Introduction to Healthcare

Health care Economic Status. Health care is among the largest economic activities in every country and is among the most visible social enterprises. It consumes between 6 and 16 percent of national income and expenditures continue to rise steadily everywhere. Health care providers are collectively among the largest employment sectors in most communities and nationally. 

Health Status. Many developing countries have had great success in their health delivery over the past several decades. However, like many middle-income countries, these countries are undergoing an epidemiological transition as a result of falling infant and child mortality rates. This means that there is a steady shift in the pattern of diseases: childhood diseases such as diarrhea, respiratory diseases, and malnutrition continue to be significant causes of illness and death, but cardiovascular diseases, cancer and injuries due to accidents and violence associated with the aging of the population, rapid industrialization and urbanization contribute significantly to the total of potential productive years lost among adults.

Now, in many countries, injuries and deaths from accidents associated with modernization represent one of the leading causes of death. It is estimated that about 60 percent of current deaths caused by accidents are preventable by preventable care and timely treatment, including access to certain secondary-level health services. The issue of secondary level of care has become increasingly important and is expected to intensify as the epidemiological transition progresses. Mental health problems due to alcohol and drug use are also increasing.

A level and quality of services that were viewed as relatively satisfactory a few years ago are now defined as quite inadequate.

Social Status. Issues include the issues of the growing elderly population , low income citizens, and the indigenous population. Increasing demand from the aging populations is forcing major adjustments in other social services. The older population consumes 30 to 40 percent of health care resources in most countries.  Access to health care services by low income citizens is still a problem as well as services to isolated indigenous populations 

Technological Status. Technological problems include the questions of how to incorporate appropriate technology that will improve care and at the same time increase efficiency.

Organization Status Required Health Care Processes are becoming more complex and can only be provided to clients if Health Care Professionals (HCPs) know who need them, at what time they need them, and where they need them. In order to do this, those managing and delivering the services must have access to reliable, well-structured and timely information.

Measurability and Comparability Today in all areas of health care applications the attention is on the measurability and comparability of results. Administrators have become more aware of the need for information for policy formulation, implementation and management (WHO 1996!). Without sufficient and quality data, without effective and proper use of data, and without the properly trained personnel, this measurability and comparability cannot be implemented.

Health Care demands information on a routine basis to provide:            

• An understanding of the health demands of populations and sub-populations within selected geographic areas,

• Management of  the health and well-being of those populations, 

• Management of the day-to-day operation of the healthcare organization,

• On going measurement of the impact of policies and of the performance of projects against the organization’s goals

• Assessment of the progress toward national health objectives and national health policies and an

• Understanding of the changes taking place in the population’s health care

• Predict the future

"Sound decisions require accurate, current, and reliable information, and the benefits of this results oriented approach depend substantially on the quality of the performance information available (USAID, 1998)."

History of this Site

The first emphasis for this site arose out of what I will call the "Guatemala Circle." The Guatemala Circle" was a group of highly esteemed personage that formed a panel for a round table discussion group in Guatemala for a class from the International Health Department of Tulane Public Health and Tropical Medicine. In this panel were some of the top officials of USAID, CARE, Peace Corp, Guatemala Health Ministry and others.  

It was there that one of the students asked the panel the question, "what do you think we can do as students to enable us to perform our jobs better?" 

The unanimous answer was that each should have a clear understanding of management and financial management procedures. 

The panel said that public health schools were graduating MPH's and PhD's in Family Planning, Maternity and Child, Nutrition, Environment, and many other disciplines but very few of these people know how to manage a project. They have had no formal training in management. The panel said that these health care professionals were going out into the world and asking funding organizations for money, yet, they have little idea of how to manage people or the money. Although many of  these people are intelligent, they still do not know how to use the formal tools of management.

Here is our argument. Just as medical doctors attend school for years to learn how to treat their patients, it is the "business - trained" individual that know how to manage. This Web site is dedicated to this training. It takes a "Business" view of health care and its management...however, we at InHCc calls this "

It was this discussion that convince me that one of the more important things that could be done in public health is the education and training of public health professionals to manage their projects effectively and efficiently. It would not only improve the quality of research and care but also minimize the costs to effect this care. This, to me, could save as many lives and improve the health of the people just as some new vaccine.

The western governments traditionally, give money based on political reasons. In general, very little accounting for that money is required and very little is done to see if the recipient actually did what they said they were going to do. However, now that may not be the case. These same donor governments are worried about their own poverty and problems at home and their funding agencies’ budgets are often less now than they were a few years ago. Now these funding organizations have to justify why they are giving the money. Just as in business, donors now want their projects to be successful and sustainable. Funding organizations are demanding that the recipients of these funds prove that they are getting the results that they have promised. They are demanding measurable indicators. In summary, funding organizations are demanding cost-benefit analysis and accountability, just like a business (well...at least they should)

The third emphasis is again taken from Guatemala. It was reported that over 210 NGO's were in the country doing approximately the same type of research, family planning, nutrition, home projects. Bangladesh is reported to have over 800 NGO's doing the same thing. Yet, none of these organizations were sharing information with others in order to minimize costs or increase their knowledge base. Each continued to reinvent the wheel. Many inhabitants had been interviewed and surveyed so many times that they knew the questions before they were asked. Yet, none of this information was saved. The researcher would take this information back home, store it on his computer, run a few reports, and it would never be used again. No trend analysis, no comparisons, and no verification of data was done. It was and still is a tremendous waste of time and money. A discussion was started with the Chairman of the School of International Health, Dr. Jane Bertrand, concerning the possibility and advantages of combining this information into a Centralized Data Warehouse where all may benefit. 

This Web site is dedicated to that "Project"