L48 Anthro 3283 Chapter Notes - Chapter 7: Neglected Tropical Diseases, Antimalarial Medication, Waterborne Diseases
RGH Ch. 7 Scaling Up Effective Delivery Models Worldwide
Principles of Effective Global Health Delivery
• The Global Health Delivery Project is a partnership between the schools of business,
medicine, and public health at Harvard and the Brigham and Women’s Hospital
o To help fill the knowledge gap about the delivery of health care services in
resource-poor areas
• GHD is developing a series of case studies drawn from countries ranging from Iran to
Kenya to Brazil to Indonesia on topics such as measles vaccination, antimalarial drug
protection, and HIV counseling and testing
• GHD framework:
1. Adapting to Local Context
• Assessing the local contours of disease burden is an essential first step: disease
prevalence and modes of transmission often vary greatly within countries and
regions
• Recognizing geographic differences in prevalence rates is essential to any health
delivery strategy
• Politics influences the provision of care and accessibility of services
• Instability, insecurity, or predation can have far reaching effects on health care
delivery and can jeopardize the work of providers
• Public health is predicated on the provision of public services; the public sector is
often the only health provider for the poor
o Public goods like potable water and clean air are necessary inputs for the
good health of a population; in their absence, waterborne diseases like
typhoid and pollutant diseases like asthma may become more common
o Clean water is also required for formula feeding children of HIV-positive
mothers, who are counseled to avoid breastfeeding
• Economic conditions play a role in determining access to care and the burden of
disease
o understanding the precise, local mechanisms by which poverty and
inequality in part shape the patterns of disease and the availability of care
are key starting points for the science of global health delivery
o ex: patients who can’t afford transportation to a local clinic or the sick
might need help with child care or food for their families
• social and cultural factors, such as gender disparities and disease-related stigma,
influence the local landscape of health care
o the health needs of marginalized populations often go unaddressed by
health providers
o the stigma associated with particular diseases, such as mental illnesses or
neglected tropical diseases, may prevent patients from seeking care
o health providers may need to intensify and expand their case-finding
efforts and provide care with even greater confidentiality to gain the trust
of patients
• local religious practices can also affect care-seeking and service delivery; can lead
individuals to avoid biomedical practices
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