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PUBH6003 Health Systems and Economics in Ghana: Assessment 2 Case Study Answer

ASSESSMENT BRIEF
Subject Code and Title
PUBH6003: Health Systems and Economics
Assessment
Assessment 2: Case Study
Individual/Group
Part A: Group presentation
Part B: Individual written submission

Length
Part A: 20 minute group presentation and submission of presentation
Part B: Case Study Summary 1,000 words (+/- 10%)

Learning Outcomes
This assessment addresses the following learning outcomes:
  • Understand the core competencies of public health workers, and how public health competencies can be fostered
  • Understand the rationale for and development of universal health coverage.
  • Analyse public health expenditure estimation strategies
  • Understand the role of government regulation of the healthcare sector

Context:

The opportunity to research a particular country’s healthcare system will facilitate understanding of the interdependent relationship between economics, health care and public health. You can begin to get an understanding of the way a country perceives health and well-­­being by examining the areas to which resources are allocated, how efficiently they are managed, and how effective they are in terms of health care outcomes.

Instructions:

Select a public health system in a country of your choosing (other than your own).

Part A: Group Presentation Assessment Description:

In a small group of 3 to 4 students prepare your presentation, discuss the following issues:

  1. How the public health system is both organised and funded. As part of this, describe the following:
    1. The percentage of Gross Domestic Product spent upon health and how this compares with Australia (or another country);
    2. Where the money to fund this system comes from;
    3. How expenditures for public health services, including prevention programs, are estimated.
    4. What the mix of public and private expenditure and services is;
    5. Whether a proportion of funding comes from development assistance for health or any form of innovative financing;
    6. The underlying trends (demographic, changes in treatment, or technology) which help to explain expenditure;
    7. The extent to which health coverage is universal.
    8. Any economic levers that are used, or could be used, to achieve better health outcomes in your chosen country.
  2. How your chosen country performs in terms of the key elements or building blocks of the health system (as identified by WHO 2007; 2009) e.g. are there key workforce shortages in a particular profession and how might imbalances be addressed; and is the workforce appropriately trained to develop core competencies?
  3. Explain what cost-­­benefit analysis and cost-­­effectiveness analysis are and how they could be used to assist with resource allocation in relation to analysing the health system (you are not expected to perform the  analysis,  but  you  are required to understand these key concepts and say how you might go about the analysis). Additionally, describe a potential health system reform you could implement in your chosen country to improve weaknesses in the system.

Part B: Individual Case Study Summary

In 1000 words (+/- 10%), write a summary of the key points from the three sections of Part A. This should include a concise summary of:

  • How the public health system is both organised and funded
  • How your chosen country performs in terms of the WHO’s key building blocks of the health system
  • A potential health system reform you could implement in your chosen country to improve weaknesses in the system

Note: This is an individual assessment and students must work independently to create their own individual work

Submission Instructions:

Submit via the Assessment 2 – link in Assessment on main navigation menu in Blackboard

Other issues

On Campus students:

How will the groups be set up?

Your lecturer will assign the groups. Groups will be formed in blackboard for each group.

Should we submit our presentation on blackboard?

Yes, the presentation slides should be submitted on blackboard after the presentation has been given in class

What if I can’t make it to class when my group are due to present?

If you have any unforeseen circumstances in week 11 (for example, illness or emergency), your group will have the option to give the presentation in week 12.

If these circumstances still prevent you attending in week 12, your group can present

their sections and you can have the option, for your section, of recording your voice to powerpoint slides and submitting this online.

How do we make sure everyone contributes?

You should all contribute evenly to the preparation and delivery of the presentation.

You will be provided with a peer evaluation form which you will submit with your presentation on blackboard.

This forms asks you to specify the contribution of group members.

If you have any concerns prior to this about group member contribution, in the first instance, you should attempt to resolve this in your group.

If this is not successful, speak to your lecturer.

If a student does not contribute at all towards preparing the presentation and does not show up in week 11 or 12 without an adequate reason, they will not receive a mark for the presentation.

How will the marks be distributed?

If all group members contribute evenly towards preparation and delivery of the presentation, they will all receive the same mark.

Variations to this will depend upon whether there is disagreement about the contribution of group members.

Such disagreements should be documented in the peer review form, and discussed with your lecturer. The lecturer will determine mark distribution depending upon relative contribution of group members.

Online students:

How will the groups be set up?

Your lecturer will assign the groups. Groups will be formed in blackboard for each group.

As online students, it is your responsibility to be in contact with each other and organise how to undertake the task and divide responsibilities.

How should we submit our presentation?

You should submit your presentation on blackboard by Sunday of week 11.

Your presentation should consist of powerpoint slides with voice recordings for each slide. Your recordings should add up to 15 minutes.

Your lecturer can provide some instructions how to record audio material to slides.

You are welcome to explore other ways to add audio and/or video content (optional) to slides. All group members should contribute towards the preparation and delivery (via voice recording) of the presentation.

How do we make sure everyone contributes?

You should all contribute evenly to the preparation and delivery of the presentation.

You will be provided with a peer evaluation form which you will submit with your presentation on blackboard.

This forms asks you to specify the contribution of group members.

If you have any concerns prior to this about group member contribution, in the first instance, you should attempt to resolve this in your group.

If this is not successful, contact your lecturer.

If a student does not contribute at all towards preparing the presentation

and does not contribute to recording audio content for the presentation, they will not receive a mark.

How will the marks be distributed?

If all group members contribute evenly towards preparation and delivery of the presentation, they will all receive the same mark.

Variations to this will depend upon whether there is disagreement about the contribution of group members.

Such disagreements should be documented in the peer review form, and discussed with your lecturer. The lecturer will determine mark distribution depending upon relative contribution of group members.

Assessment criteria:

Demonstrates the ability to interpret and analyse relevant concepts and literature on universal health coverage, health systems, core competencies in public health and cost-

­­benefit analysis and cost-­­effectiveness analysis. (30%)

Demonstrates the ability to apply knowledge and understanding of health systems and core competencies in public health to a case example. (15%)

Critical analysis of key health system issues for the selected country. (20%)

Demonstrated knowledge and understanding of the principles of health economics including health expenditure estimation, resource allocation issues, economic levers and equity considerations. (10%)

Understanding and analysis of equity principles in health economics. (10%) Addresses

General assessment criteria: (15%)

  • Uses key readings and shows evidence of reading beyond the key reading.
  • There is a lucid introduction and clear conclusion or summary
  • Complies with normal academic of referencing and bibliographical details (including reference list, use APA style).
  • Is written clearly with accurate spelling, grammar and sentence and paragraph construction.

Answer

Case Study 2

Introduction

Public spending within Ghana is observed to be the healthcare that could help ensure support in the health needs of the normal public (De Savigny, 2009). As healthcare services are expensive and cannot afford, by the normal people, as the country is known to be economically and financially weak, hence the government needs to improve and focus on the efficiency of healthcare services. It is also how to boosts health outcomes, and ensuring support for a robust health financing system. It is the most vital and the topmost priority defined in the countries globally (Afedzi, 2016). At the same time, it is also important to increase the health expenditure that would equally be challenging considering the weak financial state of the economy. As Ghana, is relatively a low prosper country, faces a high volatile economy and has a frequent economic recession along with the rising healthcare costs, the government needs to support the economically indebted people. The economy comes under the parameters of the low defined income countries, faces the public healthcare spending and also has to experience a low performance in terms of applying the policies and integrating the funding. 

The public health system is both organized and funded

Ghana has adopted a universal health care system and it is due to the extensive support of the National Health Insurance Scheme (NHISwhich secures people, as most of the Ghana people live in poverty and cannot afford the normal health care needs to support themselves in their illness.

It has recently been observed, that Ghana has experienced tremendous economic growth (due to the findings of the oil reservoirs), which has boosted the economy indefinitely. It has a sudden experienced and invested in large spending on health. It has been observed, that in comparison to the past years, the country has invested only 11% in public healthcare spending in comparison to the recent years, which has risen to 15% higher along with the large support of the increase in government revenues. As of now, there has been a tremendous population growth which has shown, an actual of 65% of the population rising and belonging to the urban dwellers by 2030. It has also been estimated with the growth in population that has signified with the tremendous ageing, showing incredible rapid urbanization along with experiencing an increase in adoption of sedentary lifestyle, which has created a sudden rise in the communicable diseases (CD) with comparison to the non-communicable diseases (NCD), that has put pressure over the scarce healthcare resources(McKim, 2017).


The country performs in terms of the WHO’s key building blocks of the health system

As per the past health care outcomes, there has been time period from 1995 to 2014 in Ghana, that has shown how there has been Infant that are under-5 mortalities which have declined by 50 and 25%, respectively, in comparison to 2014, that have shown an increased  life expectancy that has risen from 60.7 to 64.8 years. Other factual findings are of the private spending focused on health, and it has shown an increased pocket payment, which has declined ever since from the WHO findings. It has also suggested a financial threshold. 

Another finding would be based on Non-communicable diseases (NCDs) that have shown an increase in the healthcare costs that have led to cascading impacts due to the healthcare expenditures in the future. Another way to find out how there has been an investment in the government’s sector on the healthcare that has shown positive results and there has also been an improvement in the health outcomes that is due to the increased health expenditure. 

Potential health system reform 

Looking into the potential health systems reforms current projections of Ghana’s healthcare expenditure that has unprecedented been increasing and, the government has started to invest majorly in the large sector of healthcare. It has started to fund and also provide extensive support in the increased healthcare expenditures which would require enhancing the acquisition that could be helpful in better hospital resources which can improve healthcare (Modern Ghana, 2018). As observed, from the statistics, there has been a vast healthcare expenditure along with the growing health outcomes  (for example, there have been many infant mortality rates, showing incredible under-5 mortality along with experiencing a life expectancy problems. 

To improve weaknesses in the system

But the Ghana economy as a whole has to work over the improvement in maternal health, needs to focus on providing national health insurance along with showing reformed healthcare systems, that have also largely influenced the health outcomes (National Health Insurance Scheme, 2013).

It has also largely been due to the (1) inadequate financial investments that have also been largely being due to the health outcomes (2) it has to also focus on improving the limited health workforce along with facilitating the facilities. It would also be facing a significant problems due to the (1) establishing new health institutions along with focusing on expanding an existed ones; (2) It also has to provide an incentives that would also discourage the exodus of health workers; (3) It would have to face a versatile problems due to the predictive, preventive along with the isolated problems caused due to the personalized medicine (PPPM) that needs to be treated in NCDs; and (4)  At the same time, it also has to focus on improving the alternative insurance schemes that could be focused on the vulnerable groups. Ghana's government has to focus on curbing the misappropriation of funds, which would help derive better health outcomes.

Conclusion

Ghana has a little public healthcare spending which is done through the help of insufficient tax revenues along with the support of the internal and external loans along with facing necessary restricted foreign grants. The other problems, which the country faces in terms of public health funding are in the form of the lack of healthcare funding sources and also experiencing relatively low private or out-of-pocket payments and also experiencing high fee-for-service charges and the private health insurance schemes (McCusker, 2015)

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