Global Health Final Exam
Terms in this set (59)
What are examples of progress within the global health arena that has happened in the last 50 years?
-Under 5 mortality rate fallen from 148/1000 to less than 48/1000
-Life expectancy increased from 48 years to 68 years
-Overall economic development and rise in income
-Improvements in public hygiene, better water and sanitation, and better education
What is public health?
The science and art of preventing disease, prolonging life, and promoting physical health and mental health and efficiency through organized community efforts toward a sanitary environment.
What are some examples of public health activities?
-Development of a campaign to promote child immunization in a particular country
-An effort to get people in a city to use seat belts when they drive
-Actions to get people in a specific setting to eat healthier foods and to stop smoking
-Promotion of hand washing
-Promotion of bicycle and motorcycle helmets
-Promotion of knowledge about HIV/AIDS
-Large scale screening for diabetes and hypertension
-Large scale screening of the eyesight of schoolchildren
What are some reasons why global health issues are a cause for concern among different countries?
Emerging and reemerging infectious diseases, Antimicrobial resistance, Eradication of polio, TB, Malaria, HIV, The increasing cases of diabetes and heart disease globally
Review the Millennium Development Goals. All of them.
-Eradicate extreme poverty and hunger
-Achieve universal primary education
-Promote gender equality and empower women
-Reduce child mortality
-Improve maternal health
-Combat HIV/AIDS, malaria and other diseases
-Ensure environmental sustainability
-Global partnership for development
What disease has been globally eradicated?
What is the maternal mortality ratio (MMR)?
The number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year
What does the MMR indicate in a country?
-A measure of the risk of death that is associated with childbirth
-Largely occur in low-income settings
What is a DALY?
Disability-Adjusted Life Year
-A unit for measuring the amount of health lost because of a particular disease or injury
What does a DALY indicate?
Losses due to illness, disability and premature death in population
What is a HALE?
Health-Adjusted Life Expectancy
-Summarizes expected number of years to be lived in what might be termed the equivalent of good health or the equivalent number of years in full health that a newborn can expect to live, based on current rates of ill health and mortality
What does a person's life expectancy measure?
The average number of years a newborn baby could expect to live if current mortality trends were to continue for the rest of the newborn's life
What would be some causes of those in low-income countries to fall below the poverty line temporarily?
The costs of illness to individuals and their families can be high, can force them to lose or dispose of assets and therefore fall below the poverty line
How is productivity in a country related to health?
Good health increases longevity and the longer one lives, the longer one can earn and the higher one's lifetime earnings will be
What is public expenditure?
Refers to expenditure by any level of government or of a government agency, such as social security system, the national insurance agency, or of a specialized agency
What is a human right for health?
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family
Can the human right for health ever be suspended? If so, what would be a reason why?
-As narrow as possible and carried out with due process and monitored
-Circumstances in which someone's rights may be temporarily suspended
-EX: influenza epidemic - government may suspend for a certain time the right of people to leave their homes or go to work
What are the basic ethical principles of human subjects research?
-Research - essential for improving global health and necessary for development of new interventions and how to deliver them
-Most research studies don't benefit the people who participate in them - designed to create knowledge that can help future patients
-Ethical concerns about putting participants at risk for the sake other people's health
What is the Universal Declaration of Human Rights?
Everyone has the right to standard of adequate health and well-being and mother and child are entitled to special care and assistance
What is the Declaration of Helsinki?
-1964, guide physicians conducting biomedical research with human subjects
-Most influential and most cited set of international research ethics guidelines
What is the Nuremberg Code?
-Specifies the ethical principles that should guide physicians engaged in human subjects research
-Emphasizes that human subjects should only be involved in research if it is necessary for an important social good, and requires limits on and safeguards against risks to participants
What is a health system, as defined by the World Health Organization?
-All actors, institutions, and resources that undertake health actions
-Where a health action is one where the primary intent is to improve health
What types of countries would have out-of-pocket costs be the highest share of total health expenditure? (Think of also specific country examples.)
Pluralistic health system countries
-United States, India, Nigeria
What are important epidemiological issues facing health systems?
-People are living longer
-Societies face higher burdens of non-communicable diseases
-Low-income countries face a triple burden of disease simultaneously
What are important demographic issues facing health systems?
-Reduce cardiovascular disease burden related to tobacco
-Strengthen health systems to address growing non-communicable diseases
-National anti corruption programs
-Increase audits of the health system and enforce penalties for violations
A set of rules or standards shared by members of a society, which when acted by the members produce behavior that fall within a range of variation the members consider proper and acceptable
What do people in traditional cultures think illnesses are caused by?
-Personal, interpersonal, and cultural reactions to disease or discomfort
-Cultural interpretations of physical states that people perceive to be illness, but that do not have a physiologic cause
What is the "Stages of Change Model"?
Why do people seek care from traditional healers?
Understand the culture, religious beliefs, know the people and are cost-effective
What are some major contributors to a large number of DALY's lost in low- and middle-income countries?
-Unsafe water, hygiene, and excreta disposal
-Urban air pollution
-Indoor smoke from household use of solid fuels
-COPD, lower respiratory infections, and diarrheal diseases
What would be an effective and low-cost method in improving health and averting DALYs in low-income countries?
The promotion of hygiene, the promotion of sanitation, and the construction of stand posts
What is cholera? How is it spread?
-A bacterial disease causing severe diarrhea and dehydration, usually spread in water
-Most times in low-income countries people have to rely on the river and lake water which is typically never decent for human consumption
What would be a low-cost method that would promote health in a rural area of a low-income country?
Education and promotion of proper hygiene and sanitation
Why is it important for pregnant and lactating women and children under 2 to get proper nutrition more than other groups?
-Otherwise it could raise risk of illness and decreased intellectual capacity in children
-Raises risk of pregnancy-related death and delivering prematurely in women
What does South Asia have the highest rates of?
-Wasting (low weight-for-height)
What are zinc and vitamin A associated with in low- and middle-income countries?
-Important to growth and proper functioning of the immune system
-Impact on severity of illness and chance of survival from several causes, including diarrhea, malaria, and pneumonia
What are some reasons why women are more at risk for health issues?
-Iron deficiency anemia related to menstruation
-Complications of pregnancy
-Increased susceptibility to some infections
-Gender norms and roles
-Poverty, lack of or low levels of education, and low social status limit access to health care
What is a direct cause of maternal mortality in a developing nation?
-Complications of delivery, obstructed delivery, preexisting medical condition that are exacerbated during pregnancy
How can maternal deaths in low- and middle-income countries be avoided?
-Provide hygienic and appropriate post-abortion care at the lowest level of the health system possible
-Improve adolescent and maternal nutrition
-Provide effective family planning methods
-Ensure that births are attended by a skilled birth attendant
-Provide package of essential obstetric services and emergency obstetric care
What are the leading causes of death among children under 5 years of age in developing nations?
-Preterm birth complications
-Acute lower respiratory infections
-Birth asphyxia and birth trauma
What easy prevention method for which disease can be employed to add the greatest amount of healthy years of life for children in low-income countries?
referring to the first month of life
What is considered exclusive breastfeeding?
Breastfeed infants exclusively for up to 6 months
Why is exclusive breastfeeding so important for infants?
-Promotes better health and better cognitive development for infants than mixing breastfeeding with other foods during that period
What is the result from the inappropriate use of drugs in developing countries?
-Resistant forms of disease can emerge and reemerge when bacteria, parasites, and viruses are altered through mutation, natural selection, or the exchange of genetic material among strains and species
-Factors contributing to development of drug resistance include increasing use of drugs, poor prescribing and dispensing practices, inappropriate use, failure of patients to take correct dosages, and counterfeit drugs
What is a major source of emerging infections around the globe?
Bacteria, parasites, and viruses are altered through mutation, natural selection, or the exchange of genetic material
What are some examples of diseases that are better measured via DALYs than via mortality rates?
What are the major non-communicable diseases prevalent in low- and middle-income countries?
Cardiovascular disease, diabetes, cancer, and mental disorders
What action can be taken for preventing cancer worldwide?
-Addressing infectious agents associated with cancer
Why do mental disorders contribute so much to the disease burden in populations?
Start at a young age, are chronic, often cannot be cured, and produce large amounts of disability
Define "complex humanitarian emergency."
A multiparty, intra-state conflict resulting in a humanitarian disaster which might constitute multi-dimensional risks or threats to regional and international security
What are the major health concerns that needs to be addressed during the early stages of a humanitarian emergency?
-Food and water shortages
-Lack of safe water
-Breakdown of health services
Define "internally displaced person."
Some people who flee or are forced to migrate during a disaster or complex humanitarian emergency leave their homes but stay in the country in which they were living
What are the main objectives of the WHO?
-Universal health coverage
-The international health regulations
-Increasing access to medical products
-Social, economic, and environmental determinants of health
-Health related MDGs
What do public-private partnerships in health try to achieve?
To combine the strengths of public and private organizations in common quest for better health by devloping new products
What would be a good example of a successful global cooperation in health?
World Health Organization
-UN agency responsible for health
-Engage in advocacy, generating, and sharing knowledge, setting global standards and other key functions
What are some ideal characteristics of vaccines?
Safe, effective, inexpensive, include several antigens, and require only one dose to confer lifelong immunity
What is a "push mechanism"?
Means of reducing risk of developing new products enough that the for-profit sector might be interested
What is a "pull mechanism?"
Assure a future return in the event that a product is produced (ex. Co-payments and Market assurances)
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