SPHG 352 Midterm Exam With
Complete Solution
What is a health system? - ANSWER WHO: the sum total of all organizations,
institutions and resources whose primary purpose is to promote, restore,
maintain or improve health.
- improving health of the population they serve
- responding to people's expectations
- providing financial protection against the costs of ill-health
-needs staff, funds, information, supplies, transport, communications and
overall guidance and direction
-needs to provide services that are responsive and financially fair, while
treating people decently
Do health systems matter? Is there a public health system? - ANSWER Yes,
they matter. Difficult to say whether or not there is a PH system. Very
decentralized and lots of different actors influence PH.
Public Health Infrastructure - ANSWER Pyramid
Top = Public Health Response (bioterrorism, emerging infections, other PH
needs/priorities)
Middle = Capacity for Essential Public Health Services (assessment, policy
development, assurance)
Bottom = basic infrastructure (information systems, workforce,
,organizational capacity)
Essential Public Health Services - ANSWER Assurance (Enforce laws, link
to/provide care, assure competent workforce, evaluate)
Assessment (monitor health, diagnose and investigate)
Policy Development (inform, educate, empower; mobilize community
partnerships; develop policies)
At center: system management - research
Is there a U.S. PH system? - ANSWER Could argue there is not a unified PH
system in the U.S.
There are multiple systems that interact (public/private, nonprofit/for-profit,
government/NGO finances)
Degree of Public Health and Health System is questionable
Health system is not the same as health services which is not the same as
health care.
Building blocks and key components of a well-functioning health system -
ANSWER WHO has six building blocks:
-Service Delivery
-Health Workforce
-Health Information Systems
-Access to Essential Medicines
-Financing
,-Leadership/Governance
Focused on access, coverage, quality, and safety in order to achieve:
-improved health
-social and financial risk protection
-improved efficiency
-responsiveness
Characteristics of most systems (including health systems) from "Systems
Thinking" - ANSWER -Self organizing
-Constantly changing
-Tightly linked
-Governed by feedback
-Non-linear
-History dependent
-Counter-intuitive
-Resistant to change
10 steps to systems thinking - ANSWER Intervention Design:
1. Convene stakeholders
, 2. Collectively brainstorm
3. Conceptualize effects
4. Adapt and redesign
Evaluation design:
5. Determine indicators
6. Choose methods
7. Select evaluation design
8. Develop a plan and timeline
9. Set a budget
10. Source funding
Interaction between systems thinking and SEF - ANSWER Systems thinking
informs SEF
Importance of PH professionals in having a strong understanding of health
systems - ANSWER They work in diverse roles/settings
They are only a single part of a multi-faceted system to address PH issues
(wicked problems)
Complete Solution
What is a health system? - ANSWER WHO: the sum total of all organizations,
institutions and resources whose primary purpose is to promote, restore,
maintain or improve health.
- improving health of the population they serve
- responding to people's expectations
- providing financial protection against the costs of ill-health
-needs staff, funds, information, supplies, transport, communications and
overall guidance and direction
-needs to provide services that are responsive and financially fair, while
treating people decently
Do health systems matter? Is there a public health system? - ANSWER Yes,
they matter. Difficult to say whether or not there is a PH system. Very
decentralized and lots of different actors influence PH.
Public Health Infrastructure - ANSWER Pyramid
Top = Public Health Response (bioterrorism, emerging infections, other PH
needs/priorities)
Middle = Capacity for Essential Public Health Services (assessment, policy
development, assurance)
Bottom = basic infrastructure (information systems, workforce,
,organizational capacity)
Essential Public Health Services - ANSWER Assurance (Enforce laws, link
to/provide care, assure competent workforce, evaluate)
Assessment (monitor health, diagnose and investigate)
Policy Development (inform, educate, empower; mobilize community
partnerships; develop policies)
At center: system management - research
Is there a U.S. PH system? - ANSWER Could argue there is not a unified PH
system in the U.S.
There are multiple systems that interact (public/private, nonprofit/for-profit,
government/NGO finances)
Degree of Public Health and Health System is questionable
Health system is not the same as health services which is not the same as
health care.
Building blocks and key components of a well-functioning health system -
ANSWER WHO has six building blocks:
-Service Delivery
-Health Workforce
-Health Information Systems
-Access to Essential Medicines
-Financing
,-Leadership/Governance
Focused on access, coverage, quality, and safety in order to achieve:
-improved health
-social and financial risk protection
-improved efficiency
-responsiveness
Characteristics of most systems (including health systems) from "Systems
Thinking" - ANSWER -Self organizing
-Constantly changing
-Tightly linked
-Governed by feedback
-Non-linear
-History dependent
-Counter-intuitive
-Resistant to change
10 steps to systems thinking - ANSWER Intervention Design:
1. Convene stakeholders
, 2. Collectively brainstorm
3. Conceptualize effects
4. Adapt and redesign
Evaluation design:
5. Determine indicators
6. Choose methods
7. Select evaluation design
8. Develop a plan and timeline
9. Set a budget
10. Source funding
Interaction between systems thinking and SEF - ANSWER Systems thinking
informs SEF
Importance of PH professionals in having a strong understanding of health
systems - ANSWER They work in diverse roles/settings
They are only a single part of a multi-faceted system to address PH issues
(wicked problems)
