertersectoral Approach with wide Multisectoral /Intertersectoral Approach with wide country representation.country representation.

Focal Points – Dep. of Planning / Statistics/HealthFocal Points – Dep. of Planning / Statistics/Health– Sensitization Sensitization – Terms of reference and implementation plansTerms of reference and implementation plans– Core Team with technical working group Core Team with technical working group

(Health,Statistics, Economics, Epidemiologist)(Health,Statistics, Economics, Epidemiologist)– Working with Facilitators –PAHOWorking with Facilitators –PAHO– Capitalization on opportunities for In-country Capitalization on opportunities for In-country

interdepartmental communication / collaboration for interdepartmental communication / collaboration for information sharinginformation sharing

Economic Situation: Poverty and Economic Situation: Poverty and EmploymentEmployment

Opportunity to establish or strength health Opportunity to establish or strength health accountsaccounts

Standardized methodology in evaluating poverty? Standardized methodology in evaluating poverty? What are indicators for “relative poverty”?What are indicators for “relative poverty”? Ensure standardized definitions and indicatorsEnsure standardized definitions and indicators Ethnic grouping needs to be contextualizedEthnic grouping needs to be contextualized Indicators for table 8 needs to be more clearly Indicators for table 8 needs to be more clearly

defined i.e. formal vs. informal employment and defined i.e. formal vs. informal employment and extreme vs. relative povertyextreme vs. relative poverty

Usage of data for action must be the objectiveUsage of data for action must be the objective Limitations in ability to conduct trends analysisLimitations in ability to conduct trends analysis

Social IndicatorsSocial Indicators Clarify crude rate of primary schooling Clarify crude rate of primary schooling

(enrollment /completion)(enrollment /completion) Clarify school dropout level (primary school, high Clarify school dropout level (primary school, high

school etc)school etc) Prevalence of Depression - limitations in data Prevalence of Depression - limitations in data

collection in some countries (persons seek care in collection in some countries (persons seek care in private sector) but this is needed and efforts should private sector) but this is needed and efforts should be made to collect the data e.g. establishment of be made to collect the data e.g. establishment of surveillance system.surveillance system.

Limitation of access to some population groups e.g. Limitation of access to some population groups e.g. illegal immigrants whose social conditions have illegal immigrants whose social conditions have significant impact on health. significant impact on health.

Social Health DeterminantsSocial Health Determinants

ConstraintsConstraints– Lack of Technical skills for impact analysis Lack of Technical skills for impact analysis – Lack of M&E systems Lack of M&E systems

Enabling EnvironmentEnabling Environment– Technical commitmentTechnical commitment– Need for political willNeed for political will– Civic demands (population / media) and positive Civic demands (population / media) and positive

pressure on the health system will enable data collection pressure on the health system will enable data collection – Networking:Networking:

» Media, interest groups, RHIs and other sectors, knowledge Media, interest groups, RHIs and other sectors, knowledge sharingsharing