HEALTH AND DEVELOPMENT

Health & Development

Better health is central to human happiness and well-being. It also makes an important contribution to economic progress, as healthy populations live longer, are more productive, and save more. Many factors influence health status and a country's ability to provide quality health services for its people. Ministries of health are important actors, but so are other government departments, donor organizations, civil society groups and communities themselves. For example: investments in roads can improve access to health services; inflation targets can constrain health spending; and civil service reform can create opportunities - or limits - to hiring more health workers. It is concerned with the impact of better health on development and poverty reduction, and conversely, with the impact of development policies on the achievement of health goals. In particular, it aims to build support across government for higher levels of investment in health, and to ensure that health is prioritized within overall economic and development plans. In this context, 'health and development' work supports health policies that respond to the needs of the poorest groups. Poverty creates ill-health because it forces people to live in environments that make them sick, without decent shelter, clean water or adequate sanitation.

Health Services Health System constitutes of: Individuals Institutions- Public , Private hospitals, clinics Health technology Provider Consumer

Per capita income is one of the measurement used to assess Health Vs Development nexus according to Cumper Rich countries have better health system than poor countries Rich countries tend to spend more on health care than poor countries

Characteristics of Health Expenditure in Poor Countries Heavy focus on quantity improvement instead of quality improvement Inadequate health facilities Inappropriate and poorly distributed health services Focus on cure rather than prevention

Health in the Caribbean The status of health care in the Caribbean is measured by some of the following statistics (1) Infant mortality rate (2) Life expectancy at birth (3)Crude death rate

Environmental and nutritional factors are also considered in the determination of the health status in Caribbean Economies. The health system in the Caribbean is influenced by the demographic social, political and economic conditions Like poor economies the focus is on quantity instead of quality Cure rather than prevention Mainly Public Sector driven

Health Care in the Caribbean Health care is expensive and costs keep escalating. This is a painful fact which health care providers (governments and doctors) and purchasers (individuals and insurance companies) in the Caribbean have to grapple with on a daily basis. Evidence of financing difficulties in the health sector include shortage of staff, equipment and supplies; poor maintenance; high turnover and low morale of staff; delays in paying bills; long waiting lines and elimination or mothballing of expansion/renovation projects.

The issues of Health Care financing in the Caribbean can be considered from the expenditure allocation to health care. The extract of the article in the following slides provides some views on Health Care Financing by Stanley Lalta.

Issues in Health Care Financing in the Caribbean Health care finance comes from three main sources: (i) collective or public e.g. general taxes, health levies, compulsory social insurance (ii) individual or private e.g. out of pocket expenses, voluntary private health insurance (iii) donor community e.g. foreign and local charities/aid, trust funds. Resource availability from each source given the necessity of structural adjustment in the region and the attention being given internationally to more aid-deserving countries is generally out of line with resource needs (wants). This divergence is quite disturbing when placed alongside: (a) the range of health problems in the Caribbean diseases of poverty and diseases of affluence which characterize countries in the epidemiological transition; (b) the inadequacy of past policies in respect of incentives for cost containment, performance and outcome monitoring, management of cost effective care; (c) the high costs of imports which make up more than three-quarters of the supplies, pharmaceuticals, equipment etc. used in the health sector; and (d) the high percentage of the population requiring subsidized support to meet their health care needs. While some accelerating costs are inevitable e.g. costs of treating new diseases, technological innovations, upgrading of health care facilities, working conditions and remuneration levels of staff, others are more related to lifestyles, remuneration methods of health professionals in the private sector and inefficiencies in the institutions providing health care e.g. procurement, storage and inventory control. The quest for alternative financing mechanisms to improve efficiency, sustainability and adequacy of resources reflects a fundamental shift in the ideology and philosophy of health care provision. Despite the relatively large role of private practitioners, health care provision and financing is generally dominated by the public sector.

This traditional egalitarian model of health care emphasizes.

Alternative Methods for Financing Health Care (i) finance of health services through progressive taxation; (ii) little consumer choice since an individual in need is seen as a poor judge of his welfare and as such his needs can best be defined by health professionals; (iii) equity in access to health services regardless of ability to pay i.e. health as an entitlement or universal right.