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Health care system, Person centred care:
- under performed and inefficient use of resource.
- national drug policy, expensive medications.

Affordability:
- still out-of-pocket expenses
- - the government spends less than $15 USD per capita spending on per citizen per year
Availability:
- no mental health service
- very few mental centers and residential care.
- citizens flew overseas to get better access to quality health service.

Environmental, social determinants of health:
- water quality, sanitation, health education and pollution are well valued by the government.

Workforce and resources:
- less than one doctor per 1000 citizens.

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In the past, the HC system has been overloaded due to lack of funding and excess of patients. However, it is available to the public, and is very affordable at $150USD per capita for public care and $250 per capita for private care (Australia is over $1000). There is consideration of environment, with education, food labelling etc. The largest concern with the current system is resource shortage, which has been an issue in the past, with approx 14 physicians to 10,000 people. In 2015, Rio de Janeiro hospital was forced to board the doors due to severe lack of funding and resources, even basic resources such as saline and sutures. The government responded to this event with an emergency funding of $39m USD and an immediate injection of $11m USD Healthcare is also available to everyone, regardless of income or socioeconomic position. There is also a focus on primary healthcare with the aim to prevent future conditions in the population.

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Availability
- close to 500 health centres available
- outpatient programs targeted at immunisations and family planning services
Person-centred
- sick people are as likely to consult traditional medical practitioners as they are modern medical practitioners
Environment-responsive
-10 most common causes of morbidity are preventable through better hygiene practices
Affordability
- introduced a results-based finance system that pays providers based on performance
-US$1.25 per person spent on healthcare
- health insurance cover is high - over 70% of population covered

Resourced
-villages are serviced by a network of thousands of community health workers
-currently participating in a program that sees clinicians and medical educators from institutions such as Harvard and Yale

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Universal Health Care

Available-
Mexico has some 3000 private hospitals, some private "hospitals" are hardly hospitals at all, since they have no labs, radiography equipment or even nurses.
The remaining 1000 or so public hospitals account for the majority of hospital beds, and most private hospitals have fewer than 20 beds.

he public hospital infrastructure relies on a vast network of small hospitals. Over 50% of public hospitals have fewer than 50 beds.

Public Hospitals:
Account for majority of the hospital beds.

Person-centered-
Health care is provided to all Mexican Citizens.

Environment-responsive-
Affordable-
Public care is fully or partially subsidised by the federal government, depending upon the person's employment status.

The Secretariat of Health's Seguro Popular offers coverage to Mexicans who do not have formal employment. The program currently covers over 55 million people

Dentist in Mexico charge 20-25% of US Prices.
Resourced-
Private Health Sector: Hardly any nurses

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A - three systems depending on person's role in society, 99.5% coverage, 80-95% usage of essential services
P - health districts attempt to streamline population into relevant groups to make system more efficient, system facing problems such as getting new technology, duplicates of resources
E - 96% access to improved sanitation - key area of development, 98% measles vaccination; highest HIV/AIDS rate in Asia (1.3%), public discrimination against infected but this is changing
A - relatively low cost to individuals, 65% of funding from gov, 35% from private; costs rising; $345pp/year expenditure - 4.3% GDP
R - some areas lacking, 65% of emergencies are handled by volunteers; 2.9 physicians per 10000, 2.2 beds per 10000

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Healthcare in Brazil is a constitutional right. It is provided by both private and government institutions. The Health Minister administers national health policy. Primary healthcare remains the responsibility of the federal government, elements of which (such as the operation of hospitals) are overseen by individual states. Public healthcare is provided to all Brazilian permanent residents and foreigners in Brazilian territory through the National Healthcare System, known as the Unified Health System ( Portuguese: Sistema Único de Saúde, SUS). The SUS is universal and free for everyone.

The National Ministry of Health was founded in 1953.

The authoritarian military government introduced health care reforms in the 1970s to extend its control and legitimacy over the North and Northeast of Brazil where the military had limited presence. Until 1988, the health care system was centralized in the hands of the federal government and limited in its health care coverage. Prior to 1988, health care services were provided by the private sector, public sector and the social security sector.

The 1988 Constitution and subsequent reforms in the 1990s established universal health care coverage and a decentralization of health care delivery at the municipal level.

National health policies and plans: The national health policy is based on the Federal Constitution of 1988, which sets out the principles and directives for the delivery of healthcare in the country through the Unified Health System (SUS). Under the constitution, the activities of the federal government are to be based on multiyear plans approved by the national congress for four-year periods. The essential objectives for the health sector were improvement of the overall health situation, with emphasis on reduction of child mortality, and political-institutional reorganization of the sector, with a view to enhancing the operative capacity of the SUS. The plan for the next period (2000-2003) reinforces the previous objectives and prioritizes measures to ensure access at activities and services, improve care, and consolidate the decentralization of SUS management.

The current legal provisions governing the operation of the health system, instituted in 1996, seek to shift responsibility for administration of the SUS to municipal governments, with technical and financial cooperation from the federal government and states. Another regionalization initiative is the creation of health consortia, which pools the resources of several neighbouring municipalities. A vital instrument of support for regionalization is the project for strengthening and reorganizing the SUS.

Procedures for the registration, control, and labelling of foods are established under federal legislation, which assigns specific responsibilities to the health and agriculture sectors. In the health sector, health inspection activities have been decentralized to the state and municipal governments. The environmental policy derives from specific legislation and from the Constitution of 1988.

The Program for Investment in the Health Industrial Complex (PROCIS) is an example of the medical-industrial complex in Brazil. This promotes medical research, development and treatment within Brazil.

The main strategy for strengthening primary healthcare is the Family Health Program, introduced by the municipal health secretariats in collaboration with the states and the Ministry of Public Health. The federal government supplies technical support and transfers funding through Piso de Atenção Básica. Disease prevention and control activities follow guidelines established by technical experts in the Ministry of Public Health. The National Epidemiology Center (CENEPI), an agency of the National Health Foundation (FUNASA) coordinates the national epidemiological surveillance system, which provides information about and analysis of the national health situation.

In 2014 there were 6,706 hospitals in Brazil. Over 50% of hospitals are found in 5 states: São Paulo, Minas Gerais, Bahia, Rio de Janeiro and Paraná.

Throughout the country, 78% of hospitals practice general medicine while 16% are specialized and 6% provide outpatient care only.

In 2012, 66% of the country's hospitals, 70% of its 485,000 hospital beds, and 87% of its 723 specialized hospitals belonged to the private sector. In the area of diagnostic support and therapy, 95% of the 7,318 establishments were also private. 73% of the 41,000 ambulatory care facilities were operated by the public.

The public hospital infrastructure required hospitals to be spread over a territory of 8.516 million square kilometres (3.288 million square miles). As such, the public hospital infrastructure relies on a vast network of small hospitals. Over 55% of public hospitals have less than 50 beds.

Hospital beds in the public sector were distributed as follows: surgery (21%), clinical medicine (30%), pediatrics (17%), obstetrics (14%), psychiatry (11%) and other areas (7%). In the same year, 43% of public hospital beds, and half the hospital admissions were in municipal establishments.

Since 1999, the Ministry of Public Health has been carrying out a health surveillance project in Amazonia that includes epidemiological and environmental health surveillance, indigenous health and disease control components. With US 600 million dollars from a World Bank loan, efforts are being made to improve the operational infrastructure, training of human resources and research studies. An estimated 25% of the population is covered by at least one form of health insurance; 75% of the insurance plans are offered by commercial operators and companies with self-managed plans.

Brazil is among the greatest consumers markets for drugs, accounting for 3.5% share of the world market. To expand the access of the population to drugs, incentives have been offered for marketing generic products, which cost an average of 40% less than brand-name products. In 2000, there were 14 industries authorized to produce generic drugs and about 200 registered generic drugs were being produced in 601 different forms. In 1998, the National Drug Policy was approved, whose purpose is to ensure safety, efficacy, and quality of drugs, as well as the promotion of rational use and access for the population to essential products. The responsibility for national production of immunobiologicals is entrusted to public laboratories; which have a long-standing tradition of producing vaccines and are for use in official programs. The Ministry of Public Health invested some US$120 million in the development of the capacity of these laboratories. In 2000, the supply of products was sufficient to meet the need for heterologous use, such as those used in the vaccines against tuberculosis, measles, diphtheria, tetanus, whooping cough, yellow fever, and rabies. In 1999, quality control of the transfused blood consisted of 26 coordinating centers and by 44 regional centers.

In 1999, the country had some 237,000 physicians, 145,000 dentists, 77,000 nurses, 26,000 dietitians and 56,000 veterinarians. The national average ratio was of 14 physicians per 10,000 population. In 1999, of the 665,000 professional positions, 65% were occupied by physicians, followed by nurses (11%), dentists (8%), pharmacists, biochemists (3.2%), physical therapists (2.8%) and by other professionals (10%).[citation needed ] An estimated 1.4 million health sector jobs are occupied by technical and auxiliary personnel.[citation needed ]

In 2009, for the first time, more new medical licenses were given for women than for men.

As of 2010, the country had 364,757 physicians. In 2011, there were 1.95 physicians for each 1000 Brazilians, with higher concentrations in south, southeast and mid-western than in north and northeastern Brazil. For each 1000 private health insurance users there were 7.6 occupied work posts for physicians, and for each 1000 Sistema Único de Saúde users, there were 1.95 occupied work posts for physicians, making an average of 3.33 occupied work posts for physicians for each 1000 Brazilians. As to the distribution of physicians between medical specialties and primary care, 55.09% of all Brazilian physicians were specialists.

In 1998 national health expenditure amounted to US$62,000 million, which corresponded to nearly 7.9% of GDP. Of that total, public spending accounted for 41.2% and private expenditure accounted for 58.8%. In per capita terms, public spending is estimated at US$158 and private expenditure at US$225.

Technical cooperation projects are carried out with different countries, as well as with the World Bank and UNESCO among many others. International foundations also provide direct financing for projects or individuals. Brazil is also engaged in an intense exchange with the Mercosul countries, aimed at establishing common health regulations.

Surgery in Porto Alegre.

Brazilian emergency medical service is locally called SAMU ("Serviço de Atendimento Móvel de Urgência (Mobile Emergency Attendance Service)"). Emergency medicine (EM) is not a new field in Brazil. In 2002, the Ministry of Health outlined a document, the "Portaria 2048," which called upon the entire health care system to improve emergency care in order to address the increasing number of victims of road traffic accidents and violence, as well as the overcrowding of emergency departments (EDs) resulting from an overwhelmed primary care infrastructure. The document delineates standards of care for staffing, equipment, medications and services appropriate for both pre-hospital and in-hospital. It further explicitly describes the areas of knowledge that an emergency provider should master in order to adequately provide care. However, these recommendations have no enforcement mechanism and, as a result, emergency services in Brazil still lack a consistent standard of care.

Pre-hospital emergency medical services use a combination of basic ambulances staffed by technicians and advanced units with physicians on board. No universal phone number exists for emergency calls, and the dispatch center physician determines whether the call merits an emergency transport or not. Pre-hospital physicians have variable training in emergency care, with training backgrounds ranging from internal medicine to obstetrics to surgery.

Similar to the early years of EM in the United States, emergency department physicians in Brazil come from different specialty backgrounds, many of them having taken the job as a form of supplementary income or as a result of unsuccessful private clinical practice. Since 50% of medical school graduates in Brazil do not get residency positions, these new physicians with minimal clinical training look for work in emergency departments. In larger tertiary hospitals, the ED is divided into the main specialty areas, internal medicine, surgery, psychiatry, pediatrics, and staffed by the corresponding physicians. Still, significant delays in care can occur when patients are inappropriately triaged or when communication between the areas is inadequate. In the non-tertiary care centers, which make up the majority of hospitals in the country, emergency department physicians are largely under-trained, underpaid and overstressed by their working conditions. This has compromised patient care and created an incredible need for improvement in the emergency care system.

A current plan in action in Brazil called the CATCH plan (Commission for the Advancement of Technology for Communications and Health). Funding is provided by the WHO, ITU, and voluntary countries and benefactors for existing and future projects. This CATCH program approbates the best advancements to accommodate Brazil's health issues.

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Healthcare in Brazil is a constitutional right. It is provided by both private and government institutions. The Health Minister administers national health policy. Primary healthcare remains the responsibility of the federal government, elements of which (such as the operation of hospitals) are overseen by individual states.

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Healthcare in Mexico is provided by public institutions run by government departments, private hospitals and clinics, and private physicians. It is largely characterized by a special combination of coverage mainly based on the employment status of the people. Every Mexican citizen is guaranteed no cost access to healthcare and medicine according to the Mexican constitution and made a reality with the "Institute of Health for Well-being", or INSABI.

The Mexican Federal Constitution places main responsibility on the state in providing national health to the population. This segmentation in the system has allowed private organizations and offices run by physicians to offer a variety of healthcare options to people who can afford it and are willing to pay for it. The overall structure of the Mexican health system is in a continually developing and heterogenous state, and this is reflected in national health statistics and accessibility standards observed in the country.

In Mexico, the sixteenth century Badianus Manuscript described medicinal plants available in Central America. Dr. Erick Estrada Lugo, Researcher-Professor in Phytotechnics at the State of Mexico's Chapingo Autonomous University, told the National Autonomous University of Mexico's digital magazine that "at least 90% of the population uses medicinal plants," citing figures from Mexico's Secretariat of Health. These include plants like Aloe vera, Arnica, and Valeriana.

Hospitals were established in Mexico in the early 16th century, including ones exclusively for Indians. Some were established by the crown, others by private endowment, but most by the Catholic Church. Bishop Vasco de Quiroga established hospital complexes in Michoacan in the sixteenth century. In Mexico City, conqueror Hernán Cortés established the Hospital de Jesús Nazareno for Indians, which still functions as a hospital.

Hospital de Jesús Nazareno stairs and murals.

The Hospicio Cabañas in Guadalajara, Jalisco, Mexico, was founded in 1791. It is still functioning and is now a World Heritage Site. It is one of the oldest and largest hospital complexes in Latin America. The complex was founded by the Bishop of Guadalajara to combine the functions of a workhouse, hospital, orphanage, and almshouse.

The Mexican healthcare program, as we know it today, has its base on the creation of several health codes that ran during the first part of the 20th century. In 1943, the Mexican Secretariat of Health and Assistance was established to merge the Department of Public Sanitation and the Secretariat of Public Assistance. In that same year, the Mexican Social Security Institute and the Mexican Children's Hospital were founded, during the presidency of Manuel Avila Camacho. After this, several and important changes came, aiming to provide better health for the population. In 1959, the Institute for Social Security and Services for State Workers (ISSSTE) was formed as a way of more effectively covering the health services of individuals employed in government institutions. The Seguro Popular, or Popular Health Insurance, was implemented countrywide in 2003 after the creation of the Social System during the presidency of Vicente Fox Quesada. In the world's largest randomized health policy experiment, Seguro Popular was evaluated at arm's length by a team at Harvard University, which concluded that "programme resources reached the poor," an unusual result for any country. In 2020 was replaced by the Institute of Health for Welfare (INSABI), which was replaced in 2023 by the IMSS-Bienestar.

Public health issues were important for the Spanish Empire during the colonial era. Epidemic disease was the main factor in the decline of indigenous populations in the era immediately following the sixteenth-century conquest era and was a problem during the colonial era. The Spanish crown took steps in eighteenth-century Mexico to bring in regulations to make populations healthier. In the late nineteenth century, Mexico was in the process of modernization, and public health issues were again tackled from a scientific point of view. As in the U.S., food safety became a public health issue, particularly focusing on meat slaughterhouses and meatpacking.

Even during the Mexican Revolution (1910-20), public health was an important concern, with a text on hygiene published in 1916. During the Mexican Revolution, feminist and trained nurse Elena Arizmendi Mejia founded the Neutral White Cross, treating wounded soldiers no matter for what faction they fought. In the post-revolutionary period after 1920, improved public health was a revolutionary goal of the Mexican government. The Mexican state promoted the health of the Mexican population, with most resources going to cities.

Concern about disease conditions and social impediments to the improvement of Mexicans' health were important in the formation of the Mexican Society for Eugenics. The movement flourished from the 1920s to the 1940s. Mexico was not alone in Latin America or the world in promoting eugenics. Government campaigns against disease and alcoholism were also seen as promoting public health.

The Mexican Social Security Institute was established in 1943, during the administration of President Manuel Avila Camacho to deal with public health, pensions, and social security.

Centro Médico Excel, a multi specialty private hospital in Tijuana

The private healthcare sector makes up a substantial portion of the Mexican healthcare system with respect to both spending and activity. Recently, higher activity within the private sector of the Mexican healthcare system has been observed in comparison to its public counterpart. Overall spending being attributed to the private institutions accounts for approximately 52% of total health spending in the country. Furthermore, this proportion appears to be subject to a sustained increase in recent years. The services provided by private institutions and private physicians in their offices are afforded by a part of the population, either by contracting a private insurance or by paying directly for the services obtained. It is estimated that around 6.9% of the Mexican population has private insurance coverage, mainly paid as an out-of-pocket expenditure. Generally, utilization of this sector of the healthcare system is limited to Mexicans of higher socioeconomic status.

To meet the needs of the population, relationships between the private and public healthcare sectors are beginning to form in various capacities. Recently however, studies have shown little coordination between this system and the other public sector institutions. The high fragmentation of the system has been observed to affect spending trends as well as the services received from beneficiaries.

Private healthcare delivery is a heterogenous institution, with varying levels of regulation, quality, and government association being observed within the institutions which compose it. Mexico has around 28.6 private facilities per 1 million inhabitants, which account for two thirds of all hospitals in Mexico, with 2,988 institutions.

The increased use of the private healthcare sector may be attributed to the association of public forms of healthcare with restriction in accessibility and quality. The belief that these services are superior in quality appears to widespread-many patients depend heavily upon these forms of healthcare, even though public services are at times provided at no cost. Private services tend to be associated with shorter wait times, less crowding, a stronger and more satisfying patient-provider interaction, and higher quality equipment and medications. Additionally, the duration of a visits in a private hospitals tend to be more than double that of their public counterparts. The quality of services performed in these institutions, however, is of debate. Especially in the field of prenatal care, disparities in quality exist among private and public institutions.

In addition to members of the Mexican populace, some individuals with connections to Mexico-including citizens, undocumented immigrants residing in the U.S., and even permanent U.S. residents with Mexican ties-associate private Mexican institutions with convenience, affordability, and efficacy, even rating them above their American public counterparts. This, in turn, has created a phenomenon, known as medical returns, in which select populations, such as migrants, preferentially return to Mexico in order to receive medical treatment.

Additionally, Mexican providers, especially in the private sector, but also in its public counterpart, appear to be less restricted by the possibility of lawsuit in their practice, especially when compared to their equivalent American counterparts, which may contribute to a higher perceived standard of care.

Public healthcare has an elaborate provisioning and delivery system instituted by the Mexican government. It is provided to all Mexican citizens, as guaranteed by Article 4 of the Constitution.

Public care is fully or partially subsidized by the federal government, depending upon the person's employment status. All Mexican citizens are eligible for subsidized healthcare regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaría de Salubridad y Asistencia, or SSA) agency through the program called INSABI which offers coverage to Mexicans who do not have formal employment. The program currently protects over 57 million inhabitants and covers all conditions, services and medicine free of charge. This public insurance scheme, coupled with Social Security, represents 95% of the insured population in Mexico. Funding for INSABI is derived from the federal government, the Secretariat of Health, and the individuals who form a part of this system. However, approximately 20% of individuals in this system, representing the poorest covered sector, are exempt from this.

Employed citizens and their dependents, however, can use the program administered and operated by the Instituto Mexicano del Seguro Social (IMSS) (English: Mexican Social Security Institute). The IMSS program is a tripartite system funded equally by the employee, the private employer, and the federal government. There are more than 65 million people covered through IMSS and its programs. Further, within IMSS there exists the IMSS-Opportunidades, a program established out of the Program to Combat Poverty, which is specifically targeted towards aiding the poorest individuals in the country in both the health and educational fields. This program is completely funded by the government.

The IMSS does not provide service to public employees, who instead are serviced by the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) (English: Institute for Social Security and Services for State Workers), which attends to the health and social care needs of government employees at the local, state, and federal levels. Nearly 9 million people are covered by the ISSSTE.

Secretary of Health of Mexico Julio Frenk with former President Vicente Fox and Reyes Tamez, Secretary of Education, in Los Pinos during the initialing ceremony of the National Institute of Genomic Medicine.

The state governments of Mexico also provide health services independently of those that are provided by the federal government programs. In most states, the state government has established free or subsidized healthcare to all of its citizens.

The Secretariat of Health is the largest public healthcare institution, operating 809 hospitals throughout the country. The IMSS grants hospital care and services to employed citizens and their dependents and had 279 hospitals affiliated to it. The ISSSTE grants hospital care and services to government employees and has 115 affiliated hospitals. The other 279 hospitals are affiliated with 9 government dependencies, including State Facilities, Secretariat of National Defense (Secretaria de Defensa Nacional), Mexican Navy ( Secretaria de Marina), Petroleos Mexicanos ( PEMEX), and the Red Cross (Cruz Roja). The health systems associated with SEDENA, SEMAR, and PEMEX cover over one million individuals combined.

In 2007, there were a total of 23,858 health units within the Mexican state. Approximately 27% of these were contained in the public sector.

Development of child mortality in Mexico since 1960

Development of life expectancy in Mexico

Mexico has seen an overall improvement in almost every aspect of health trend. However, Mexico lags well behind other Organisation for Economic Co-operation and Development countries in health status and availability.

Life expectancy at birth, male (years)

75.1*

Life expectancy at birth, female (years)

79.9*

Mortality rate from communicable diseases (age-adjusted per 100,000)

52.1

Mortality from ischemic heart diseases

(age-adjusted rates per 100,000)

83.2

Tobacco consumption among adults

(age adjusted, %)

14.2

Alcohol consumption among adults

(liters/per person/year)

6.5

Overweight and obesity in children aged < 5 years (%)

5.2**

Antenatal care coverage by skilled birth attendants of 4+ visits (%)

89.5

*Data from 2018

**Data from 2012

Source: Pan American Health Organization

Comparison of healthcare spending and life expectancy for some countries in 2007

Total health expenditure represented around 5% of GDP in 1995, which went up to around 6.2% in 2012; however, in 2015 it declined to 5.6%. Historically, out-of-pocket expenditure has been a big portion of health expenditure, going from around 56% in 1995 to below 50% since 2008, with the most recent data being 40.6% in 2015. Recent reform has seen the establishment of new special funding programs, as well as more progressive limits on patient contribution was also included. Funding was restructured in a manner that both promoted coverage through incentives directed towards state-level governments and reassessment of funding on a need-level basis.

Susana Lopez Charreton virologist specialized in understanding the mechanisms of infection of rotavirus.

According to recent international statistics, Mexico has an estimated population of 130 millions of inhabitants, with a reported annual population growth rate of 1.2%. Since 1990 there was an increment of about 45 million people.

Demographic transition have been notorious in the last 7 decades in Mexico. Life expectancy at birth (general) changed from being 45 years in 1950 to 71.5 years in 1990, and to actually reach 77.5 years, close to some high-income countries in America and the World. Child mortality rate, as one of the major health trends, have improved most notoriously after 1950, when an average of 252 children under-five years were dead per 1000 live births, decreasing to 44.5 in 1990 and reaching 14.6, in 2018. Finally, after 1970, at least 20 years after the major changes in life expectancy and child mortality rate, there was a decrease in fertility rate. In 1950 it was estimated that for every woman, around 6.67 babies were born; in 1970, it increased to 6.8 and then, steadily decreased to 3.4 in 1990 to finally end in 2.1, which is below the world average.

The IMSS La Raza Medical Center, a well known public hospital in Mexico City

Besides this demographic transition, there have been major changes in the principal causes of death and morbidities among Mexicans. Epidemiological transition has been notorious in the history of Mexico when it comes to Disability-adjusted life year (DALY) but not when comparing causes of death, with most data coming since 1990. According to the Institute for Health Metrics and Evaluation, in 1990 the leading causes of death in the country were also cardiovascular diseases, neoplasms and diabetes, which remain the same until recent data. Some infectious diseases (respiratory infections, tuberculosis and enteric infections) were also among the most common causes in the 90's, which were displaced for other non-communicable diseases in 2017. Taking into consideration the burden of disease according to the years lost due to disability ( DALY), in 1990, the three most common causes of disability were communicable and maternal diseases (maternal and neonatal disorders, respiratory infections, tuberculosis and enteric infections). In 2017, these 3 diseases were replaced by diabetes and kidney diseases, cardiovascular diseases and self-injuries, displacing most of the communicable diseases out of the top ten.

The prevalence of diabetes is rapidly increasing on a global scale. One of the countries in which such precipitous growth has been observed is in Mexico. The proportion of the country with diagnosed diabetes mellitus increased roughly four times from 1993 to 2006, where it directly affected close to a quarter of the population. The impact of this disease on overall mortality increased by over twenty times in the same thirteen-year period, and future projections see this figure only increase. In 2011 alone, health spending attributed to diabetes in the country amounted to almost eight billion dollars. A staggering amount of this spending is in the form of out-of-pocket expenses. This economic burden is most strongly pronounced on the uninsured population. The prominence of this disease in national healthcare system, and especially the financial implications derived from this are significant. A study conducted by Arredondo and Reyes found that the financial aspects of this alone have been observed to generate independent health disparities. Additionally, a large proportion of severe health complications, such as heart attacks and renal disease, can be determined to stem directly from this epidemic. In Mexico, where the health system is subject to unique segmentation, this issue poses an amplified public health and economic challenge. The public healthcare system is overwhelmingly utilized in the management of this disease and its secondary developments- with only ten percent of population depending on the private sector for care.

People entering a "respiratory illness symptom assessment area" at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. The hospital was converted into a special care area for the 2020 COVID-19 pandemic patients.

The Mexican healthcare system remains a continually expanding and progressive structure. Mexico first began enacting initiatives to extend health coverage, particularly in rural communities in 1979. Data from a national survey in 2012 demonstrated that a majority of Mexicans maintain a positive perception on the quality of their primary care. In 2013, a report by the Ministry of Health projected that over 90% of the population was covered. There are some areas, though, were inequities in accessibility can be seen. Results from a national survey conducted by Arredondo and Najera (2008) revealed stark disparities in accessibility despite expansion of services and coverage association, demonstrating that despite enhancements to the national health systems, inequities in accessibility of institutions, care, diagnostic services, medication, and travel were pronounced, especially as it related to rural and impoverished communities. These include insurance coverage, cost reduction, primary care association, and specialized services accessibility.

Insurance coverage rates across Mexico have been marked by a recent period of large growth. The induction of Seguro Popular (Popular Health Insurance), the coverage program targeted at individuals who do not receive coverage under IMSS or ISSSTE, in 2003 spurred massive growth in insurance coverage across Mexico. A couple years after the plan was introduced, Seguro Popular became the second largest health institution by coverage in the nation. Within this, the percentage of insured poor families increased by five times- to include more than a third of this demographic. Inequities between public and private expenditure, as well as the distribution of these expanded services, began to lessen. In 2015, it was projected that the proportion of the Mexican population with no access to health insurance decreased by close to seventy percent across this period, with only about 18% of the population falling under this group currently. This effect has been particularly effective in treating the older demographics. Furthermore, in 2012, it was observed that 4.3 million households in the nation possessed no health coverage of any kind, with an additional 7.6 million households associated with partial coverage of some members only.

In Mexico, where government-sponsored health insurance coverage remains a stark limitation characteristic of the system, self-medication is observed in increased proportions. Over 30 million Mexicans, especially those associated with older, uneducated, and low socioeconomic backgrounds. This may be indicative of societal attitudes toward the current system. This notion is furthered by the large proportions of residents which postpone reception of initial services, have little-to-no connection to a preventative care specialist, and heavily utilize alternative medicinal practice. Over 500 over-the-counter drugs are available in the Mexican market. This enhanced availability of over-the-counter drugs has also contributed to this phenomenon.

Cost of healthcare services in Mexico is variable and dependent on the nature of the service and the institution utilized. Generally, health costs associated with use of the public healthcare sector are higher than their private counterparts. Furthermore, individuals not insured under any current health insurance scheme most often utilize private doctors instead of public institutions. A study conducted in 2015 by Doubova et al. determined that roughly four percent of the uninsured population was faced with catastrophic expenditure of some sort at some point. Additionally, it was found that over half of uninsured individuals had not accessed care despite having a health issue due to financial issues. Additionally, a report by Munoz (2013) established that in the period following the implementation of the new 2003 health reform to the end of the decade, out-of-pocket patient expenditures, related to hospitalization, visit, medicine, diagnostic tests, alternative options, dental care, prolonged treatments, among others, had remained relatively similar.

Comparative analysis of the cost of Mexican healthcare services costs has been performed by analysts. In 1992, the New York Times reported that residents of the United States living near the Mexican border routinely crossed into Mexico for medical care. Popular specialties included dentistry and plastic surgery. In 2007, The Washington Post reported that Mexican dentists charged 20-25% of US prices, and other procedures typically cost a third of the US price.

Health outpost operations in Izlapalapa, Mexico City

Factors that have demonstrated influence on the magnitude of accessibility available to healthcare include sparse distribution of institutional resources, and lack of specialized care services in isolated populations. Case studies involving clinical management of diarrheic disease in rural communities have emphasized concerns relating to the quality and range of services available to more isolated populations. Accessibility as it relates to rural communities has been a heavily studied topic and work here has revealed the existence of great disparities in breadth and effectiveness of services offered. Issues related to accessibility of specialized services, especially institutions offering forms of care related to mental health, are prevalent in rural communities. Factors such as location, transportation, and the economic cost of implementation are the main factors associated with this.

The 1990 Regional Conference for the Restructuring of Psychiatric Care in Latin America established guidelines that the Mexican government has sought to keep. The Caracas Declaration, issued during the conference, recognized the need to protect the rights of individuals with non-physical disabilities and called for mental health to be integrated with primary care. Created with the goal of aligning Mexico with global recommendations issued by the World Health Organization, the National Council on Mental Health (Consejo Nacional de Salud Mental) was created as part of the federal Health Ministry in 2004. Although the restructuring of psychiatric care began in the 1990s with the Regional Conference for the Restructuring of Psychiatric Care in Latin America, psychiatric care was found to be inadequate and in need of a larger budget. Though it mentioned mental health care, the 2004 Seguro Popular did not succeed in its goals of improving access to health insurance or mental health care for low-income individuals. In 2003, it was projected that up to a quarter of the population was afflicted with some form of mental illness. Rural populations made up especially large proportions of this demographic.

Due to political and socioeconomic factors, Mexico's Indigenous communities are one of the groups that has faced inequities in mental health care. Indigenous communities are likely to live in remote areas where they may be unable to access health services, exposed to pollution, and live in areas being exploited for their natural resources. Although studies have found that it is socio-economic status as opposed to ethnicity that influences the use of programs like SP, Indigenous communities are more likely to live in extreme poverty. Treatment for mental health in Indigenous communities also encounters a cultural barrier. Although the need for services exists, treatment has been typically conducted by community "healers". The negative stigma that mental health carries is seen to prevent treatment carried during early indication periods.

Urban populations are also subject to unique issues and conflicts, mostly related to delivery and the ability of the institutions to service the large populations they are associated with.

Preventative care is still an under-focused area across the country. A 2015 projection model found that almost a quarter of the Mexican population did not have a regular primary care provider or institution that year.

On December 1, 2006, the Mexican government created the Health Insurance for a New Generation (also called "Life Insurance for Babies"). It was followed by a February 16, 2009, announcement by President Felipe Calderon, who stated that at the current rate, Mexico would have universal health coverage by 2011, and a May 28, 2009 announcement of universal coverage for pregnant women. In August 2012 Mexico achieved universal healthcare coverage.

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Healthcare in Mexico is provided by public institutions run by government departments, private hospitals and clinics, and private physicians. It is largely characterized by a special combination of coverage mainly based on the employment status of the people.

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1. Analysing the topic

Before you start researching or writing, take some time to analyse the assignment topic to make sure you know what you need to do.

Understand what you need to do

Read through the topic a few times to make sure you understand it. Think about the:

learning objectives listed in the course profile - understand what you should be able to do after completing the course and its assessment tasks

criteria you'll be marked on - find out what you need to do to achieve the grade you want

questions you need to answer - try to explain the topic in your own words.

Identify keywords

Identify keywords in the topic that will help guide your research, including any:

task words - what you have to do (usually verbs)

topic words - ideas, concepts or issues you need to discuss (often nouns)

limiting words - restrict the focus of the topic (e.g. to a place, population or time period).

If you're writing your own topic, include task words, topic words and limiting words to help you to focus on exactly what you have to do.

Example

Example keyword identification - text version

Topic: Evaluate the usefulness of a task analysis approach to assignment writing, especially with regard to the writing skill development of second language learners in the early stages of university study in the Australian university context.
Task words: Evaluate
Topic words: task analysis approach, assignment writing, writing skill development
Limiting words: second language learners (population), early stages of university (time period), Australian university (place)

Brainstorm your ideas

Brainstorm information about the topic that you:

already know

will need to research to write the assignment.

When you brainstorm:

use 'Who? What? When? Where? Why? and How?' questions to get you thinking

write down all your ideas - don't censor yourself or worry about the order

try making a concept map to capture your ideas - start with the topic in the centre and record your ideas branching out from it.

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Before you start researching or writing, take some time to analyse the assignment topic to make sure you know what you need to do. Read through the topic a few times to make sure you understand it.

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These are some links to websites where you can make free infographics, you may like to use these to help you with Part A:
https://www.canva.com/create/infographics/
https://venngage.com
https://www.visme.co/make-infographics/
https://piktochart.com/formats/infographics/

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There is a ladder on the floor- you need to walk/creep/run/jump through the ladder in a demonstration of how you tend to move through the ladder.

https://youtu.be/KJLqOclPqis

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1. Writing support
2. Structure
3. Common Errors
4. The point of assessment

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If you want to pick up a few handy study skills that will help you through uni and beyond, we've got you covered!

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Come up with an interview question for a job scenario. Also list the key competencies you would expect an applicant to answer with?

1. Role Clarification
2. Team Functioning
3. Collaborative Learning
4. Conflict Resolution

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Join a game of kahoot here. Kahoot! is a free game-based learning platform that makes it fun to learn – any subject, in any language, on any device, for all ages!

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There is a ladder on the floor- you need to walk/creep/run/jump through the ladder in a demonstration of how you tend to move through the ladder.

https://youtu.be/KJLqOclPqis

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Kiwi
roses about the course: flexible, can re-watch the modules, no exams, new friends 
buds: learn about other health disciplines 
thorns: forget to do online module, weekly assignments, 

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Roses: Having the different options to learn about each profession

Buds: Provides the opportunity to do extra research and additional readings

Thorns: Learning about the different cultures and cultural competency was vague

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Thorn:
Not all clinical professionals included in the videos
Superiority
Favouritism

Rose:
DIfferent lenses for different professions. Expand your horizons

# data[].attributes.body
roses about the course: flexible, can re-watch the modules, no exams, new friends
buds: learn about other health disciplines
thorns: forget to do online module, weekly assignments,

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Roses
- Questions help us to focus and absorb information
- Multi-professional opinions
-Well-structured
- Flexibility in when we watch the lectures/complete activities -

Thorns
- Length of articles - too long
- Word activity was not in-depth enough

Buds
-  Subtitles on videos or a transcript directly next to the video so we don't have to open the transcript in a separate tab

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Roses
- The online content is comprehensive and clear
- Not just text, quizzes and videos help the learning process

Buds
- More little questions would reinforce the content taught
- Videos are often repetitive and say the same thing over and over across different health professionals

Thorns
- Time difference between due date and tutorial - everything's been forgotten 5+ days later
- ePortfolio is not very good

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Roses
-We can learn in our own time and at our own pace
-skip to different slides
-explain what is the correct answer and why
-not too time consuming
videos are really interesting

Thorns
- A huge amount of links
-sometimes ePortfolio breaks down

Bud
-because tutorials are based on content you have to keep up to date (kinda good that you are forced to keep up)

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https://www.health.org.uk/sites/health/files/HelpingMeasurePersonCentredCare.pdf
https://www.health.org.uk/sites/health/files/PersonCentredCareMadeSimple.pdf
http://www.ipfcc.org/about/pfcc.html

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inter: corporately and coordinately
multi: independent

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multiprofessional: multiple disciplines working to provide health services in an individual way
interprofessional: multiple disciplines working together holistically towards a common goal

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Interprofessional: working collaboratively to achieve a common goal
vs
Multidisciplinary: Working separately to achieve common goals

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Interprofessional: two or more health professionals (as well as patients and families) working together towards a common goal in a collaborative and cohesive manner.

Multiprofessional: people / professionals with multiple different backgrounds working toward their own goals while still working together.

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Interprofessional teams are professionals from different professions working together towards a shared goal. This is collaborative and the professionals interact with each other a lot.

Multiprofessional teams are professionals from different professions working independently towards individual goals. This type of team does not interact very much. They have defined roles and do not work collaboratively. They still communicative and work together but focus more on their individual goals.

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What are some examples of team functions?
- Collaborative leadership
- Shared goals
- Wide range of skills and expertise
- Collaboration
-Building trust among all team members
- Understanding of team dynamics

- Cooperation

-Shared decision making

-Shared collaborative leadership and responsibility

- Commitment

-Reflection

o   Reflection is an essential part of learning and professional development

- Strength in one’s professional role

- Clarity and understanding of the professional role of others

- Ethical practice

- Recognise diversity in others

- Mutual support between all healthcare professionals
- Conflict resolution

- Problem-solving
- Self-awareness
- Listening skills

How does IPP affect how do you your job?

What is the impact of collaborative work on patients/clients/their families and healthcare professionals themselves?
- Avoids fragmented care
- Makes patients understand what is happening
- Safer care
-  Less frustration and confusion
- Client knows what everyone's roles are
- Better understanding for you

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Apples R/B/T
Roses
- The online content is comprehensive and clear 
- Not just text, quizzes and videos help the learning process 

Buds
- More little questions would reinforce the content taught
- Videos are often repetitive and say the same thing over and over across different health professionals

Thorns
- Time difference between due date and tutorial - everything's been forgotten 5+ days later
- ePortfolio is not very good

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Hi all, just a heads up that the new biennial report is now available (since late June). Please let students know that the content was written when the 2018 report was not yet available. You may want to refer to Chapter 4 highlights on determinants if students have further questions.

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Australian Institute of Health and Welfare

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Boats and boating--Equipment and supplies

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Australia's health 2018, Chapter highlights - Australian Institute of Health and Welfare

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Australia@s health 2018 is the AIHW@s 16th biennial report on the health of Australians. It examines a wide range of contemporary topics in a series of analytical feature articles and short...

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balance of physical, emotional, mental, social, spiritual well-being

- personal perspective (looking at a global scale)

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- more photos
- put active pharmaceutical ingredient in brackets beside brand name on the brochure because maybe its the same API as her home country
- find out more information about her
- calm her down
-

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Urinary Tract Infection

How does it communicate information generally?
-  Simple layout
- Lots of info
- No images
-Technical language
- unnecessary information

Can the health information be understood and acted upon?
- Preventative measures
- Home care
- Treatment options

How would you improve it?
- convert some text to dot points
-Testimonial of someone who has experienced UTIs

RED GROUP - Keelan
- Respect what they already know and believe and ask them what they have already done
- Cultural competence
- Honesty
- Reiterate that there is lots of help available
- Be clear
- Discuss preventatives
- Look for additional information - possibly specifically about males with UTIs
- Use influence in community to encourage Aboriginal people to come to uni
- Services specifically for Indigenous Australians with representatives and advocates who are more than happy to support you

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confusing cuz of ekka
rose: easy

buds: repetitive

thorns:

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https://clinicalexcellence.qld.gov.au/resources/emergency-department-patient-information-sheets

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Clinical Excellence Queensland | Queensland Health

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Emergency department factsheets provide condition specific health and medical information for people attending the emergency department.

They are designed to assist communication between emergency department clinicians and patients and/or carers.

How to use these factsheets

Clinicians are encouraged to use emergency department factsheets as a communication tool in their conversation with the patient and/or their carers.

A clinician should give the factsheet to the patient when they are discharged from the emergency department.

Some factsheets can be given to patients when they arrive in the emergency department. Notes can be made on the factsheets by the clinician, patient and/or carer, to personalise the information.

Adult Fact Sheets

Children Fact Sheets

Plesae visit the Children's Health Queensland website for children's emergency department patient information sheets.

Social Support Fact Sheets

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Emergency Department Patient Information Sheets

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Emergency department factsheets provide condition specific health and medical information for people attending the emergency department. They are designed to assist communication between emergency department clinicians and patients and/or carers.

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Quit Smoking Assistance
How does it communicate information generally?
- Through images, dull colours (has negative connotations), bold writing for critical information, dot points for ease of understanding.
Can the health information be understood and acted upon?
- Yes the information was clear and there were phone numbers for more information.
How could you improve it?
- More statistics showing negative aspects of smoking.

Black Group:
- Use QR codes or audio files to link to an audio version of the brochure.
- Use braille.
- Refer to GP for other referral points.
- Use an interpreter.

Avalon
Refer her to a support group, give her more in depth information.

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- patient centred care/autonomy/holistic care
- non-judgemental (open and respectful)
- build rapport
- communication skills
- leadership skills
- industry knowledge
- lifelong learner
- empathetic
- decision maker
- teacher/educator
- researcher
- strong work ethic
- caregiver
- maintains professional boundaries

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- less medical jargon
- no pictures
- good layout
- pretty good, gives reasons for why person might be experiencing constipation, also gives preventative measures, what to do if the person experiences it, when to seek medical attention
- gives lifestyle advice

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Week 5 Weekly

Roses
- Had 2 weeks to complete
- Easily understandable
- Improved our communication skils

Buds
- Lack of experience for some of the questions (Q2)

Thorns
- Reading
- Cultural competency

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In addition to WHO:
- Fragility of health - how easy would it be for you to become "unhealthy" due to an accident - this in itself can be a measure of health
- Lack of hindrance / impact by adverse situations

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Experience
Education
Communication
Open minded
Empathy
Adaptability
Desire to Learn
Respectful
Selflessness
Self-care
Skilful
Reflective
Motivated

Health

Socially
Mentally
Physically
Healthy Communities
Well-being

Social Determinants
- Socio-economic status
- Culture

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rose: learning about different cultural needs, authorized references

buds:

thorns: the examples given in the videos aren't concise enough

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1. It will effect the quality of care for the patient, effecting the health outcome. If done correctly, many benefits: save money,

2. Provides patient with security and trust in the system, overall will increase patient centred care.

3. Loss of trust within the system, errors could be made, could cost the patient more money if unnecessary bookings are made. Prolong the health-care process. No clear goal, mixed messages.

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How does IPP affect how you do your job?
- With good IPP, you can deliver better care and more  efficient health literacy
What are some examples of team functions?
- Referral process, treatments/diagnoses requiring more than one health professional, prescription of medication.
What is the impact of collaborative work on patients?
- Better quality of healthcare delivered.
What are the consequences of a lack of communication?
- Adverse effects for the client/patient. Potential de-registration of practice, loss of reputation. Potentially severe monetary circumstances

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bad health outcome for the patient
treatment failure
death
misunderstanding and mistrust of health care system

expands knowledge, explore different perspective

# data[].attributes.body
Team Functions:
- shares responsibility and delegates
- sharing is caring
- communication
- open-mindedness

How does IPP affect how you do your job?
- changes structure of day-to-day business - have to talk to others
- allows professional to learn from each other for continuous improvement in your field
- good for double checking and problem solving through challenges

What is the impact collaborative work on patient care?
- improved health outcomes
- less mistakes made = less preventable negative health events
- increased trust between patients and professionals
- PCC more likely to be achieved

What are the consequences of a lack of communication? 😯
- death / other negative health outcomes
- decreased cohesion between HPs
- diminished patient-HP trust
- detrimental to patient
- more room for error in communication / handover etc.

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Grapes Week 2
Roses
-We can learn in our own time and at our own pace
-skip to different slides
-explain what is the correct answer and why
-not too time consuming 
videos are really interesting 

Thorns
- A huge amount of links
-sometimes ePortfolio breaks down


Bud
-because tutorials are based on content you have to keep up to date (kinda good that you are forced to keep up)

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the equilibrium of cultural, mental, and physical satisfying state that benefits the individual and the community

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- communications
- empathy
- person-centered care
- questioning
evolution
follow-up
continuing service
active listening
legal
research and development
helping hand
peer review
knowledge
team work
elimating stigma
condifentiality
family-centered care
leadership
educator
efficiency
time management
organization skill
professional dress
adaptive personality

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-Roses
-Very well put together
-Well structured
- Can look at online content in own time
- Linked it to PCC

Buds
-Include all professions in the videos

Thorns
-Not all professions were represented in the videos
- Readings are too long

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- easy to understand language
- vague information, boring, not specific
- improvement: add pictures, empathsize the more important part

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General Communication of Info:
- Small font
- Lots of information
- Confusing organisation
- Relevant pictures

Can the information be understood and acted upon?
- Yes, provides supports services, pros of quitting are easy to understand

Improvements
- None.

Adaptations for pamphlet:
More images, catchy cover. Aim to frighten him, but not trigger an anxiety attack. He may not even read the pamphlet, so put up videos, 15-30s duration, with the same information delivered quickly. This may be more suited to a teenager's learning style. Encourage quitting and provide support

Additional Information:
Include mother in information delivery. Perhaps give the pamphlet to the mother, hopefully they will absorb more information. Most likely, Beau will not listen to his mother if she constantly badgering him to quit. Overexposure should be avoided, as it would probably desensitise Beau to key information.

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House MD - Do I Look Like An Idiot (Asthma patient)

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https://learn.uq.edu.au/bbcswebdav/pid-3996035-dt-content-rid-16435626_1/courses/HLTH1000S_6860_62431/HLTH1000%202018%20A2%20Task%20Sheet.pdf

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AVALIBILITY:
- Every citizen has the basic right to adequate health care.
- NO Mental health service covered, only 50 outpatient mental health centre, 11 residential facility.

Human workforce:
- 0.4 doctors per 1,000 people. 46,931 qualified doctors in the whole country.
- very underperform and inefficient.

Person-centre care, an effective heath care system:
- National drug policy available at high price.
- $16.2 medical expenditure per capita per year
- underperformed service drives citizens to travel oversea for health care and low confidence in their system.

environmental:
- water, sanitation, adequate food, and health education are well-valued by the government.