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Presentation/PPT
27/08/2022
We need 250 words to reply to two classmates, thanks 6.1 – Discussion | Applying diagnostic tools to understanding causes of health outcomes You have been invited to provide consulting advice to a major funder who wants to help Liberia, a country that is wrestling with an infectious disease epidemic involving high rates of mortality and morbidity (such as Ebola). In your discussion post, respond to the following prompts: Assess the impact of an uncontrolled epidemic on ultimate health system goals for Liberia, including any supporting arguments. What would you recommend in terms of policy action and why? first classmate post by Cherann-Lee Edwards – Thursday, 6 October 2016, 3:18 PM As described in Module 1, ultimate health system goals include the improvement of health, protection against financial risks associated with ill health, increased consumer choice and satisfaction, and an overall decrease in health inequities, which is linked to the achievement of the other ultimate goals. An uncontrolled epidemic of an infectious disease with high rates of morbidity and mortality would have devastating consequences for Liberias health system, as evidenced by the 2014 Ebola outbreak. Recently ranked as the fourth poorest nation in the world (1), Liberia has been slowly rebuilding its health system following the end of the countrys civil war in 2003, and although gains have been made over the past decade there is still a chronic shortage of human resources, equipment and drugs. (2) While basic health outcomes are improving, Liberia is still far from achieving the ultimate health system goals outlined above. Using a diagnostic approach with the control knobs framework, I have identified three policy ideas which could be implemented to increase the Liberian health systems ability to manage an infectious disease epidemic: 1. Allocate increased resources to programs targeting the infectious disease At the beginning of the 2014 Ebola outbreak in West Africa there were only 50 licensed doctors in Liberia (3) and no laboratory capable of testing blood samples for the disease. (4) It is evident that the high mortality and morbidity outcomes of that outbreak were linked to the inadequate levels of care provided due to a lack of availability of health care professionals, equipment and supplies. These issues fall under the Financing control knob, and may be addressed by increasing the resources allocated to epidemic control programs. However the major issue with the implementation of this reform is that resources are already incredibly scarce – according to the World Bank, in 2014 Liberias health expenditure per capita was just US$46; in comparison, Australias expenditure in the same year was US$6,031. (5) 2. Devolve responsibility for these programs to county health teams As we learned in Module 4, decentralisation (an Organisational control knob mechanism) is considered to be an effective reform measure because it is assumed that local governments will be more responsive to local needs and challenges than national governments. In the battle against an epidemic of an infectious disease such as Ebola different approaches would be required for crowded urban communities and sparsely-populated rural communities. The WHO has previously outlined the difficulties of reaching remote areas of Liberia during the 2014 epidemic and the lack of essential services such as vehicles and telephone coverage in these areas. (6) An issue with decentralisation in the Liberian context however is again the scarcity of overall available resources, as well as the difficulties associated with recruiting health professionals to work in rural areas (mass migration from rural areas to the countrys capital, Monrovia, took place during the civil war and the city now hosts more than one-third of Liberias population). (2) 3. Provide people with information about the disease Information provision, which falls under the Behaviour control knob, was recognised to be critically important in generating behaviour change during the initial response to the 2014 West African Ebola outbreak. (7) The high morbidity and mortality rates in Liberia at the beginning of the outbreak can again be linked to inadequate levels of care for Ebola patients, however in this context there was actually an insufficient demand for services because people had little understanding of the disease. An on-going I Survived Ebola campaign released in 2015 is designed to continue to raise public awareness of the virus and also to reduce the stigma experienced by survivors of the 2014 outbreak and to promote their reintegration into society. (8) second classmate post by Evi Ningrum – Wednesday, 12 October 2016, 7:09 PM The epidemic began in the end 2013 in Guinea which was followed by notification from WHO that the epidemic became public health emergency of international concern by August 2014.(1) By September 2014 it was confirmed a total of 4507 confirmed The impact of an uncontrolled epidemic on health system goals in Liberia – Increasing maternal and child mortality rate. The plight has disproportionately affect women. In Guinea, women who were infected by the virus reach 74% and 62 % of total sufferer respectively of two different regions.(2) During the period of outbreak there were 800.000 women gave birth in the three affected countries which also worsen by inadequate of health facilities and staff.(1) – Decreasing national economic because the productivity of human resources rapidly declined. As the main family care givers were affected the most, family and community activities were slowly paralysed. Women in West Africa are responsible for growing, trading, and cooking food.(2) Based on UNDP Survey, nearly all respondent reported reduced income from farming and trading. While Liberia encountered 30% deflation.(3) In some countries mining operation has been ceased after workers left the affected areas, two third of farmers abandon their field causing food shortage, and stifled cross-border commerce. In addition, there has been reducing employment in informal sector and education(4) causing terminated learning activity for children.(4) – Destabilisation of health system in the country. The large number of EVD patients overwhelmed clinics and make them non-functional.(5) There is difficulty controlling infection because uncontrolled migration of people across the border due to weak government control over migration administration. The health system will be further disintegrated and non-ebola cases could poorly addressed adding the number of mortality rate.(5)
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