1. Describe what a health system is (MO6).

Health system refers to the organizations, institutions, resources and people who’s primary focus is
to improve health. The efforts to influence determinants of health and more direct health
improvement activities.

Boundaries- every country can decide what they want to include in the health system ( ex . does it
include the determinants of health)

Primary purpose is another key word.

Different health systems – the system reflect the societal and environmental context , other
influences are the geography and political history. Ex. If a country was prev colonised , its current
health system is a reflection of the country that colonized them .

Health systems are dynamic and constantly adapting to the needs of the population.

Socialized Medicine: Beveridge Model- Provide health care delivery in the form of a state supported
consumer service that is financed by taxation. Health care is bought but the buyer is the government
that makes its services available at little or no cost tot the consumer.

Bismark Model- Decentralized healthcare system , indirect government control and management of
health care delivery. The government acts to regulate the health care system more than to make the
changes/ upright the system. Government is more like a third-party mediator of delivery of health
care between the provider and those who finance the system (opposite to socialized medicine
model) Both the employer and the employee contributes and those who are not employed the
government contributes
Socialist Medicine: Samshko Model: Health care is a state provided public service. The state
controls, organizes, finances and allocates health care directly to all citizens free of charge. No Third
party or insurance companies between the health care providers and the companies. Prev
communist companies

Free-market Medicine

The free-market medicine system is based on wider free-market principles, particularly the private
funding by fee-for-service and private initiative and ownership, and has very little state or third-party
intervention. Encourage or enforces private care ? in RSA we cannot enforce for those who can not
afford. Only the employer who does that.
Despite countries being grouped under the same model , in the respective countries there are
enormous difference between the health systems due to internal pressure and shifts over time

2. Describe the WHO health system building blocks (MO6).

The 6 building blocks lead to the strenghtening of health care systems in different ways. Cross
cutting components-leadership, governance and health information systems—these provide the
basis for the overall policy and regulation of all the other building blocks

Key input components- financing in the work force

Medical products and techonologies and service delivery reflect the immediate outputs of the health
system. In other words the availiblity and distribution of care.

Weakness of this frame work is that it focusses on health sector action and underplays the affect of
other sectors AND does not take into account the actions that influence peoples behavior both in
promoting and protecting health and the use of healthcare services. Does not address the underlying
social and economic determinants of
health, such as gender inequities or education

NIMART- Nurse Initiation & Management of ARV Therapy – due to a shortage of doctors, nurses can
now prescribe the form of therapy to patients

What is striking is that in Free market system- maldistribution of health care professionals between
the public and private sector etc.

Strategies to overcome shortfalls-

Produce more: the problem with producing more is it is often difficult to keep up with population
growth. Professionals also immigrate, retire, or decide to work in other sectors.

Retain more: difficulty bc doctors and nurses are mobile and highly sought after as we have a global
shortage

Supplement: other countries or other cadres. Short term exhange

Task sharing (use other categories)

Health information systems

Individual level data eg- health care records Health facility level data eg- drug
of patients procurement records

Patient’s health profile- treatment - clinical To determine resource needs.

decision-making.
Population level data
For public health decision making and
generates info not only about those who uses
the services but also about those who do not
Community outreach, household testing ,
awareness campaign.
Public health surveillance
Brings together info from facilities and
communities to define problems and provide
timely base actions

Uses household services, census collection

In an outbreak situation- we would use public
health surveillance to determine if it is an
outbreak
3. Identify key indicators and targets used to measure health system performance
(MO6).
4. Explain what a policy is (MO7).
5. Identify the steps in the policy process (MO3,7).
6. Identify a public-health related policy (MO7).
7. Discuss your views on a global perspective in public health policy (MO7).