Health Systems and Management
HSMP 6615 - Colorado School of Public Health – University of Colorado, Anschutz
Medical Campus
Spring Semester 2012
Course Syllabus
Instructor:
Susan Rifkin
Department of Health Systems, Management and Policy
E-mail: susan.rifkin @ucdenver.edu
Office Hours: Available by appointment
Course Title:
Credit Hours:
Meeting Time:
Meeting Place:
Global Health Policy Issues
Two Credit Hours
4:00-5:50 15 weeks plus examination
Ed 2 South L28-1308
Introduction:
This course describes critical current issues of global health policy and provides cases
studies to examine and analyze how these policies are being implemented. Focusing
on one of the major challenges for policy planners, that of poverty reduction,
lectures and seminars will investigate how national health systems response to this
challenge. The course emphasizes the importance of a multidisciplinary approach
to the comprehension of and response to global health challenges. Students will be
introduced to main concepts of global health policy planning and financing and the
critical links between health and social and economic development. The purpose of
this course is to enable students to 1)identify major issues in global health policy
with an emphasis on providing care for those in poverty 2) to analyze the theory and
practice of policy and its implementation 3) to use case studies to examine how
these issues are articulated, formulated as policy and implemented.
Course Learning Objectives:
Upon successful completion of this course, the students should be able to:
Identify the social, political, economic and cultural determinants of ill health and
health.
Identify the major actors in global health policy and analyze how history has shaped
their objectives and influence.
Analyze the role of health systems and the financing of these systems in shaping
national health care and contributing to the global dialogue on health policies.
Identify key issues in global health policy and identify examples of how these issues
are addressed in specific country situations.
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Critique programs, policies, and research addressing global health issues focusing on
planning and financing of national health programs.
Write a policy brief to make recommendations based data and analysis to a public
health official for his/her actions.
It is also the hope of the instructor that this course will inspire students to address
global health challenges in their academic and professional careers.
EVALUATION:
In-Class Participation: 25%
Assessed Essay: 50%
Final Exam: 25%
In-Class Participation: Seminars
One quarter of the grade will be based on seminar presentations. Seminars will be
for approximately 1 hour following the lecture. The topic for each seminar is
described below with the lecture. Students will be divided into groups and each
group will be responsible for managing at least one seminar presentations.
Management will include introduction of the topic, development of an exercise for
the class and summing up the conclusions. Students will need to read the
assignment and prepare their presentations according the management group’s
directions before the class.
Most seminars will use case studies to illustrate how the policy topic is attempting to
be implemented in specific country situations. Each group will have one case study
with the managing group providing the overview of the topic and support for the
presentations.
The presentations will be no more that 10 minutes answering the following
questions:
What policy is being address and implemented?
Why have they chosen to undertake these actions?
Who is involved as planners? As intended beneficiaries?
Where has the program be undertaken?
When has it been undertaken?
How has the planning and implementation be done? This part of the presentation
should be the core analysis of the policy implementation highlighting achievements
and challenges.
The final part of the presentation should identify broad “take home” messages from
the case study.
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One quarter of the grade will be based on a written examination at the end of the
course. The examination will be one hour. The examination will be composed of 4-6
essay questions of which each student must answer two of the questions.
One half of the grade will be based on a written assessment. This is the assignment.
Task Written Assignment (50% of the class grade)
To write a policy analysis paper not exceeding 2000 words (excluding the appendices
and references) as described below.
You are a policy analyst in the research wing in the Ministry of Health of a country of
your choice. A new Minister of Health has just been appointed and she wants a brief
analytical document with recommendations on a specific policy area in the health
sector with a view to drawing up policy proposals for the area. Please produce this
document, drawing on the course material as appropriate.
The document should be no more than 2000 words and presented as follows:
Describe the background to, and context of, the problems that the policy is intended
to address.
Specify possible aims for policy and provide justification for the chosen policy.
Critically analyze the relevant literature from countries, which have implemented the
chosen policy and identify the lessons from their experience.
Based on these lessons, make recommendations to the Minister of Health and
reasons for the recommendations.
Appendices (not in word count)
A brief description of the country for which you are writing the brief. Please include
an overview of the health status, major health problems, financing and delivery of
health care.
References (not in word count)
Policy topics
The policy area chosen may be any one of the following:
Decentralization
Management of human resources
Community financing schemes
Universal coverage for health care
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The role of for-profit providers
Role of civil society
Donor Assistance for health programs
Community Health Workers
Expectations:
Class attendance & Participation
Attendance is not required, but is highly recommended.
Policies:
Academic Honesty: Refer to School/College guidelines.
Students are responsible for being attentive to or observant of campus policies
regarding academic honesty as stated in the University’s Student Conduct Code.
Plagiarism is the use of another person’s words or ideas without crediting that
person. Plagiarism and cheating will not be tolerated. Either plagiarism or cheating
may lead to failure of an assignment, or the class, and/or dismissal from the
University.
You are responsible for being attentive to or observant of campus policies about
academic honesty as stated in the University’s Student Conduct Code.
(http://thunder1.cudenver.edu/studentlife/studentlife/discipline.html )
Access, Disability, Communication:
The University of Colorado Denver is committed to providing reasonable
accommodation and access to programs and services to persons with disabilities.
Students requesting accommodations should contact:
The Office of Disability Resources & Services (DRS)
13001 E. 17th Place, Building 500, Rm. W1103
(303) 724-5640.
Their staff will assist in determining reasonable accommodations as well as
coordinating the approved accommodations.
Civility:
Adherence to the Student Conduct Code is expected. I am committed to creating a
climate for learning, characterized by respect for each other and the contributions
each person makes to class. I ask that you make a similar commitment.
Please turn off beepers and cell phones during class.
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Schedule at a
Glance
Week
1
Date
January 24
Topic
Introduction to the
course
Presenter
Susan Rifkin
2
January 31
Overview of Global
Health Policy:
Susan Rifkin
3
4
5
Discussion: How does
health improve?
The US Health Care
Joel Levine
System
February 7
Group Work
Introduction to
writing a policy 2:305:50 analysis paper
February 14
Seminar
Low and Middle
Income Countries
and Health System
Reforms
February 21
Susan Rifkin and
Elaine Morrato
Susan Rifkin
Seminar
6
February 28
Introduction to
writing a policy
analysis paper
Susan Rifkin and
Elaine Morrato
7
March 6
Major actor in Global
Health
Susan Rifkin
8
Presentation of
policy analysis group
work
Decentralization
March 13
Seminar
9
March 27
Private Study
5
Susan Rifkin
10
April 3
Financing Health
Care
Adam Atherly
11
April 10
Private/Public
Partnerships
Susan Rifkin
Seminar
12
13
April 17
Human Resources for Susan Rifkin
Health : Migration
and Capacity Building
Presentation of
topics for Written
Assignment
Human Resources for Susan Rifkin
Health: Community
Health Workers
April 24
14
May 1
15
May 8
Seminar
Private Study
Assessing Health
System Reforms
Susan Rifkin
Written Assignment
Due
Role Play
CLASS DESCRIPTION AND READING LIST:
Week 1 Introduction to the Course
This session will be an introduction to the entire course. We will review expectations
from students. The course organizer will present the focus of the course and the
potentials and limitations of the course framework. After introductions, we will look
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at major challenges in global health policy and discuss why poverty alleviation is a
key to meeting these challenges. We will discuss the course structure and the course
assessments.
Week 2 Lecture 1 Overview of Global Health Policy (Primary Health Care, the Social
Determinants of Health)
We will begin by listening to a clip from the Swedish public health statistician Hans
Rosling who traces the changes in health status among the world’s nations and links
it with income. He gives a background to the lecture which will start by examining
what factors influence improved health status. The lecture will review the history of
global health policy responses to these developments culminating with the
acceptance of all nations of the World Health Organization of the policy of Primary
Health Care. The final part of this lecture will look at the challenges of implementing
this policy by national governments over the last 30.
Seminar/Discussion
We will focus on the question about how health improves by focusing on the role of
health services. We will look at some of the reasons why services alone do not
account for long term sustainable improvements of health in large populations and
identify issues that public health policies must address to ensure better health for all.
Readings:
Lecture:
Maciocco, G. Alma Ata to the Global Fund: a history of international health policy.
Social Medicine. 3:1. 2008. pp. 36-48. (available online:
www.socialmedicine.info/index.php/socialmedicine/article/view/186/380
WHO. Report of the Commission on the Social Determinants of Health (Executive
Summary) 2008 WHO:Geneva (online:www.who.int) (executive summary)
The World Health Report, 2008 Primary Health Care: Now more than ever. Available
online at www.who.int/whr/2008 (executive summary)
Additional
Braveman P & Gruskin S. Defining equity in health. Journal of Epidemiology and
Community Health. (2003)
57:254-258.
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Lawn, J., Rohde, J., Rifkin, S., Were, M.,Paul, V., and Chopra, M. Alma-Ata 30 years
on: Revolutionary, relevant and time to revitalize. 2008 The Lancet ( 917-927
(online: www.Lancet.com)
Rasanathan K, Montesinos EV, Matheson D, et. al. Primary health care and the
social determinants of health: essential and complementary approaches for
reducing inequities in health J Epidemiol Community Health (2010).
doi:10.1136/jech.2009.093914
Rifkin, S. and Walt, G. How health improves: defining the issues concerning
"comprehensive primary health care" and "selective primary health care". Social
Science and Medicine 1986 Vol 23, No 6, 1986.: 559-566.
Wolfensohn, J. and Bourguignon, F. Development and Poverty Reduction: Looking
Back, Looking Forward. 2004 World Bank online:
http://www.worldbank.org/ambc/lookingbacklookingahead.pdf
Week 3 Lecture 2 The US Health System ( Dr. Joel Levine)
To understand how global health policy is formulated and implemented it is
important to examine the health systems that most influence this process. The next
three lectures will examine health systems and policies which are most dominate in
this process. This lecture will present one of models of health care delivery that
dominates the global health system. This model is based on a free market economy
and a large role for private sector health care.
Seminar:
Your group is charged with creating a system of health care financing and delivery so
that in 2020 the US will provide improved equitable access to high quality affordable
health care for the poor and underserved. Each group will be given a role to play that of advocates for one of the following approaches 1) a real free market
approach, 2) sole payer (Canada), 3) expansion of MK/MC services with a private
insurance exchange (Obamacare), and 4) focused funding and expansion of the
safety net. We will draw lots to decide on which approach you will be advocating for.
Readings:
Lecture:
Myers,B. A. 1977 Health Care for the Poor Proceedings of the Academy of Political
Science, Vol. 32, No. 3, Health Services: The Local Perspective, pp. 68-78.
Katherine Swartz Health care for the poor: For whom, what care, and
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whose responsibility? (source not known)
Additional:
Kunitz, S. and Pesis-Katz, I 2005 .Mortality of White American, African-Americans and
Canadians: the causes and consequences for health of welfare state institutions and
policies. Milbank Memorial Fund Quarterly 83:1 1-21.
McKee, M and Stuckler, D. The assault on universalism: how to destroy the welfare
State British Medical Journal 2011;343:d7973 doi: 10.1136/bmj.d7973
Week 4 Policy Analysis Workshop (see separate workshop description)
Lecture 5 Low and Middle Income Countries and Health System Reforms
The global health dialogue, as we have seen, sees equity as a major principle.
Achieving equity has been hampered by both the lack of resources for the provision
of health care and the misdistribution of available resources. The countries that
have supported health care in poor countries and the UN/Bretton Woods
organizations called for Health Sector Reforms in the 1980 to address issues of
equity and quality of health care. We will identify the conflicting ideologies that
helped shaped these reforms and look at some of the results of their
implementation.
Seminar:
Each group will present an analysis of the effects of the health system reform agenda
on health outcomes for one country. The presentations will be based on case
studies. Groups are asked to examine the effects of reforms in their case study
looking at both the potential and barriers to implementing the reforms. They will be
asked to identify the assumptions about health improvements specific reforms were
chosen to address and evidence of the effects on outcomes.
Guidelines for presentation
Why are reforms necessary?
What is the main area of concern and how do the reforms address this area?
What are the strengths and weaknesses of the proposed reforms?
What are the “take home messages from the case study?
Readings:
Lecture
Kaul, M. 1977 The new public administration: management innovations in
government. Public Administration and Development 17: 13-26.
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Sen K and Koivusalo M. Health care reforms and developing countries - a critical
overview. International Journal of Health Planning and Management; 1998 13, 199215.
Seminar
Homedes, N and Ugalde. A. Twenty-Five Years of Convoluted Health Reforms in
Mexico, PLoS Medicine 2009 Volume 6 | Issue 8 | e1000124 (online:
www.plosmedicine.org
Sakyi, E. K. A retrospective content analysis of studies on factors constraining the
implementation of health sector reform in Ghana international journal of health
planning and management 2008; 23: 259–285.
Yip,W. and Mahal, A.The Health Care Systems of China and India: Performance and
Future Challenges Health Affairs, 27, no.4 (2008):921-932
Additional
Segall M. District health systems in a neoliberal world: a review of five key policy
areas’. International Journal of Health Planning and Management, 2003 18 S5–S26
Swanson, R. C.Bongiovanni, A. , Bradley, E. et. al. 2010 Toward a Consensus on
Guiding Principles for Health Systems Strengthening PLoS Medicine | Volume 7 |
Issue 12 | e1000385 (online: www.plosmedicine.org)
Week 6 Workshop on Policy Analysis
Week 7 Lecture 4 Major actors in global health (UN system and donor aid)
This lecture will focus on the major actors on the global health scene and their
influence through financial contributions to low and middle income countries. We
will briefly trace the history of the UN organization, focusing on the World Health
Organization and the United Nations Children’s Emergency Fund (UNICEF) and the
Bretton Woods Agencies (the World Bank and the International Monetary Fund),
some of the national bi-lateral donors including the US and Great Britain and Nongovernment organizations. (NGOs) We will then examine donor aid and its influence
on shaping health systems particularly in low and middle income countries. We shall
describe how the health system reform agenda has dominated donor support the
results of this orientation. We investigate the potentials and challenges of donor aid
and consider its future in the present era of financial austerity.
10
Seminar
Each group will be responsible to give a presentation using case studies on one of
the following topics:
The need for co-ordination of donor aid
The role of the UN in defining health aid focus examining the tension between the
World Bank and WHO
The potential and challenges of SWAPS (Sector Wide Approaches) to strengthening
national health systems
The strengths and weaknesses of conditionalities for developing recipient nation’s
accountability
The challenge posed by new Actors particularly China is shaping the aid agenda
Readings:
Lecture
Kickbusch, I Advancing the Global Health Agenda UN Chronicle, 2011 Vol. XLVIII No.
Brown, T., Cueto, M. & Fee, E. The World Health Organization and the Transition
from 'International' to 'Global Public Health'. American Journal of Public Health 2006
96 pp. 62-72.
de Beyer JA et al. The role of the World Bank in International Health: Renewed
Commitment and Partnership Social Science and Medicine 50: 2, 2000, 169 -176.
Riddell, R. Does aid work? Can it work better?" North South Institute Panel 2008.
Seminar
Kirigiaa, M and Diarra-Namaa,A. Can countries of the WHO African Region wean
themselves off donor funding for health? Bulletin of the World Health Organization
2008;86:889–895
Pfeiffer, J. International NGOs and Primary Health Care in Mozambique: the need for
a new model of collaboration Social Science and Medicine 56 2003: 725-738.
Sundewall, J, and Sahlin-Anderson, K. Translation of health sector SWAps,--a
comparative study of health sector development cooperation in Uganda, Zambia and
Bangladesh’, Health Policy 76(2006):277-287
Additional
Killick, T. ‘Politics, evidence and the new aid agenda’, Development Policy Review
22:1 (2004), 5-29.
11
McCoy,D., Chand, S. and Sridhar, D. Global health funding in: how much, where it
comes from and where it goes. (2009) Health Policy and Planning 24:407-417.
Peters, D. and Chao, S. The Sector-Wide Approaches in Health: What is it? Where is it
leading?" International Journal of Health Planning and Management 13 (1998), 17790
Week 8 Lecture 5 Decentralization and the Delivery of Health Services
A major policy issue for government is the question about at what level of the
government structure is responsibility for decisions on financing and delivery made.
To examine this question we will look at a theory of decentralization that has been
widely used in analyzing health policy issues. We will then look at case studies to see
how this analysis helps us to understand the potentials and challenges of
decentralizing health services.
Seminar
Each group will be given a case study to analyze and present finding concerning the
expectations about these reforms and the outcomes in implementation. The theory
of decision space will be used to examine the case studies
Guidelines for presentations
How does the theory of decision space apply to the case study?
Does it help explain the success or failure of the implementation of decentralized
services?
What are the main challenges to policy implementation?
How can these challenges be overcome particularly in the field of regulation?
Readings:
Lecture
Bossert, T. Analyzing the decentralization of health systems in developing countries:
decision space, innovation and performance .Social Science and Medicine. Vol. 47,
No. 10, pp. 1513-1527, 1998
Bossert, T. and Beauvais, J. Decentralization of health systems in Ghana, Zambia,
Uganda and the Philippines: a comparative analysis of decision space Health Policy
and Planning 17(1): 14-31.
Seminar
12
Collins C, Araujo J and Barbosa J. ‘Decentralising the health sector: issues in Brazil’,
Health Policy 52:2 (2000), 113-127
Men B, et al. Key issues relating to decentralization at the provincial level of health
management in Cambodia, International Journal of Health Planning and
Management 20:1 (2005),3-19.
Singh, Nirvikar. Decentralization and Public Delivery of Health Care Services in India.
Health Affairs (2008) 27(4).
Additional
Mills A, Antonius R, Daniel J, Gray H, Haqq E, Rutten F. ‘The distribution of health
planning and management responsibilities between centre and periphery: historical
patterns and reform trends in four Caribbean territories’. Health Policy, 62 2002, 6584.
Week 9 Financing Health Care ( Adam Atherly)
TBA
Week 10 Private/Public Partnerships
While in the past health care for many countries has been provided mainly by the
government, the current financial crises has demanded new channels of funding be
identified and used. A major focuses has been to involve the private sector including
non-profit foundations such as the Bill and Melinda Gates Foundation to provide
substantial support to government programs. These partnerships have been key in
provision of care particularly to the poor who have little or no resources to access
services. This week we shall look at the potentials and challenges of this funding
mechanism and examine the way in which these partnerships are being transformed
by the global financial and political environment.
Readings:
Lecture
Buse K & Harmer A. Seven habits of highly effective global public private health
partnerships: practice and potential. Social Science and Medicine 64:2 (2007), 259271.
Nishtar, S. Public – private 'partnerships' in health – a global call to action. Health
Research Policy and Systems 2004, 2:5 doi:10.1186/1478-4505-2-5
13
Seminar
Based on the case studies present arguments either to support or reject PPP as a
means for improving health care delivery wider access in poor countries.
Malmborg, R., Mann,G. and Squire, S.B. A systematic assessment of the concept and
practice of public-private mix for tuberculosis care and control International Journal
for Equity in Health 2011, 10:49 http://www.equityhealthj.com/content/10/1/49
Sambo, L. G and Kirigia, J.M. Africa’s health: could the private sector accelerate
the progress towards health MDGs? International Archives of Medicine 2011, 4:39
http://www.intarchmed.com/content/4/1/39
Shet, A., DeCosta, A. Hielen, E. et.al, High rates of adherence and treatment success
in a public and public-private HIV clinic in India: potential benefits of standardized
national care delivery systems BMC Health Services Research 2011, 11:277
http://www.biomedcentral.com/1472-6963/11/277
Week 11: Private Study
Week 12: Lecture 8 Human Resources for Health: migration, capacity building for
health personnel
There is a major concern today about human resources for health. Not only is there
a lack of trained people to provide the services demanded but also the right people
are not in the right place. This lecture will describe the situation concerning the lack
of staff and highlight the role of migration around the world. It will then look at the
type of staff necessary to meet health needs and examine how to build the
necessary capacities through systematic analysis for planning and management.
Readings:
Lecture
Dayrit, M., Taylor, A., Yan, J., Braichet, J., Zurn, P. and Shainblum, E.
WHO code of practice on the international recruitment of health personnel. Bulletin
of the World Health Organization 86:10 (October 2008) 739. (Online at:
www.who.int
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Martineau, T. and Willetts, A. "The health force: Managing the crisis ethical
international recruitment of health professions: Will codes of practice protect
developing country health systems?" Health Policy 75:3 (2006) pp. 358 -367.
Potter, C. and Brough, R. ‘Health systems in developing countries: public sector
managers and the management of contradictions and change’. International Journal
of Health Planning and Management 18 (2003), S67-S78.
WHO The World Health Report 2006: Working together for health Geneva: WHO,
2006 (Online: www.who. int ) (Read Executive Summary)
Additional:
Glassman, A., Becker, L. & de Ferranti, C. Planning and costing human resources for
health", The Lancet 371: p. 693-695. (2008)
Fritzen, S. Strategic management of the health workforce in developing countries:
what have we learned?’ Human Resources for Health 26 February, 2007
http://www.human-resources-health.com/content/5/1/4
Rigoli,F. and Dussault, G. The interface between health sector reform and human
resources for health Human Resources for Health 2003 1:9 http://www.humanresources-health.com/content/1/1/9
Stilwell,B., Dia llo, K, Zurn, P., Dal Po, M.R., Adams, O. and Buchan, J. (2003)
Developing evidence-based ethical policies on the migration of health workers:
conceptual and practical challenges. Human Resources for Health 2003,
http://www.human-resources-health.com/content/1/1/8
WHO. WHO GLOBAL CODE OF PRACTICE ON THE
INTERNATIONAL RECRUITMENT OF HEALTH PERSONNEL WHA63.16 Adopted May
2010.
Week 13: Human Resources for Health: Community Health Workers
With the increasing lack of trained health personnel particularly in poor and rural
areas, there has been increasing interest in training local people to provide basic
health care. Community Health Workers (CHW) gained popularity in the wake of the
Alma Ata Declaration in 1978. Although challenges to initial programs decreased
their popularity, in the wake of the HIV/AIDS epidemic they have seen resurgence.
This lecture will review their history, identify main challenges and examine recent
experiences of CHWs using the examples of Africa and India to define their
potentials and limitations.
Readings:
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Lecture
Rifkin SB. Community Health Workers. In Heggenhougen, K. and Quah, S.
International Encyclopedia of Public Health. San Diego: Academic Press;
2008;(1):773-782
WHO 2007 Community health workers: What do we know about them? The state of
the evidence on programmes, activities, costs and impact on health outcomes of
using community health workers Geneva: WHO.
Seminar
Groups will review one case study each and present a SWOT (Strengths,
Weaknesses, Opportunities and Threats) on the potentials and challenges in the case
studies provided. The presentations should examine the possibility of creating
mechanisms for accountability of the Government for health provision by the local
community and for the empowerment of women.
Bedjhat,H. Rifkin, S. B. Tarin, E and Sheikh, M. “A new role for women health
volunteers in urban Iran in Eastern Mediterranean Health Journal 15:5: 1164-1173
2009.
Manongi, R.N., Marchant, T.C. and Bygbjerg, I.C.Improving motivation among
primary health care workers in Tanzania: a health worker perspective Human
Resources for Health2006, 4:6 (available online at: http://www.human-resourceshealth.com/content/4/1/6
UNICEF 2004 What Works for Children in South Asia Country experiences:
Bangladesh: UNICEF, Regional Office for South Asia: 4-8
Additional
Campbell C, Gibbs A, Nair Y, and Maimane S. Frustrated Potential, False Promise or
Complicated Possibilities? Empowerment and Participation amongst Female Health
Volunteers in South Africa Journal of Health Management. 2009; 11(2): 315–336.
Week 14 Private Study
Week 15 Lecture 1 Assessing Health System Reforms
(Written Assignment Due)
This lecture will examine models of assessing health system. These models have
been designed to see if the objectives of the reforms have been achieved and
identify barriers to where they have not been achieved. Three models will be
presented and the strengths and weaknesses of each will be discussed.
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Seminar:
For the concluding seminar of this course, we will do a role play. It will enable us to
address major issues in health policy that we have identified and studied in this
course. The role play will be based on examining how different actors present their
views on how best to meet the Millennium Development Goals (MDGs). You will be
divided into 5 groups. The country for which you are presenting your views is
Ghana. You have a health profile of the country. Below is the scenario of the role
play.
You will be divided into five groups. All groups are representatives of various
organizations in Ghana which are reviewing a new HSR agenda to fulfill its promises
for the MDGs. The presenting groups must suggest why the approach considered by
them is more appropriate for achieving MDGs.
Groups
Group A's role: You will represent MOH and make a presentation to support a major
role for government in pursuing the MDGs.
Group B's role: You will represent the Private/NGO sector and make a presentation
to support HSR agenda in pursuing MDGs based on decentralization, public private
partnership, and reduced role for government in health service delivery.
Group C;'s role: You are a consortium of international donors who have been
requested to fund health program in this country. You need to present a strategy to
ensure your interests in accountability for funding is in place.
Group D’s role: You are member of civil society advocating for a role in health
decision making at the policy level, creation of structures to ensure human rights
and a role at the community level to be able to have a voice in the way health
services are delivered.
Group E's role: You are members of the presidential committee who will be asked to
make present a strategy for the government will follow to meet the MDGs.
The presenting group must suggest why the approach considered by them is more
appropriate for achieving MDGs.
Readings
Lecture
Daniels, N. et. Al. ‘An evidence-based approach to benchmarking the fairness of
health-sector reform in developing countries’ Bulletin of the World Health
Organization 83:7 (2005), 534-540
Rifkin S ‘Linking equity and empowerment with health outcomes: it’s a matter of
CHOICE’. Journal of Health, Population and Nutrition, 21:3 (2003),168 -180
17
WHO World Health Report 2000 Health Systems: Improving Performance
http://www.who.int/whr/2000/en/whr00_en.pdf (Read the Overview)
UNDP Millennium Development Goals online:
http://www.undp.org/mdg/progress.shtml
Seminar
Please use all the information you have had available for the entire course.
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