Powerpoint Lecture to Introduction to Health Policy

In many countries, the health sector is an important part of the economy. Some see it as a sponge – absorbing large amounts of national resources to pay for the many health workers employed. Others see it as a driver of the economy, through innovation and investment in bio-medical technologies or production and sales of pharmaceuticals, or through ensuring a healthy population which is economically productive. Most citizens come into contact with the health sector as patients or clients, through using hospitals, clinics or pharmacies; or as health professionals –whether as nurses, doctors, medical auxiliaries, pharmacists or managers. Because the nature of decision making in health often involves matters of life and death, health is accorded a special position in comparison to other social issues.
Health is also affected by many decisions that have nothing to do with health care: poverty affects people’s health, as do pollution, contaminated water or poor sanitation. Economic policies, such as taxes on cigarettes or alcohol may also influence people’s behaviour. Current explanations for rising obesity among many populations, for example, include the promotion of high calorie, inexpensive fast food, the sale of soft drinks at schools, as well as dwindling opportunities to take exercise.
Understanding the relationship between health policy and health is therefore important so that it is possible to tackle some of the major health problems of our time – rising obesity, the HIV/AIDS epidemic, growing drug resistance – as well as to understand how economic and other policies impact on health. Health policy guides choices about which health technologies to develop and use, how to organize and finance health services, or what drugs will be freely available. To understand these relationships, it is necessary to better define what is meant by health policy.

Policy is often thought of as decisions taken by those with responsibility for a given policy area – it may be in health or the environment, in education or in trade. The people who make policies are referred to as policy makers. Policy may be made at many levels – in central or local government, in a multinational company or local business, in a school or hospital. They are also sometimes referred to as policy elites – a specific group of decision makers who have high positions in an organization, and often privileged access to other top members of the same, and other, organizations. For example, policy elites in government may include the members of the Prime Minister’s Cabinet, all of whom would be able to contact and meet the top executives of a multinational company or of an international agency, such as the
World Health Organisation (WHO).
Policies are made in the private and the public sector. In the private sector, multinational conglomerates may establish policies for all their companies around the world, but allow local companies to decide their own policies on conditions of service. For example, corporations such as Anglo-American and Heineken introduced anti-retroviral therapy for their HIV-positive employees in Africa in the early 2000s before many governments did so. However, private sector corporations have to ensure that their policies are made within the confines of public law, made by governments.
Public policy refers to government policy. For example, Thomas Dye (2001) says that public policy is whatever governments choose to do or not to do. He argues that failure to decide or act on a particular issue also constitutes policy. For example, successive US governments have chosen not to introduce universal health care, but to rely on the market plus programmes for the very poor and those over 65 years, to meet people’s health care needs.
When looking for examples of public policy, you should look for statements or formal positions issued by a government, or a government department. These may be couched in terms that suggest the accomplishment of a particular purpose or goal (the introduction of needle exchange programmes to reduce harm among drug takers) or to resolve a problem (charges on cars to reduce traffic congestion in urban areas).
Policies may refer to a government’s health or economic policy, where policy is used as a field of activity, or to a specific proposal – ‘from next year, it will be university policy to ensure students are represented on all governing bodies’. Sometimes policy is called a programme: the government’s school health programme may include a number of different policies: precluding children from starting school before they are fully immunized against the major vaccine-preventable childhood diseases, providing medical inspections, subsidized school meals and compulsory health education in the school curriculum. The programme is thus the embodiment of policy for school children. In this example, it is clear that policies may not arise from a single decision but could consist of bundles of decisions that lead to a broad course of action over time. And these decisions or actions may or may not be intended, defined or even recognized as policy. As you can see, there are many ways of defining policy. Thomas Dye’s simple definition of public policy being what governments do, or do not do, contrasts with the more formal assumptions that all policy is made to achieve a particular goal or purpose.
Health policy may cover public and private policies about health. health policy is assumed to embrace courses of action (and inaction) that affect the set of institutions, organizations, services and funding arrangements of the health system. It includes policy made in the public sector (by government) as well as policies in the private sector. But because health is influenced by many determinants outside the health system, health policy analysts are also interested in the actions and intended actions of organizations external to the health system which have an impact on health (for example, the food, tobacco or pharmaceutical industries).

Contd.........

Situational Analysis :
The first step in such process involves an assessment of the present situattion.This is often reffered to as situational AnalysisThis analyses the present situation from various perspectives.
1. it examines the current and projected charachteristics of the population including its
demography
2. It looks at the physical and socio-economic characteristics of the area and its
infra-structure
3. It analyses the policy and political environment including existing health Policies.
4. An essential part is the analysis of the health needs of the poulation.
5. It also examines the the services provided both by the non-health sector and by the
health sector itself.The latter woulld focus on the facilities provided,their utilization and
service gaps,together with organizaional arrangement.
6. the situational analysis would also examine the resources used in the provision of
services and their current efficiency,effectiveness,equity and quality of services
It would be stressed that a situational analysis conducted by a public sector plan needs to
cover the whole of the health sector and not just those services provided directly by the
public sector,
To be continued..................

Dear Sir

Can you reupload the book ,give message file is expired.
Your kind cooperation will be appreciated.

Thanks

Zahid

Sir can you reload the book for us please