1 / 30

Health and development

Health and development . Introduction to economics and health MAE - FETP India. Objective of this lecture. Understand major current issues in economics and public health. Key areas. 1993 World Development Report Commission on macroeconomics and health . World Development Report, 1993.

adanne
Télécharger la présentation

Health and development

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Health and development Introduction to economics and health MAE - FETP India

  2. Objective of this lecture Understand major current issues in economics and public health

  3. Key areas • 1993 World Development Report • Commission on macroeconomics and health

  4. World Development Report, 1993 • Published by the World Bank • Supported the concept of investment in health • Made special reference to the WHO Global Burden of Disease study

  5. Explaining past declines of mortality • Income growth • Improvement in health technology • Spread of public health knowledge World Development Report, 1993

  6. Explaining past declines of mortality • Income growth • More food, better housing, more health care • Rise of life expectancy with income • Relationship shifted upwards every 30 years • Improvement in health technology • Spread of public health knowledge World Development Report, 1993

  7. Explaining past declines of mortality • Income growth • Improvement in health technology • 1930: Anti-bacterials, drugs and vaccines • Heterogeneous benefits from technology • Public health and spread and knowledge World Development Report, 1993

  8. Explaining past declines of mortality • Income growth • Improvement in health technology • Spread of public health knowledge • Affluence and education makes little difference until effective prevention measures are known World Development Report, 1993

  9. Key problems identified • Misallocation • Teaching hospitals absorbing 20% of national health budgets • Inequity • Direct / indirect subsidies to tertiary care • Inefficiency • Brand name pharmaceuticals • Exploding costs • Middle income countries • Expenses growing faster than income World Development Report, 1993

  10. Global burden of disease, by cause and type of loss, 1990 Death Injuries Disability Non communicable diseases Communicable diseases 0 100 200 300 400 500 600 700 DALYs (millions) World Development Report, 1993

  11. DALYs lost to communicable diseases, India, 1990 (Total: 148 million) Malaria Worms Maternal Respiratory causes infections STD HIV Tuberculosis Other Diarrhea Vaccine- preventable diseases Perinatal causes World Development Report, 1993

  12. Key recommendations • Foster an environment that enables households to improve health • Improve government spending on health • Promote diversity and competition World Development Report, 1993

  13. Key recommendations • Foster an environment that enables households to improve health • Pursue economic growth benefiting to the poor • Invest in schooling, particularly for girls • Promote right and status of women • Improve government spending on health • Promote diversity and competition World Development Report, 1993

  14. Key recommendations • Foster an environment that enables households to improve health • Improve government spending on health • Reduce expenditure bringing little gain • Finance essential prevention package • Finance essential clinical services • Improve management of health services • Promote diversity and competition World Development Report, 1993

  15. Cost effectiveness of various health interventions

  16. Key recommendations • Foster an environment that enables households to improve health • Improve government spending on health • Promote diversity and competition • Encourage social or private insurance • Encourage suppliers to compete • Disseminate information on performance World Development Report, 1993

  17. Essential prevention package • Immunization • School-based health services • Family planning and nutrition • Reduction of tobacco / alcohol consumption • Healthier household environment • HIV infection prevention World Development Report, 1993

  18. Essential clinical package • Making pregnancy safer • Family planning • Tuberculosis control • Control of sexually transmitted diseases • Integrated Management of Childhood illnesses (IMCI) • AIDS prevention World Development Report, 1993

  19. Direction for government action:Essential clinical package • Finance • Essential clinical services • Require • Insurance coverage of essential package • Encourage • Private and NGO provision of essential services World Development Report, 1993

  20. Direction for government action:Services outside essential package (1) • Reduce / eliminate • Subsidies outside of essential package • Legislate • Health insurance • Limit • Government involvement in non essential services World Development Report, 1993

  21. Direction for government action:Services outside essential package (2) • Regulate • Private insurance • Define • Content of pre-paid package • Encourage • Prepayment / salary based approaches • Foster • Improvement in quality World Development Report, 1993

  22. Estimated costs and health benefits of minimum public health and clinical services, low income countries, 1990 World Development Report, 1993

  23. Millennium development goals(September 2000) • Eradicate extreme poverty and hunger • Achieve universal primary education • Promote gender equality/ empower women • Reduce child mortality • Improve maternal health • Combat HIV, malaria and other diseases • Ensure environment sustainability • Develop global partnership for development Developmentgoals.org

  24. Report of the WHO commission on macroeconomics and health, 2000: Investing in health for development • Need to go beyond the 1993 world development report • Need to link health and development • Need to obtain consensus from major economists • Need to define a new modus operandi

  25. Investing in health for development: Rationale • Growth alone will not lead to health • Poor health status limits economic growth • Economic growth is not sufficient • Investment in health leads to progress in low-income countries WHO commission on macroeconomics and health

  26. Investing in health for development: Key recommendations • Scale up access access of the world’s poor to essential health services • Focus on specific interventions • Close to client (CTC) systems • Malaria, tuberculosis and HIV • Research and development WHO commission on macroeconomics and health

  27. Financing increased investments in health, low-income countries, 2001-2015 G l o b a l p u b l i c h e a l t h g o o d s D o n o r i n v e s t m e n t N a t i o n a l i n v e s t m e n t 1 4 0 1 2 0 1 0 0 8 0 US$ billions 6 0 4 0 2 0 0 2 0 0 1 2 0 0 7 2 0 1 5 WHO commission on macroeconomics and health

  28. Returns on investments, 2015 • 8 million early deaths prevented • 330 DALYs saved • Conservative assumption • 2015 GDP: $ 563 / capita • One year of per capita income / DALY saved • Economic benefit • 330 x 563 = $186 billion /year WHO commission on macroeconomics and health

  29. Criticisms made to the approach used in the World Bank and WHO reports • Values assigned to disability • Healthy life is more valuable than life lived with disability • Age weighting is associated with “productivism” • Cost effectiveness data oversimplifies choices in public health

  30. Key areas • Invest in public health • Expect return on development

More Related