Introduction to Health Systems & Economics

Some housekeeping
• Flipped classroom learning – Assessing course readings in Blackboard,
weekly PowerPoint/ video uploads from lecturer, Q&A during weekly
workshop on Wednesday.
• Students to actively participate in classroom discussion (A3 20%).
• Textbooks
• Guinness, L., Wiseman, V., & Wonderling, D. (2011). Introduction to Health Economics. Maidenhead:
McGraw-Hill Education. eBook available via
http://search.ebscohost.com.ezproxy.laureate.net.au/login.aspx?direct=true&db=nlebk&AN=399237&
site=eds-live
• Duckett, S. & Willcox, S. (2015). The Australian Health Care System. (5th
). Oxford University Press, South Melbourne. eBook available via
https://lesa.on.worldcat.org/oclc/939262360
Important
• compulsory >80% attendance for International students
• Urgent absences: inform your learning facilitator
• Blackboard content issues: use ‘Ask the Facilitator Forum’
• Blackboard issues: Blackboard Support blackboard@laureate.edu.au
• Email access or IT related issues itservicedesk@laureate.net.au
• make sure your email address is correct in Blackboard
• Academic Writing Support
http://library.laureate.net.au/learningsupport_rocks
• Plagiarism http://library.laureate.net.au/research_skills/plagiarism
Laureate International Universities®
Health Systems & Economics
• 12 weeks @ 6 modules (1 module= 2 weeks)

1. Introduction to Health Systems & systems-thinking approach in Public Health
2. Health workforce
3. Health Financing and Universal Health Coverage
4. Resource allocation and expenditure
5. Demand and Supply in Health Services
6. Economic analysis in Public Health
   Assessment
   Module Assignment /Discussion % of Grade Due
   1 Assignment 1: Individual Report
   Applying systems-thinking in Public Health
   1000-words (+/- 10%)
   35% End of Week 5
   2 Assignment 2: Group Presentation (20 mins) &
   Individual Report [1000-words (+/- 10%)]
   45% Group presentation (Week 11)
   Individual report (Week 12)
   3-4 Assessment 3: Discussion during F2F workshops 20% Weekly workshop
   Total 100%
   Assignment 1
   • Due date end of W5
   • Submit via Blackboard
   • Please save your Assessment and submit it as the title of your
   submission using the following naming convention: subj
   code_M#_surname_first name initial_assessment title
   • E.g. PUBH6003_T12018_Sazali_S_Report1ApplyingSystemsThinking
   • Automatic plagiarism checker by SafeAssign (Turnitin receipt is not
   necessary).
   • Assessment #1: Individual Report – 35%
   • Applying systems-thinking in Public Health
   • Discussing PH issue affecting the population in your chosen
   country
   • Submit to Blackboard by midnight Sunday W5
   Assessment 2 Group work
   Why we need Group Work?
   ● Collaboration is the future—collaborative skills are essential in Public
   Health. We are dealing with the population & systems -require
   concerted effort.
   ● Working with others builds upon existing knowledge. Great ideas were
   not created in vacuum.
   ○ https://www.youtube.com/watch?v=0af00UcTO-c
   ● Learning now more than ever needs to be social and active. Our work
   culture is about connecting with people – e.g. knowledge dissemination
   using digital and social media.
   Tips on how to get started
   ● Choose a group leader who will be responsible for communications among the group
   members and setting up the first meeting to discuss the assignment. The group can discuss
   the progress during F2F workshop. Also, that can be done via BB Collaborate, Zoom,
   Whatsapp, Messenger etc.
   ● Create a communication plan. Group members should note a preferred method of
   communication (email, group discussion area, text chat, instant messenger, conference
   calls, etc.).
   ● List tasks and group roles required to complete the Assignment. Together, the group should
   identify which person will undertake each task.
   ● Set deadlines and specific check-in dates for each part of the Assignment. Leave a
   “cushion” of a few days between the scheduled completion of the Assignment and the due
   date.
   ● When a group member drops off the radar and misses meetings,
   ignores communications, or does not complete work on time, the other
   group members must figure out how to get that work done. [ >2
   students = Group] Suggestion – assign 2 students for 1 task.
   ● If the issue cannot be resolved, the group leader should contact me
   (Dr Shaz Sazali at shaz.sazalin@laureate.edu.au) so that the group
   can get advice about how to proceed.
   ● The KEY to any group work, and especially one that is completely
   online, is to make a schedule and meet due dates on time. Group
   assignment can be successfully completed without undue stress if the
   lines of communication are kept open.
   Timeline
   Week Learning module Submissions/ proposed tasks Dateline
   5 & 6 Module 3 Health Financing & Universal
   Health Coverage
   ● Group allocation
   ● Create communication plan
   ● Decide on presentation method
   ● Tasks timeline
   7 & 8 Module 4 Resource Allocation &
   Expenditure on Public Health
   ● A2 Part 1
   ● A2 Part 2
   9 & 10 Module 5 Demand & Supply in Health
   Services
   ● A2 Part 2
   ● A2 Part 3
   11 Module 6 Economic Analysis in Public
   Health
   ● A2 Part 3
   ● Group presentation during Week 11 workshop
   (20mins/ group)
   ● If no major correction, group leader to submit
   PowerPoint/slides/pdf in Blackboard by Sunday
   W11.
   Sunday W11
   12 ● 1000-word summary (A2 individual)
   ● Self & Peers Evaluation form (A2 individual) -KIV to
   integrate with Blackboard form
   Sunday W12
   Suggestions:
   Platforms & Tools for Collaboration
   ● Collaborative platforms
   ○ Google Docs, Google Slides
   ● Communication channels
   ○ Blackboard Group, emails, Whatsapp, Facebook Messenger, phone
   ● Real-time meetings
   ○ Blackboard Collaborate, Zoom, Skype, Google Hangouts, Facetime
   ● File sharing
   ○ OneDrive (using Torrens email address), Google Drive, Dropbox
   Contribution Summary Table (example)
   Name Contribution(s) Note
   Joshua Sanders Summarized Part 1
   Suggested video animation as the
   presentation method
   Contributed voice recording for final
   presentation
   Group leader
   Anupama Suresh Contributed materials for Part 2 & 3
   Summarized Part 2
   Casey Petra Helped to organized weekly meetings
   Summarized Part 3
   Created video animation & slides
   presentation
   Grace Okeke Contributed materials for Part 1 Grace stopped responding
   to group communication
   from Week 9 onwards.
   Assessment & Reflection
   ● Assignment 2 assess the group-work process as well as its final product
   and individual skills.
   ● Group presentation 20% (each member will receive the same
   marks).
   ● 1000-word individual case study summary & Self & Peers Evaluation
   (contribution/effort) 25% (marks differ for each student).
   ○ student self-assessment and peer-assessment form
   ■ describe in details your contribution and score your group
   members.
   ● Group work is often challenging, and being able to deal with conflict and
   solve problems that arise in groups is an important skill. It helps
   students to develop problem solving, conflict resolution and
   interpersonal skills.
   ● When conflict arises within the group, group members to negotiate a
   resolution first —lecturer step in only as a last resort.
   ○ understand that negotiation and conflict management/resolution are
   a normal part of working collaboratively with others.
   Submission and marking of your assignments
   • All late submissions (unless extension or exemption granted) will
   be penalised by 5% of the maximum mark per day (including
   Saturday, Sunday and public holidays).
   • Note: Any assessment submission that occurs more than 14 days
   (without prior extension approval) AFTER the due date for that
   assessment will be ineligible for marking and will receive a mark of
   zero.
   • Extension request need to be submitted at least 3 days prior to
   dateline.
   Module 1
   At the end of Module 1 you should be able to:
   • Discuss different definitions of ‘health’ and the ‘healthcare system’
   • Outline the goals/objectives and functions of a healthcare system
   • Understand the components of a healthcare system
   • Have a general understanding of what systems thinking is.
   Defining Health
   WHO defines health as:
   “a state of complete physical, mental and social well-being and not merely
   the absence of disease or infirmity”.
   Some criticisms:
   • The absoluteness of the word “complete” in relation to wellbeing –
   unintentionally contributes to the medicalisation of society – might result in
   higher levels of medical dependency and risk.
   • Unintentionally declares people with chronic diseases and disabilities
   definitively ill.
   Defining Health System
   “A health system consists of all organisations, people and actions whose
   primary intent is to promote, restore or maintain health” (WHO 2007)
   By this definition a health system includes:
   • More than formal health services such as health professional delivering
   personal medical care in a health facility.
   • Home care of the sick; private providers; traditional healers
   • Public health activities as health promotion and disease prevention
   programmes;
   • Other health enhancing interventions like road and environmental safety
   improvement.
   How important is a health system?
   Different views: some people think they are important, others think health
   systems make little or no difference.
   Note:
   • A health system is not an end in itself but a means to an end.
   • The ultimate goal is to improve the health of the population.
   • Strong health systems can facilitate the achievement of that
   goal – better health outcomes.
   10
   Goals/objectives of health systems
   Improving the health of the population they serve
   • Note that other systems in society may contribute greatly to the population’s
   health,
   but not as their primary goal (e.g. the education system).
   Responding to people’s expectations
   • Responsiveness = reducing the damage to one’s dignity and autonomy that
   sickness
   often brings with it.
   Providing financial protection against the costs of ill-health
   • Health care can be catastrophically expensive. Much of the need for care is
   unpredictable – critical for people to be protected.
   11
   Functions of health systems
   Delivering personal and non-personal health
   services;
   Raising, pooling and allocating revenues to purchase those
   services;
   Investing in people, buildings and equipment; and
   Acting as the overall stewards of the resources, powers
   and expectations entrusted to them.
   13
   Key components or building blocks
   WHO describes health systems in terms of 6 core components or
   “building blocks”:
   • Service delivery
   • Health workforce
   • Health information systems
   • Access to essential medicines
   • Financing, and
   • Leadership/governance
   14
   WHO Framework
   15
   WHO Building Blocks Framework
   Service delivery:
   Good health services are those which deliver effective,
   safe, quality personal and non-personal health services to
   those who need them, when and where needed, with
   minimum waste of resources.
   16
   WHO Building Blocks Framework
   • Health workforce
   • “A well-performing health workforce is one which works in ways that are
   responsive, fair and efficient to achieve the best health outcomes possible,
   given available resources and circumstances. i.e. there are sufficient
   numbers and mix of staff, fairly distributed; they are competent,
   responsive and productive” (WHO 2007).
   17
   WHO Building Blocks Framework
   Health information system
   A well-functioning health information system is one that ensures the
   production, analysis, dissemination and use of reliable and timely
   information on health determinants, health systems performance and
   health status (WHO 2007).
   18
   WHO Building Blocks Framework
   Medical products, vaccines and technologies
   A well-functioning health system ensures equitable access to
   essential medical products, vaccines and technologies of
   assured quality, safety, efficacy and cost-effectiveness, and
   their scientifically sound and cost- effective use (WHO 2007).
   19
   WHO Building Blocks Framework
   Health financing
   A good health financing system raises 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 health care (WHO 2007).
   20
   WHO Building Blocks Framework
   Leadership and governance
   Leadership and governance involves ensuring strategic policy frameworks
   exist and are combined with effective oversight, coalition building, the
   provision of appropriate regulations and incentives, attention to systemdesign,
   and accountability (WHO 2007).
   21
   Assessing health systems performance
   Challenging to assess health systems’ performance due to
   the multifaceted nature of health systems and the spread of
   direct and indirect responsibilities across multiple sectors.
   Several frameworks including:
   • WHO building blocks framework (main)
   • World Bank control knobs framework
   Frameworks have varying starting points, resulting in
   emphases on different outcomes to be tracked.
   22
   Value of international comparisons of healthcare systems
   Comparing how health systems perform means looking at what they achieve
   and how they carry out key functions in order to achieve what they achieve.
   International comparisons help us to:
   • Understand and appreciate common healthcare problems
   • Understand how characteristics of the delivery system impact population
   outcomes
   • Comparative strategies for reform and increasing quality and containing
   costs
   • Offer benchmarks and other useful insights into how to improve care
   24

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