Integrating Health Care and Public Health Systems.

When considering public health and health care systems and the services they provide, it is important to think about how these systems and services are integrated. Systems thinking tools are helpful to consider the various links, feedback loops, and decision points within a system to identify opportunities for improvement and increase efficiency. Integrating Health Care and Public Health Systems.

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For this assignment, select a low- or middle-income country of interest and assess its health system. In a 1,000-1,250-word paper, address the following: Describe the major components of the health system. Discuss core services the health system provides and who manages them(government, private sector, a mix of both, etc.). Integrating Health Care and Public Health Systems. Discuss who is responsible for paying for those services or who funds the provided services. Apply a systems thinking tool, such as a causal diagram or process map, to identify opportunities for how gaps in public health services can be bridged through a strong health system. Conclude by considering how the convergence of communicable and noncommunicable diseases can be addressed more effectively through an integrated health system in the selected country.

Integrating Health Care and Public Health Systems

Major Components

In Guyana, healthcare is made up of both a private and a public sector. Guyana’s Ministry of Public Health is responsible for leading the public health sector, which works as a universal healthcare system catering for all residents and Guyana residents. The World Health Organization would in 2013 partner with the Guyanese government agencies and other essential stakeholders to create an initiative by the name “Health Vision 2020.” The initiative was a national health strategy that would improve the standard of living in the country (Klatman et al., 2017).Integrating Health Care and Public Health Systems.

While the country does not have universal healthcare, free healthcare facilities and resources are present and are catered to reach most of the country’s population. Nearly 90% of the population of this country live in coastal areas while the remaining 10% dwells in the rural hinterlands. Because of this, there is a significantly greater concentration of healthcare resources and facilities in coastal areas. For those living in Guyana’s hinterlands therefore, access to healthcare is limited, especially because very few healthcare facilities are located outside the coast.  Furthermore, clinics and other healthcare facilities located in the remote areas provide services that are of inferior quality compared to those in coastal areas (United States Agency for International Development 2011).Integrating Health Care and Public Health Systems.

In terms of healthcare professionals, the country has recruited over 500 trained doctors and physicians over the past half-decade, there are still existing shortages in the workforce. These are especially when it comes to nurse midwives and registered nurses, medical technologists, radiographers and social workers (Mallampati, 2019). Some of the problem has been seen to stem from a lack of incentives for workers on healthcare to remain in the public sector and as workers in the country. Furthermore, the country is lacking in foreign expertise in its healthcare system. This means that the system fails to benefit from the valuable knowledge offered by foreign doctors especially when it comes to arresting cases relating to viruses and diseases that may be uncommon in Guyana (Bleeker and Deonandan 2016).Integrating Health Care and Public Health Systems.

Core Services

Healthcare services in Guyana’s public sector are divided into five different levels based on the level of care available and the facilities. These levels are as follows.

• Level 1 – health posts,
• Level 2 – health centres,
• Level 3 – district hospitals,
• Level 4 – regional hospitals,
• Level 5 – referral hospitals.

Guyana’s public health sector is made up of 10 regional hospitals, 70 health centres, 22 district hospitals, 4 regional hospitals and 32 health posts as well as one psychiatric hospital. The first and second levels mainly provide preventative care and only focus on curative care for common diseases. These facilities tend to be staffed by nurses, nursing assistants and community health workers. Majority of the health centres and health posts are found in rural areas of Guyana and they mainly serve the health needs of the poor (Klatman et al., 2017).Integrating Health Care and Public Health Systems.

The system is designed such that proper functioning is dependent on a process of referrals. Apart from emergencies, patients will be seen at the first levels first. Integrating Health Care and Public Health Systems.Those whose problems cannot be addressed at these levels will then be referred to higher levels within the system. In practice however, many patients are able to by-pass the lower levels. Currently, Guyana’s healthcare system cannot offer some sophisticated medical and tertiary services. This is either due to the fact that the technology is not available in the country or for which medical specialists are required but are not available. Despite the substantial improvements the health sector has experienced, the need for overseas services for many patients continues to exist. Guyana’s Ministry of health provides patients with such needs with financial assistance while ensuring that priority is given to children, specifically those whose conditions can be rehabilitated this improving their quality of life (Klatman et al., 2017).Integrating Health Care and Public Health Systems.

Funding

As stated above, the Guyana government operates the public healthcare system ensuring that it is universal and can be accessed by all people in the country. The country’s ministry of health is responsible for effective operation of the public healthcare system as well as the distribution of the system.Integrating Health Care and Public Health Systems. The ministry’s roles include the establishment of regulations, determination of national policies, creating legislation, construction of facilities, and ensuring that it meets certain reasonable standards. While the government is responsible for the primary funding of healthcare services in the country, other stakeholders including the private sector and international partners also fund certain services and initiatives. To citizens of Guyana, services and treatments offered by public hospitals are usually free of charge. It is however worth noting that private room accommodations and some services will require patients to make some out-of-pocket payments (Klatman et al., 2017).Integrating Health Care and Public Health Systems.

Process Map

Appendix 1 below illustrates a process map identifying an opportunity for the elimination of an important gap in the health care system in Guyana. The map illustrates how to ensure that patients follow the designed hierarchy of healthcare services depending on the nature of their illnesses. It will ensure that services and resources in the upper levels of healthcare services are not used on common illnesses that can be treated in lower level facilities. Furthermore, it will ensure that funds allocated to treatment of common illnesses are used for the same and that no funds for emergency services and complicated illnesses are strained due to patients bypassing the system (Walker 2017).Integrating Health Care and Public Health Systems.

Convergence of Communicable and Non-communicable Diseases

The convergence of infections and non-communicable infectious diseases in low-income countries such as Guyana presents new opportunities and new challenges for the enactment of responsive challenges in research and policies. Most low and middle-income countries experience significant dual burdens of disease such as diabetes, cardiovascular disease and cancer and also infectious diseases such as HIV/AIDS, tuberculosis and parasitic diseases. It is therefore important to employ a combined disease control and surveillance strategy. However policies, experts and institutions that supports the control and preventions of the above categories of diseases continue to have limited alignment and interaction.Integrating Health Care and Public Health Systems.

The diseases in question share several common features. These include overlapping high risk populations and long-term care needs. Furthermore, there exist some direct interactions between the diseases. This includes the association between some infectious diseases, and cancers. There is also an increased susceptibility to certain infectious diseases for people with non-infectious diseases. The integration of public health activities for infectious diseases and non-infectious diseases need beyond health care services bit also to prevention of both infectious and non-communicable diseases.Integrating Health Care and Public Health Systems.