Term
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Definition
| Health issues and concerns that transcend national boundaries and might better be addressed by cooperation. GH has replaced the term International Health. IH refers to the traditional north south cooperation between nations. GH includes the role plaids by foundations and other NGO's. |
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Term
| Describe the stages in the development of International Health |
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Definition
1. Roots on colonialism and tropical medicine.
2. The interwar period: origins of international Health institutions (Pan American Sanitary Bureau, The League of Nations, Rockefeller Foundation Int Health Board
3. Postwar period: from disease eradication to PHC.
4. Health Care in the 1980's: from PHC to selective PHC.
5. The new Global Health. |
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Term
| Describe the trends in IH? |
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Definition
1. Health strategies developed outside the countries where problems exist. Policy was shaped by science and colonial finances. Few efforts to incorporate local perspectives.
2. Approaches to health have been selective rather than comprehensive.
3. Health programs linked to economic development |
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Term
| Mention some of the disease specific approaches to health of the first part of the XX century |
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Definition
1. Bilharizia in Egypt and China
2. Hookworm in the Americas
3. Cholera in the Philipines
4. Plague in India
5. Yaws and Syphilis in East Africa. |
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Term
| What were some of the success of PHC? |
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Definition
1. Increase access to family planning.
2. Reduction in maternal mortality.
3. Elimination and eradication of diseases
4. Reduction in micronutrient malnutrition. |
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Term
| What was shown in the World Bank 1993 Report? |
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Definition
| That Health and Development are linked |
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Term
| Which are the key determinants of health? |
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Definition
Individual: Sex, race, genetic, age
Physical Environment: water, hygiene and santiation.
Social environment: SES, education, culture, gender norms.
Behavior
Access to health services |
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Term
| What are the Millennium Development Goals |
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Definition
| It is a set of 8 goals with 15 core targets that were presented at the UN Millennium Summit. Countries that signed this declaration pledge to meet the goals by 2015. |
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Term
| What is the infant mortality rate? |
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Definition
| It is the number of infants that die <1 yr / 1000 live births in 1 yr. This is a powerful indicator of the health status of a country. |
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Term
| What is the Under five mortality rate? |
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Definition
| It is the number of infants that die <5 yr / 1000 live births in 1 yr. This is a powerful indicator of the health status of a country. As with IMR, it is strongly linked to the economic status of a country. |
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Term
| What is Maternal Mortality Ratio? |
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Definition
| It is the number of pregnant women who die/ 1000 live births. It is a measure of the risk of death related to childbirth. Has great within country variability. |
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Term
| How many maternal and child deaths have undernutrition as an underlying cause? |
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Definition
| 3.5 million deaths have undernutrition (stunting, wasting, underweight, low birth weight) as underlying cause of death. This represent 35% of total Daly's for |
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Term
| How many maternal and child deaths have undernutrition as an underlying cause? |
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Definition
| 3.5 million deaths have undernutrition (stunting, wasting, underweight, low birth weight) as underlying cause of death. This represent 35% of total Daly's for |
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Term
| What is the estimated burden of disease attributed to breastfeeding? |
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Definition
| It has been estimated that BF for < 6 months, especially non-exclusive BF, is responsible for 10% of DALYs in < U5 and 1.4 mill deaths. |
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Term
| What are two major risk factors for maternal deaths during delivery? |
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Definition
1. Iron deficiency
2. Short stature
These two factors account for 20% of maternal deaths. |
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Term
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Definition
| Weight for height having a Z score < to 2 in relation to the standard population. The global estimate for wasting is 10%. And the highest prevalence is in SEA (16%). |
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Term
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Definition
| Height for age < 2 Z scores in relation to the standard population. Stunting is an indicator of chronic malnutrition. It reaches its plateau at 24 mth of age. Stunting and wasting do not coexist frequently. 32% prevalence in DC. |
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Term
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Definition
| Weight for age Z score of < 2. Prevalence highest in South and Central Asia with 32%. |
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Term
| How are estimates for stunting, wasting and undernutrition calculated? |
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Definition
| Data from national health surveys form 139 countries is analyzed with comparable methods including the new WHO Child Growth Standards. |
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Term
| What is the major cause of iron deficiency anemia? |
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Definition
| Low consumption of meat, fish and poultry. Anemia increases risk of maternal deaths and has an effect on child cognition. |
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Term
| What are two indirect indicators that have been proposed by the Internationl Zinc Nutrition Consultative Group to estimate Zn deficiency in the food chain? |
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Definition
1. Prevalence of stuntitng
2. Adequacy of absorbable Zn in available food. |
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Term
| Zn deficiency increases the risk for which diseases? |
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Definition
| Diarrhea, pneumonia and malaria as has been evidenced by RCT in several countires |
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Term
| What are the main benefits of vitamin A? |
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Definition
| Vitamin A protects against dying from measles and from diarrhea. You have the same risk of getting sick, but you are not as likely to die. To achieve mortality reduction, a high coverage of vitamin A needs to be achieved. |
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Term
| What are the top 5 causes of DALYs? |
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Definition
1. LRI
2. HIV
3. Conditions arising during perinatal period.
4. Diarrheal disease
5. Unipolar major depression.
6. Ischemic Heart Disease
7. Vaccine preventable diseases.
8. CVD
9. Malaria.
10.Nutritional deficiencies.
Tuberculosis is 14.
SSA with 10% of pop has 26% of Dalys. |
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Term
| What is the golden rule of decision making? |
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Definition
| Resources are always constrained |
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Term
| What are the principal characteristics of the demographic transition? |
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Definition
Change in population distribution from high fertility and mortality, to low fertility and mortality.
Usually, mortality rates drop quicker. This effect is observed in the growth at the base of population pyramid.
Population Change= Births - Deaths + Migration In - Migration Out.
Atypical pyramids are observed in HIV/AIDS. |
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Term
| What is epidemiological transition? |
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Definition
| It refers to the movement from a context with high mortality linked communicable diseases to a context of high mortality due to non-communicable diseases. |
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Term
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Definition
| Eradicate Poverty and Extreme Hunger. Goal: halve the people who live with <1 dlls/day and the proportion of people who suffer from hunger by 50% from 1990 levels. |
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Term
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Definition
| Universal primary education for everyone, everywhere. |
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Term
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Definition
Economic indicator calculated from the Lorenz curves for income and consumption. 100 means perfect inequality
0= perfect equality.
Most countries with values between 20 and 60. |
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Term
| What are the 5 leading causes of death in L-MIC? |
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Definition
1. IHD
2. CVD
3. LRTI
4. HIV/AIDS
5. Perinatal conditions
7th Diarrhea
8th TB
9th RTI
10th Malaria |
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Term
| Which are the 3 leading causes of disability globally? |
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Definition
1. Unipolar major depression
2. Hearing loss, adult onset
3. Alcohol use disorders |
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Term
| What is the Global Burden of Disease Study? |
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Definition
| Research published by WHO in 2000 that presented estimates for global mortality, morbidity, disability and DALY's. The results of this study were based in a variety of sources (demographic studies, registration systems, vital registration and expert opinion). This estimates were presented first in 1990 and had projection for 2020. These projection showed that chronic disease will be dominating disease burden |
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Term
| What is the fundamental concern of IH? |
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Definition
| The health of the populations. The first step to improve this is by measuring health, which will give us an idea of the magnitude of a problem and will help us to plan interventions. |
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Term
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Definition
| A DALY is Disability Adjusted Life years. It is a composite indicator that is frequently use to estimate the importance of a health issue in a population. Common to aid in decision making. Important limitations. This measure combines time lost due to disability and that due to premature death (life that would have been expected if disease had not occur). A fundamental and controversial point with DALYS is that they are age weighted, meaning that more weight is given to life at a younger stage. First published by Murray and Lopez in 1994. |
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Term
| Name other composite health indicators? |
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Definition
DALY
QALY: Quality Adj Life Years
HeaLY: Health Life Years
HALE: Health Adj Life Years |
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Term
| What is the purpose of the DALY? |
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Definition
| To compare disease burden in different population. Its level of use is in broad policy decisions. |
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Term
| What is the purpose of the HALE? |
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Definition
| Compare disease burden in different countries. Measure developed by WHO (2000). It's level of use is for GLOBAL COMAPRISIONS. |
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Term
| Who was the first to use the term demographic transition? |
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Definition
| FW Norstein in 1945 used it to describe the changes in fertility in mortality that were associated with the change from a traditional to a modern society. |
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Term
| What is the demographic trap? |
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Definition
| Historically, countries that undergo modernization change from high to low mortality and fertility. Why fertility follows the decrease in mortality is not clear. Maurice King described the demographic trap, that contemplates a scenario where there is no decline infertility that leads to a Malthausian scenario, with widespread disease and stravation. King points out that decrease in fertility rate is linked to social and cultural practices. |
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Term
| Who described the Epidemiologic transition? |
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Definition
| Omran in 1971 described it as the basis for the demographic transition. |
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Term
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Definition
It is the Global Alliance for Vaccines Initiative. It was created in 2000 by WB, WHO and UNICEF. BAsed in Geneva. Funded By BMGF. It goals are:
1. Improve capacity of HS to provide immunization.
2. Safe inmmunizations.
3. Development of new immunizations.
4. Increase coverage of underused immunizations. |
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Term
| What are the innovative approaches to GH by GAVI? |
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Definition
1. Link support to achievements.
2. Develop plan with countries.
GAVI advocates for vaccines, provides techinical and financial support |
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Term
| What is the Global Fund to fight AIDS, Malaria and TB? |
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Definition
| Created in 2002. It is an NGO that has a board formed by endemic countries, civil society, WB, WHO, UNAIDS, communities and international organizations. Supports funding to control diseases. Money comes from developed countries and foundations |
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Term
| Innovative approaches of the Global Fund? |
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Definition
1. Not a technical but a financial mechanism.
2. Seeks to raise additional funds
3. It operates in a performance based manner.
4. Countries develop plan for GF that is evaluated by independent review process. |
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Term
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Definition
International AIDS Vaccine Initiative. It is a Public-Private organization. Based in NYC and established in 1996.
Goals:
1. Advocate for HIV vaccine
2. Facilitate countries in the development of polices for vaccine implementation.
3. Engage in vaccine research and development. |
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Term
| What event led to the first international conference on health in 1851? |
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Definition
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Term
| Name and date of foundation of health agencies |
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Definition
International Office of Public Hygiene 1909, Paris
League of Nations 1920, Geneva
International Sanitary Bureau 1924.
This organizations were used for disease surveillance and technical support. |
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Term
| What are the GOBI interventions? |
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Definition
| Growth monitoring, ORT, BF and Immunizations. This activities were the center of the effort led by USAID and UNICEF for child survival. Later this strategy was adopted by WHO, WB and many bilateral organizations. |
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Term
| What was the importance of the Alma Ata Declaration? |
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Definition
| In 1978, this declaration brought to the center of the GH the importance of health for all. Other issues like equality, community based approach and access to primary health services were central in this document. This declaration stated that HEALTH WAS A UNIVERSAL HUMAN RIGHT AND THAT COUNTRIES NEEDED TO ENSURE ACCESS TO ALL ITS CITIZENS. |
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Term
| What was the importance of the WB Development Report of 1993? |
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Definition
| It was focused on health. This document set the trend for the next era of health project of the WB. |
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Term
| Name some of the factors that have been associated with positive outcomes in GH? |
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Definition
1. Political will.
2. Close collaboration among governments.
3. Stable funding
4. Flexible technologies.
5. Community participation.
5. Approaches that strengthen health systems |
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