Areas of Work
Health Systems Development, Management and Financing
Each country’s health system is the product of a complex range of factors, especially regarding its historical development pattern and the power balance among different societal groups.
One of the key issues in the design of health systems is the role assigned to the state. Nothwithstanding the health system adopted model, regulation is one of the functions that all governments must carry out regardless of their degree of involvement in direct health service provision. Financing the health care system is a most complex matter and several formats have been proposed. They all refer to the raising or collection of revenue to pay for the operation of the system, commonly including different combinations of public and private sector involvement as well as a variety of group insurance payment schemes.
Financing mechanisms to be adopted in support to international health policy should be designed to:
· Ensure universal access to basic health care, giving absolute priority to the poorest and most vulnerable groups in the population (ex. children, women, elderly);
· Reinforce comprehensive health systems, instead of strategies based on vertical programs;
· Strengthen infrastructure, organization and control of programs and the acquisition and distribution of essential medicines (ex. antiretroviral drugs for the treatment of AIDS);
· And, above all, invest in human resources within the public health sector through training, motivation, and the appropriate remuneration of health personnel to prevent loss of staff to the private sector and to emmigration.
GHIA (Global Health International Advisors Association) is presently collaborating with national programs in the regionalization and decentralization of community health programs and assisting countries and communities in reviewing their health care services coordination and referral mechanisms.
Social and Economic Policies and Development
The relation between Public Health and Social and Economic Policies and Development is a well-recognized one, albeit not necessarily at the operational and evidence level.
It is necessary to avail decision makers of, or develop when necessary, instruments to characterize the socio economic situation of countries or specific target populations. Additionally, decision makers need to be exposed to alternative scenarios or alternative futures, as social policies may have unexpected consequences in the long run that are beyond customary projections.
Most developing countries are not familiar with evidence based decision making approaches, hence it is important to identify the sources available for information or those areas in which it will be necessary to generate such information, including the definition of metrics and indicators suitable for modern Public Health decisions.
Finally, although attention to the poorest countries will always be a priority, there is consensus on the emergency of a big cohort of middle and upper middle income countries. There is a lack of policies regarding these, running from the establishment of a suitable taxonomy to the preparation of a conceptual framework to intervene in countries where the issue is not so much the availability of resources, but rather their optimal utilization in a context of an increasing demand for good quality services