Samenvatting Class notes - Global Health

- Global Health
- Caro-Lynn Verbaan
- 2018 - 2019
- Wageningen University (Wageningen University, Wageningen)
- Gezondheid en Maatschappij
126 Flashcards en notities
1 Studenten
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Samenvatting - Class notes - Global Health

  • 1552863600 College 1

  • Why study Global Health?
    - Strong link between health, human development, labour productivity and economic development
    - Enormous progress in improving health status over last 50 years in many countries
    - However progress has been very uneven; many are left behind
    - Disparities in health status, access to health services:
    0 Within and across countries
    0 Wealthier, urban dwellers, ethnic majorities better off
    - World continues to shrink rapidly
  • What are (global) health problems?
    Crossing borders, magnitude, violation of human rights/ethics, the issue itself has a global nature
  • What are the 17 Sustainable development goals (SDGs)?
    no poverty
    zero hunger 
    good health and well-being 
    quality education
    gender equality
    clean water and sanitation
    affordable and clean energy
    decent work and economic growth
    industry innovation and infrastructure
    reduced inequalities
    sustainable cities and communities
    responsible consumption and production
    climate action
    life below water
    life on land
    peace-justice and strong institutions
    partnerships for the goals
  • 1552950000 College 2

  • Check schema.
    Gender -> welke sociale rol aan sekse geven
    Foetal experiences ->  complicaties bij zwangerschap
    Psychological factors -> personality
  • What are the key messages of the determinants of health?
    Health status is determined most immediately by a variety of factors, including income, education, knowledge of healthy behaviors, social status, sex, age, genetic makeup and access to health services
    The political will that countries have to improve health status, particularly for their poor, as well as policies and program in areas that affect health, such as economic management, education, nutrition, water and sanitation all have a major impact on health
  • What are health indicators?
    - From what conditions/diseases do people suffer
    - Determining extent to which the disease causes death or disability (severity)
    - Disease surveillance
    Consistent set of indicators to make comparisons between and within countries, populations:
    - Key health indicators
    - Burden of Disease -> index taking into account morbidity, mortality, disability by age, gender, regions to make comparisons of health status across regions within a countries and across countries
  • What are the key health indicators (with explanation)?
    Indicators linked to the biggest health issues

    Infant mortality rate -> aantal doden onder kinderen per jaar jonger dan 1
    Life expectancy at birth -> leeftijd die je verwacht te halen als je geboren wordt
    Maternal mortality ratio -> moedersterfte (van zwangerschap en geboorte)
    Neonatal mortality rate -> 28 dagen oud sterftegraad
    Under-5 mortality rate -> kans dat pasgeboren baby niet leeftijd van 5 haalt

    Morbidity: ziekte
    Mortality: sterfte
    Disability: handicap

    Prevalence: aantal mensen dat lijdt aan ziekte op bepaald moment
    Incidence: hoe veel nieuwe gevallen
  • In which three ways can diseases be classified?
    Communicable disease (infectieziekte): illnesses causes by a particular infectious agent that spread directly or indirectly from people to people, animals to people or people to animals

    Non-communicable disease (chronisch): illnesses not spread by an infectious agent

    Injury: include road traffic injuries, falls, self-inflicted injuries and violence, among other things
  • What does burden of disease means?
    Verandering over tijd -> infectie naar chronisch (shift from CDs to NCDs)
    Index measure
    Compare how far different countries are from the state of good health
    Important to gain an understanding of:
    - Leading causes of illness, disability, and death in the world  
    - Variations in these causes by age, sex, ethnicity and socioeconomic status
    - Changes over time and how these causes might change in the future
  • What are the two indicators for the burden of disease?
    - Health Adjusted Life Expectancy (HALE): summarizes expected number of years to be lived in what might be termed the equivalent of good health, a health-expectancy measure, to calculate HALE: the years of ill health are weighted according to severity and subtracted from overall life expectancy
    - Disability Adjusted Life Years (DALY): verwachting aantal jaren in ziekte te leven
  • What are demographics/epidemiology, risk factors, indicators (key messages) trends?
    - Countries develop -> less epidemics -> mortality and fertility decline, life expectancy increases -> population ages -> BoD shifts toward NCD
    - Pace of transition depends on DoH
    - Poorer countries still relatively more communicable diseases than richer countries
    -> trend kan ook minder snel als overheid niet ingrijpt

    Risk factors:
    Contributing of risk factors to DALY globally    
    - Men = smoking, high blood pressure, low birthweight and short gestation
    - Women = high blood pressure, high BMI, high fasting plasma glucose
    - Metabolic risk factor leading factor in 113 countries
    - Smoking remains among top 5 in 109 countries
    - Low birthweight and short gestation leading risk factor in 38 countries (SSA and SA)
    - Changes result from: decline mortality, less exposure to risks and ageing

    Indicators (key messages):
    - Poorer countries relatively larger BoD fromCD than NCDs than richter countries
    - As poorer countries develop, mortality and fertility decline, population ages, BoD, shifts toward NCD (demographic & epidemiological transition)
    - CVD leading cause of death worldwide, CD remain relatively much more important in South Asia and Sub-Saharan African than in the rest of the world. Only in sub-Saharan Africa do CD predominate
    - Improvement in health status partly result of economic development and improvements in income
    - Other contributors: water, sanitation, hygiene, nutrition, education
  • Give more information on Health-education-economics.
    - Health usually increases as national income increases
    - Illness often leads to a decrease in earnings
    - Costs of illness can cause individuals and families to dispose of assets and fall into poverty
    - Indirects costs to illness, such as transportation
    - Long-lasting disabilities generally require considerable expenditure on health services

    - Education contributes to disease prevention and management
    - Intergenerational links: parents' health and education affects their children
    - Malnutrition and disease affect children's cognitive development and school performance

    -> inkomen toename = gezondheidstoename, ziekte van kostwinner = afname gezondheid, onderwijs (ouders op kind overdragen) = voorkomen en beter omgaan omgaan met ziekte
  • What are health disparities and the belonging common patterns?
    - Health disparities: 'A type of difference in health that is closely linked with social or economic disadvantage' 

    Common patterns:    
    - Income -> education, water access, sanitation, hygiene, health services, safe work environments
    - Being born female is dangerous to your health - especially in low and middle income countries (geweld, minder eten, minder onderwijs)
    - Ethnicity: health status, access and coverage health services (meerderheden vaak betere gezondheid)
  • What is (in)equity and (in)equality?
    (In)equity = Wat is nodig om op zelfde level uit te komen
    (In)equality = Iedereen krijgt hetzelfde ondanks dat iemand misschien meer nodig heeft
  • What are the key messages on education, income and health disparities?
    Education, knowledge correlated with: 
    a) appropriate health behaviors, healthy living
    b) income opportunities

    Health strongly associated with productivity and earnings: 
    a) healthier people can work harder, longer
    b) better health promotes labor productivity, reduces country expenditure on health & creates attractive investment climate
  • What are the overview of determinants of health?
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Laatst toegevoegde flashcards

What are the overview of determinants of health?
How is health system organised?
- Besmettelijke ziektes meer individueel gezien: gaan overheden anders mee om
- Also disparities in health outcomes within countries (USA), health and poverty
2.3 What is culture? And give an example of an advantage and a disadvantage of making assumptions about what group members would be like.
Culture is about the learned and shared values of a particular group that guides thinking, beliefs, actions, behaviors, and emotional reactions.
Advantage: e.g. it enables us to act upon the values, beliefs, etc. of other people, and to make sense of what they are doing
Disadvantage: e.g. stereotyping, ignoring complexity
2.2 Describe which three different actors/stakeholders (NL: belanghebbende partijen) should participate in a program that aims to promote the use of Oral Rehydration Therapy (used when a child suffers from diarrhea) at home in low-income countries. For each actor, shortly describe their role
• Mothers: gain insight in their habits and ways, which you have to take into account; word of mouth (NL: mond-tot-mond reclame).
• Health professionals: explain ORT and use of ORS; prevent the use and advise of the wrong types of medicines; use status to convince the mother of necessity.
• Researchers: monitoring and evaluation the programme on impact and adjust if necessary; deliver evidence that is needed to get financing and cooperation.
• Suppliers ORS (industry): make ORS affordable
• Government: infrastructure for transport to remote areas
• Financers: international financers like the World Bank or bilateral banks, global finance
2.1 Shortly describe two different routes through which nutrition influences the health status of children
1. Route: Nutritional status influences children’s physical and cognitive health status
2. Route: Nutritional status influences the immune system and hence, the vulnerability to infections that in turn, may further influence their nutrition intake and nutritional status
3. Route: Nutrition influences children’s educational enrolment and performance:
a. This will influence their knowledge on health, health care and health seeking when being a child and later in life
b. This will influence their job opportunities and hence, resources that they can use for health
10. To which kind of practitioner below would a poorly educated, low-income family in a lowincome country probably take a sick child first?A. PharmacistB. Indigenous healerC. Medical doctor who practices allopathic (Western) medicineD. A general practitioner (NL: huisarts)
9. What is NOT an example of a horizontal approach in health interventions?A. Distributing mosquito nets to prevent malariaB. Enabling more clinics to carry out circumcisions (NL: besnijdenis) to prevent the spread of HIV or other STDsC. Educating mothers about proper child feeding practices and food preparationD. Constructing new policies on how to prevent brain drain
8. Push mechanisms for enhancing new pharmaceutical product development include all the following, except:A. Tax credits for research and developmentB. Direct financingC. Transferable patentsD. Performing or facilitating clinical trials
7. An indicator commonly used to assess the health impact of a complex humanitarian emergency is:A. Age-adjusted mortality rateB. Crude mortality rateC. Age-specific mortality rateD. Cause-specific mortality rate
6. What is the most cost-effective intervention to address neglected tropical diseases in subSaharan Africa?A. The SAFE strategyB. The rapid-impact packageC. DewormingD. Mass chemotherapy with praziquantel