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Emergencies and the Health Systems

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Title: Emergencies and the Health Systems


1
Emergencies and the Health Systems
2
Health System
3
Objectives
  • At the end of this 1-hour session, the
    participants will be able to
  • Define and discuss the building blocks of the
    health system
  • Discuss how emergencies/disasters disrupt the
    existing health system
  • Describe health emergency response using the
    health systems approach

4
Contents
  • WHO health system building blocks
  • Health systems in emergencies

5
Emergency
Save lives
6
Health system
Evacuation centres Security Nutrition
Surveillance Disease prevention and control
Logistics Information Management Resource
Mobilization Risk Communication
Emergency
Save lives
7
What is a health system?
8
The Health System
  • A health system consists of all organizations,
    people and actions whose primary intent is to
    promote, restore or maintain health
  • Includes efforts to influence determinants of
    health as well as more direct health-improving
    activities
  • Includes
  • A mother caring for a sick child at home
  • Private care providers
  • Behaviour change programmes
  • Vector-control campaigns
  • Health insurance organizations
  • Occupational health and safety legislation
  • Inter-sectoral action by health staff

9
The WHO Health Systems Framework
System building blocks
Goals/outcomes
Service delivery
Improved health (level and quality)
Health workforce
Access coverage
Responsiveness
Information
Medical products technologies
Financial risk protection
Quality safety
Health financing
Improved efficiency
Leadership/ governance
10
The WHO Health Systems Building Blocks
  • Service delivery
  • Health workforce
  • Information
  • Medical products and technologies
  • Health financing
  • Leadership/governance

11
The WHO Health Systems Building Blocks
  • Service delivery
  • Effective, safe, quality personal and
    non-personal health interventions to those who
    need them, when and where needed, with minimum
    waste of resources
  • Health workforce
  • Responsive, fair and efficient to achieve the
    best health outcomes possible, given available
    resources and circumstances
  • Sufficient numbers and mix of staff, fairly
    distributed
  • Competent, responsive and productive.
  • Information
  • ensures the production, analysis, dissemination
    and use of reliable and timely information on
    health determinants, health systems performance
    and health status

12
The WHO Health Systems Building Blocks
  • Medical products and technologies
  • Equitable access to essential medical products,
    vaccines and technology
  • Assured quality, safety, efficacy and
    cost-effectiveness, and their scientifically
    sound and cost-effective use
  • Health financing
  • Adequate funds for health, in ways that ensure
    people can use needed services, and are protected
    from financial catastrophe or impoverishment
    associated with having to pay for them
  • Leadership/governance
  • Existence of strategic policy frameworks that are
    combined with effective oversight,
    coalition-building, the provision of appropriate
    regulations and incentives, attention to
    system-design, and accountability

13
Health Systems in Emergencies
  • Emergencies/disasters affect the health system
  • Consideration for assessment, planning and
    implementation of response
  • Response, reconstruction and preparedness phases

14
How do disasters affect the health system?
6 Building Blocks of the Health System Health
services Health Workforce Health
Information Medical Products and
Technologies Health Financing Health Governance
Socio-political context
Environmental context
Health
Economic context
Community lifelines water, electricity,
transportation
Source Informal discussion with Dr R Lejano, UC
Irvine, 2009
15
Activity 3 How emergencies/disasters affect the
health system
  • Divide into 3 groups
  • Discuss on how disasters can affect the building
    blocks of the health system,
  • Group A Service delivery, health workforce
  • Group B Information, medical products and
    technologies
  • Group C Health financing, leadership/ governance
  • List down salient points and discuss with the
    group

16
Activity 3 Results
  • Service delivery
  • Health workforce
  • Information
  • Medical products and technologies
  • Health financing
  • Leadership/governance

17
How disasters affect the health system
  • Service delivery
  • Medical surgical services outpatient and
    inpatient care
  • Public health services immunization, health
    promotion, reproductive health, environmental
    health, maternal and child health
  • Health workforce
  • Direct and indirect impact to health
    professionals and their families
  • Same number of staff to work on increased demand
  • Safety, security psychosocial support

18
How disasters affect the health system
  • Information
  • Information system breakdown
  • Need for rapid information
  • Medical products and technologies
  • Damages and losses
  • Increased demand for medical products and
    technologies

19
How disasters affect the health system
  • Health financing
  • Direct and indirect economic losses
  • Increased demand for expenditure
  • Response require faster resource/finance
    mobilization mechanisms
  • Leadership/governance
  • Increased demand for quick decision making
  • Shift to emergency mode
  • Influx of external agencies, NGOs and groups

20
WPRO Health Systems Assessment Tool
  • WHO/WPRO, 2009
  • (Lejano, Sablan, et al)
  • Tool developed for assessment of the health
    systems in order to aid health emergency planners
    and policy makers for medium- and longer- term
    decisions.
  • Questions are answerable by YES or NO.

21
WPRO Health Systems Assessment Tool
  • Service delivery
  • Are there health facility structures/buildings
    and/or key equipment within them that have been
    damaged by the disaster?
  • Are there support systems that have been damaged
    by the disaster?
  • Are there health services/programs that have been
    compromised by the disaster?

22
WPRO Health Systems Assessment Tool
  • Health workforce
  • Did staff complement/ number of personnel
    reporting for work become a problem in the
    adequate carrying out of emergency response and
    recovery measures?
  • Did staff knowledge and skills become a problem
    in the adequate carrying out of emergency
    response and recovery measures?
  • Were the members of the hospital staff affected
    by disrupted lifelines (i.e., communication,
    transportation, shelter)?

23
WPRO Health Systems Assessment Tool
  • Information
  • Are there concerns regarding health information
    systems concerning individuals as patients?
  • Are there concerns regarding health information
    systems on health facilities?
  • Are there concerns regarding health information
    on the general population?
  • Are there concerns regarding health information
    concerned with public health?

24
WPRO Health Systems Assessment Tool
  • Medical products and technologies
  • Is there adequate supply of essential drugs in
    the health facilities? Are these readily
    available and affordable?
  • Are there concerns regarding quality of the
    drugs/vaccines available in the health facilities
    and pharmacies?
  • Are there concerns regarding availability, safety
    and accessibility of blood transfusion services
    in the health facilities?
  • Are there concerns regarding the availability of
    hospital equipment necessary for the basic
    surgical, anesthetic, medical and emergency care
    appropriate for the level of service a health
    facility offers?
  • Are there concerns regarding safety, reliability
    and availability of diagnostic and laboratory
    technology services in the area?
  • Are there concerns regarding safety, reliability
    and availability of diagnostic and imaging
    services in the area?

25
WPRO Health Systems Assessment Tool
  • Health financing
  • Did the disaster affect (increased, decreased,
    scrapped) the revenue, government funding, and
    expenses of the health facilities in the subject
    area?
  • Was funding of health programs affected
    (increased, decreased, scrapped) by the disaster?

26
WPRO Health Systems Assessment Tool
  • Leadership/governance
  • Did the disaster reveal any major issues in how
    emergencies are responded to, in how tasks and
    funds are allocated during emergencies, and how
    decisions are made during emergencies?
  • Did the government and other agency response to
    the disaster divert from and possibly change the
    way decision-making, allocation of funds, and
    allocation of tasks among agencies are made
    during an emergency?

27
References
  • http//www.wpro.who.int/sites/hsd/overview.htm
  • Philippine Floods Response Evaluation using the
    Health Systems Approach (WHO/WPRO, 2009)
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