Global Health: Communicable & Non-Communicable Diseases, Health Systems & Women's Health

Communicable disease

Illnesses caused by exposure to infectious or parasitic agents.

Outbreak

Spike in incidence.

Epidemic

Sudden increase in a given era.

Pandemic

World Wide Epidemic (SARS in 2003).

Endemic

Infectious disease always present in an area (Malaria in many tropical areas).

Mode of transmission

How germ reaches human to infect.

Zoonoses

Spread of infection from animal to human (60% are).

Clinical focus

Diagnosis of individual, treatment with drugs, provide support if no treatment, protect those in healthcare facility.

Public health focus

Survey population for outbreak, enact population level strategies to prevent and control, spread information to population.

Epidemiological Triangle

Hosts - nutritional, immune status; Agent - Pathogen attribute: TYPE, INFECTIVITY, VIRULENCE; Environment - Modes of transmission like vectors.

Infectivity

Ability of an agent to spread/transmit from one host to another.

Virulence

Power of infectious agent to produce disease.

Case Fatality Rate

Express how deadly a disease is: Number of deaths from a disease / total cases in outbreak * 100.

Vaccines

Prevention by training your immune system.

Antibiotics

Kill or inhibit growth that's already existing.

Control strategies for communicable diseases

Based on how it is transmitted and the reservoir (source host).

Vector borne transmission

Animal control - mosquito control.

Air borne transmission

Reduce breathing in germs like quarantine, isolation, protective gear.

Vehicle borne transmission

Through a contaminated inanimate object (food, blood, utensil, etc.).

Person to person transmission

Behavioral.

GOARN

Global outbreak alert and response network; reduce reemerging infectious outbreaks, give access to experts and resources if outbreaks occur.

Ebola

New disease in Zaire; direct contact with bodily fluids NOT airborne; more deadly; harder to contain in weaker healthcare systems.

SARS

Re-emerging (new form) in West Africa; respiratory drops; solved through isolation and infection control.

At risk populations for communicable diseases

People in poor countries - limited prevention and education; children - respiratory infections, measles, diarrheal diseases; adults - TB, HIV; everybody in a new pandemic.

Communicable diseases affecting children

Measles, malaria, diarrheal diseases, respiratory infections.

SDG related to communicable diseases

3.3 End epidemics of AIDS, TB, Malaria, and Other Diseases.

Vaccine-preventable diseases

Tuberculosis, Measles, Hep B, yellow fever.

HIV

Virus

Transmission of HIV

Blood, sexual contact, mother to child

HIV Treatment

Chronic no cure

TB

Bacteria

Transmission of TB

Airborne

TB Treatment

Treatable

Malaria

Mosquitos

Malaria Treatment

Treatable and preventable

Vertical Transmission

From pregnant person to their child

HAART

Highly Active Antiretroviral Therapy - suppression of the virus

Barriers to Identifying Outbreaks

Weak disease surveillance systems in poor countries, bad labs or tests to rapidly identify, hiding or distorting info about outbreaks between countries

Neglected Diseases Factors

Weak health and public health systems in low income countries, drug resistance, few new anti infective drugs being developed

Scientific Decision View

What are the FACTS

Cost Effective Decision View

How much health do we buy for the cost

Cultural Decision View

Will this fit in with the culture?

Ethics/Human Rights Decision View

Does this respect HUMAN DIGNITY and is it fair?

Distributive Justice

Based on EQUALITY - all are eligible for equal amount of care

Social Justice

Based on NEED - all are eligible to receive care but amount VARIES BY NEED

Market Justice

Based on INVESTMENT - amount received depends upon how large their FINANCIAL CONTRIBUTION has earned them or what their resources give them

Universal Declaration of Human Rights

Document that established the basic doctrine of universal human rights and included health defined as a human right

Organizations Concerned with Human Rights

Amnesty International, Office of the UN High Commissioner for Human Rights, Human Rights Watch

Nuremberg Code

Set standards for physicians conducting research

Declaration of Helsinki

Set PROTOCOLS/PRINCIPLES of health research - informed decision to participate, independent ethical review, risks and benefits need to be considered

Universal Health Coverage (UHC)

Everyone has access to health services they need without it creating financial burden as they pay

Basis for Right to Health Care

Universal Declaration of Human Rights (article 25)

Key Factors for Universal Health Coverage

Well trained and motivated health WORKERS, essential medication and technology, affordable financial system, strong and efficiently run health system

Health System

All the organizations, institutions, and resources SPECIFICALLY dedicated to improving health

Scope of Health System

Promote health and preventing illness, detect health conditions early, having the capacity to treat disease, helping patients with rehabilitation, ensuring sensitive end of life care

Health System Limitations in Poorer Countries

Gaps are widening in health outcomes, some areas LACK CAPACITY to care for those in need, many essential medicine NOT AVAILABLE, health expenditures create poverty, shortage of workers, medical equipment is unused

Six Building Blocks of Health Systems

Services - Safe and effective care given, Workforce - trained capable staff, Health Information System - reliable, accurate, Medical Products - essential medicine available and equipment in working order, Health financing - public financing may be low in LMIC, Leadership/Governance - accountable management and spending

Types of Institutions Running Health Systems

Three types of institutions running health systems

PUBLIC

VA hospitals, county

PRIVATE

Cancer treatment centers of America

NGO

Non-profit filling gaps - Aravind in India

National Health

Germany

National Service

UK

Pluralistic

India

Demographics & epidemiologic shifts

Challenges for health systems in low-income countries

Stewardships

Challenges for health systems in low-income countries

Human Resources

Challenges for health systems in low-income countries

Quality of care

Challenges for health systems in low-income countries

Financing health system

Challenges for health systems in low-income countries

Financial protection

Challenges for health systems in low-income countries

Access and equity of care

Challenges for health systems in low-income countries

Reduce tobacco use

Solution for health systems in low-income countries

Limit Corruption

Solution for health systems in low-income countries

Use standards

Solution for health systems in low-income countries

Shift to low cost

Solution for health systems in low-income countries

GENDER EQUALITY

Emphasis of SDGs related to women and maternal health

GLOBAL MATERNAL MORTALITY RATIO

Reduce to less than 70 per 100,000

Son preference

Biological risks & social determinants of women's health and maternal mortality

Less legal rights and life control

Biological risks & social determinants of women's health and maternal mortality

Poverty and LESS EDUCATION

Biological risks & social determinants of women's health and maternal mortality

Intimate partner violence

Biological risks & social determinants of women's health and maternal mortality

Sexual abuse and rape

Biological risks & social determinants of women's health and maternal mortality

Iron deficiency anemia

Biological risk related to women's health

Obstetric fistulas

Biological risk related to women's health

Maternal mortality ratio

Key maternal health indicator measuring maternal deaths

% of births attended by skilled health personnel

Key maternal health indicator

% of cesarean births

Key maternal health indicator

Preterm birth

Birth that occurs before 37 weeks of pregnancy are completed.

Asphyxia

A condition arising when the body is deprived of oxygen, causing unconsciousness or death.

Sepsis

A life-threatening organ dysfunction caused by a dysregulated host response to infection.

Pneumonia

An infection that inflames the air sacs in one or both lungs, which may fill with fluid.

Diarrhea

A condition in which feces are discharged from the bowels frequently and in a liquid form.

Injury

Physical harm or damage to the body.

MCH interventions

Key maternal and child health interventions that can reduce child mortality.

Nutrition for pregnant women and children

Essential dietary intake from conception to two years of age.

Breastfeeding

The practice of feeding a baby with milk from the mother's breast.

Passive immunity

Immunity acquired by the transfer of antibodies from another individual.

Vitamin A supplementation

The provision of vitamin A to prevent deficiency and associated health issues.

Non-communicable diseases (NCDs)

Chronic conditions that aren't infections or transmitted from person to person.

Causes of NCDs

Genetics, behaviors, and environment.