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Working in health means life long learning

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victoria.jones@uqconnect.edu.au

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Do we have to use the Driscolls (1994) model

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Do we have to use the Driscolls (1994) model

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Yes

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But I can't grant extensions or give permission for missing a tute... for that email HABS@enquire.uq.edu.au

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Are due in week 3 on Tuesday the 7th at midnight.

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Know how and when to reference!

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The "APA style" is an author-date style for citing and referencing information in assignments and publications. This guide is based on the "Publication Manual of the American Psychological Association" 6th edition (2010).

Always check with your lecturer or tutor about the bibliographic style preferred by the School. There may be differences in the style recommended by the School.

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Library Guides: APA 6th referencing style: About APA 6th

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This guide looks at how to create in-text references, reference lists and bibliographies using the APA 6th style.

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Aphasia and reperfusion therapies in hyper-acute settings: A scoping review. - PubMed - NCBI

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Focus on the first column...

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HLTH1000 2018 A1 Marking Criteria revised

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Task guide.

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If the system is not working and you cannot submit the task on ePortfolio, please email the completed task in a word document (so I can say it was completed on time) and submit it on ePortfolio when you can.

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Check your spelling

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Oxford Languages | The Home of Language Data

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Explore Oxford Languages, the home of world-renowned language data.

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Is it okay if my experience was a positive one? (A1)

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Is it okay if my experience was a positive one? (A1)

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Yes! You can critique a positive interaction! You’re just analysing what they did!

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As many as you need to ensure that you're not passing off other peoples ideas or research as your own.

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https://padlet.com/referrals/victoria_jones8

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The following tips are aimed at helping you master the difficult craft of scholarly writing.

Write your work up as you go

Don't wait until you have finished analysing all your data. Why?

Writing at the PhD/MPhil level is expected to be of a standard that could be published in internationally recognised scholarly journals. Writing at this level can be likened to a craft and, like crafts such as painting and sculpture, it takes time and reflective effort to learn the "tricks of the trade" and to develop competency, let alone mastery. This time is best spread out over the length of your degree rather than squeezed in at the end where it will lead to a lot of avoidable stress. ... Not that there won't be other things to stress about, but why add to these?

Rough notes quickly become meaningless if not written up properly. This means that if you leave writing up until the end, you may have to redo a lot of work because you won't be able to understand, let alone write from, your rough notes.

Writing things up properly helps you to "debug" your thinking. Human thinking is notoriously "fuzzy". Consequently, it is often only when you start to write things up carefully that you will discover "holes" in your reasoning or further things you need to consider. Obviously, it is better to find these problems earlier rather than later.

Learn from others

To learn from the writing of others (and only imitate writers you actually like reading!), you need to learn to read for structure and not just content. How do good writers introduce and link ideas? How do they structure their arguments? How do they indicate their level of confidence in the conclusions they draw from their evidence? What sorts of questions do they address in different sections? It is not plagiarism to use stock standard phrases like, "These results suggest that ...", or "A second approach to addressing the problem of X is to do Y", so it is okay to collect such phrasings for use in your own writing.

Thus an abstract provides a brief summary of the entire study, which (ideally) answers the following five questions:

What did you do?

Why was it worth doing?

How did you do it?

What were the key results?

What are the implications or significance of your results?

Example analysis of an abstract

Example analysis of a body paragraph

Using tables and figures effectively

Although the key principles are not very complicated, tables and figures are often not as well integrated into a piece of writing, as well explained, or as well designed as they could be. To learn what the key things you should be paying attention to are, download our notes on "Incorporating Tables and Figures Effectively Into Your Writing."

Ask for feedback

All writers can benefit from feedback on their writing. To get the most out of this:

don't just ask someone to "check it for you" (apart from anything else, this may come across as you asking them to do your work for you). Rather, ask for something specific such as, "Do you think the structure is okay?" "Are my explanations clear?" "Is the argument in section 3 convincing enough?" "Do you think I need more supporting data in section 2.4."

In particular, if you give someone a rough draft to check if your basic structure is okay, make sure that the reader knows that this is what you want and that you know it still needs a lot more polishing but that you aren't worryied about that at this stage.

Students for whom English is a second language may find their supervisors focussing more on English errors than on more important stylistic, structural or analytical issues because the English errors are more obvious and easier to deal with. Consequently, such students may need to encourage their supervisor to ignore the English issues and focus on issues that are of more concern to the student.

Edit your work

Checking and developing structure. One aspect of editing is to ensure that there is a logical flow of ideas in your writing. Some form of outline, either developed in the planning stages or after you've put some ideas down to see what you've got, can help with this. One form such an outline might take is a flow chart of main ideas or as a list of questions each paragraph has to introduce and answer (see following examples).

Example flowchart of main ideas to check for a logical flow

Example of seeing paragraphs as answering a logical sequence of questions

Are you explaining things clearly or enough? You will be better able to determine if your writing and explanations are clear if you put it aside for a few days and then come back to it. By doing this, you will start to forget what you were thinking when you wrote what you wrote and so will be able to see your writing more as another reader would.

Proofreading

This is the part of editing that looks at correcting typos and errors in punctuation and grammar. Proofreading requires close, careful reading, and as such is best done with a paper copy rather than on screen (of course, while reviewing your work on screen, you can and will pick up some errors). It is also best done by reading out aloud (even if only in your head), as speaking speed is much slower than normal reading speed, and reading out aloud requires every word to be read. When doing this, try to read in an interesting way (i.e. as though you were reading to an audience) and listen for when you pause as this will help you identify where commas and full stops should and shouldn't go. Also listen for sentences that sound odd, incomplete, or are awkward to say, as these things generally indicate grammatical problems.

Students for whom English is not their first language may need to seek the help of a proofreader to improve their written expression to the required level. However, such assistance is best sought after all other issues have been addressed, as there's not much point in paying for proofreading if your supervisor then recommends significant revisions.

Learn how to deal with "writer's block"

If the cause is:

So many ideas to coordinate that it's hard to work out what order to put them in

Try mind mapping your ideas since in a mind map you don't have to worry about order, only what the themes are. Once you have your mind map, then you may be able to work out a logical order.

Not being able to come up with the perfect way to say something

Don't worry about achieving perfection on a first draft. Write sketchy dot points if that's all you can do. It's easier to revise than to create, so getting anything down, even if only dot points or something like "Discuss Bloggs' ideas about X", is a good starting point. It is known from Beethoven's sketch books that it took him 20 attempts to get his famous, Daa naa naa naa, Daa naa naa naa, just right. The point being that getting things just right can take a lot of tinkering, and just getting something down gives you something to work on: "Okay, why I aren't I happy with this? Ahh, I need to explain that more, so maybe if I say ..., that will improve things. ... Okay, still doesn't seem quite right, what's the problem now? ... Oh, that idea doesn't link to that one. Perhaps if I add ... that will help. ... ... ... Ahh, finally, I think that works really well now."

A similar idea is that of "free writing", where you just write whatever of relevance pops into your head, not worrying about grammar, punctuation, writing in complete sentences or even logical flow.

Not really knowing what you want to say

Try explaining verbally what you want to say to someone else or to yourself (you might tape what you say), or explain to someone else or yourself why you are having problems. If all else fails, it might help to take a break from writing for a few days to see if "clearing your head" can help you get a fresh perspective on how to say what you want to say.

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The following tips are aimed at helping you master the difficult craft of scholarly writing. Writing at the PhD/MPhil level is expected to be of a standard that could be published in internationally recognised scholarly journals.

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What is brevity in writing?

Brevity in writing is writing in a style that is brief, while at the same time covers all necessary points. Basically you are saying as much as possible in as few words as possible. It is one of the more difficult things to do well in writing, but often produces some of the best work and influences on writing of a great business plan.

Why use brevity in writing?

Using brevity in your writing enables you to arrive quickly at the point you are making in a clear and understandable manner. This style of writing is known as laconism, and it is well suited to a business environment. In business people often tend to be rushed, and may not have time to work their way through a wordy document of 4 or 5 paragraphs. If you can say essentially the same thing using only 1 paragraph it saves time. In general, writing in this style is also easier to understand, as it uses both short words and short sentences. It has been stated as writing to edify and not to impress. Many people writing in a business environment have a tendency to use long flowery sentences and big words in an attempt to impress with their intelligence. Often the results are vague emails, letters and documents that leave those reading them unclear as to what was said. It is better that writing edifies, and makes ideas clear and easy to understand. In addition, you may find more information about the importance of e-mail subjects by visiting our site.

How can I use brevity in my writing?

If you would like to introduce brevity into your business writing there are several techniques that you can begin practicing. Some of the different ways you can use are as follows:

Cut extraneous words - Extraneous words are words that aren't needed, and when removed aren't missed and meaning isn't changed. Many times people use unnecessary words without thing about it. As an example look at the following before and after sentences.

Before: I couldn't go to the beach because of the fact that I was needed at work.

After: I couldn't go to the beach because I was needed at work.

Both sentences say the same thing but the after sentence has less words.

Restructure your sentences - Reordering and combining ideas and thoughts in sentences and paragraphs can use fewer words. It may require a little more effort on your part, but the end result will be using less words to say the same thing that was in the original.

Before: The pass, made by John, was the games highlight.

After: Johns pass was the games highlight.

By reordering fewer words were used.

Avoid using clichés. They are overused and don't add anything.

Image credit: http://www.ces.sdsu.edu/blog/2013/02/business-writing/

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2 Techniques for Brevity in Writing | Writing Tips

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Brevity in writing is writing in a style that is brief, while at the same time covers all necessary points. Basically you are saying as much as possible in as few words as possible. It is one of the more difficult things to do well in writing, but often produces some of the best work and influences on writing of a great business plan.

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At the Writing Center, we often talk about the flow in writing. While it's a small word, flowincorporates many parts of writing, which can make it difficult to define and complicated to achieve. Creating flow involves using logical connections between ideas, strong topic sentences to start paragraphs, transitions to link sentences, concise wording, and a varied sentence structure.

One commonality between these parts of writing is that they make the reader's job easier. And, that's essentially what flow is: Techniques and characteristics of good writing that make the writing easy for the reader to navigate and understand. In this way, good flow is a lot like a good road trip.

Logical connections

If I was writing a paper about the advantages of online education, I might first discuss how online education can be useful to people who are working adults, as well as people who live in rural areas. But what if I then talked about how students are more engaged when they live on campus?

This last idea doesn't fit with my other two ideas, so my reader will have to pause and try to understand the connection, thus interrupting the flow. This idea that doesn't fit is like road construction. Both the unconnected idea and the construction impede progress, and the reader, like a driver, must take extra time and effort to try to figure out a way to get around the construction. But, remove the road block-the idea that doesn't fit-and driver/reader has smooth sailing.

Topic sentences
In academic writing, topic sentences are the first sentences of a paragraph that tell the reader the focus of the paragraph. See how I used a topic sentence for this paragraph? My first sentence clearly told you, as the reader, that I was going to discuss topic sentences in this paragraph. Topic sentences act as informational sign posts so readers can anticipate what's coming up ahead.

Transitions

Transitions create flow by linking ideas and sentences. Writers can create transitions in a couple of ways: (1) using words like additionally or however to begin sentences and (2) repeating key terms or phrases between sentences. Transitions are like bridges between roads. They help guide the reader between sentences, showing the reader how to easily get from one sentence to the next, just like a bridge can bring you from one side of the road to the other safely and easily.

Clear, concise wording.

Clear and concise wording also creates flow. Take this sentence: Online education, which means education in an online format where you are not face-to-face with your teacher or classmates, can help a student become more proficient in their area of expertise or field, which in turn can also help a student show leadership skills and receive a promotion or recognition for his/her good work at their job.

Whew, that's a long one. Note all the phrases and ideas stacked on top of one another that the reader must navigate. Instead, I could have easily said: Online education helps students become proficient in their field, which can result in recognition for students in the form of a promotion. Much clearer! This sentence has the same meaning as my previous sentence, but is more concise and easier to follow. Using concise and precise wording is like creating a direct route in a road trip. Instead of taking your reader through all the winding back roads and causing car sickness, you're taking the reader on the most direct route to your ideas.

Varied wording and sentence structure

Avoiding repetition creates flow by getting readers interested in your ideas and in the way you talk about your ideas. Think taking a long road trip through flat, rural countryside. Without variety in scenery, the drive can become boring pretty quickly. Variety in scenery-like variety in sentence structure-makes the journey more interesting. Take these sentences, for example:
Online education is beneficial for many students. Online education benefits many students in rural areas. Online education benefits many students working full-time jobs. My sentence structure is the same in each sentence (a simple subject + verb construction), and I repeat the words online education, benefit, and many students. Here's another version that varies the sentence structure and wording, and thus is more engaging: Online education is beneficial for many students. In particular, students in rural areas and those working full-time jobs can find online education convenient and useful.

As you write, remember to use logical connections; topic sentences; transitions; clear, concise writing; and varied wording and sentence structure. If you can master these aspects, then you're on your way to creating flow in your writing!

Editor's Note: In 2016, we expanded Beth's discussion of Follow this link to access the expanded, in-depth discussion on increasing your writing's flow today! flow in academic writing. Our Instructors and Editors expanded on each one of these strategies in a full-length blog post. So, if you'd like more insight and instruction on any of these five categories, check out our Writing Center Greatest Hits Update: 5 Flow.

Writing Instructor and Coordinator of Webinar Writing Instruction
Beth Oyler writes about literature in her spare time and enjoys contemplating the possibilities writing creates.

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Five Ways to Create Flow in Your Writing

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At the Writing Center, we often talk about the flow in writing. While it's a small word, flowincorporates many parts of writing, which can make it difficult to define and complicated to achieve. Creating flow involves using logical connections between ideas, strong topic sentences to start paragraphs, transitions to link sentences, concise wording, and a varied sentence structure.

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https://www.visme.co/make-infographics/

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Free Infographic Maker - 700+ Beautiful Templates | Visme

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Use our free online infographic maker to create beautiful infographics, reports and charts. Choose from hundreds of pre-made templates. Get started for free.

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A rematch?

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https://padlet-uploads.storage.googleapis.com/305608661/3061274eba32b81157af745837bb795d/HLTH1000_2018_Tutorial_5.pdf

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Speech Language Pathology "Intergalactic" rap

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Bieber - Boyfriend (Parody "If I Was Your Physio")

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Singing Dentist - I Like Your Molars (parody of I Like To Move It by Reel 2 Reel)

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WHO: The many paths towards universal health coverage

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Australian Government Department of Health

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Our health landscape

Australia's health system is one of the best in the world. It provides quality, safe and affordable health care for you and your family.

Government responsibilities

The Australian and state and territory governments share responsibility for running our health system.

The Australian Government is responsible for:

the Medicare Benefits Schedule (MBS)

the Pharmaceutical Benefits Scheme (PBS)

jointly funding public hospitals which are owned and operated by the states and territories

subsidising and regulating aged care services, including residential care, care at home and other care such as respite care

supporting quality, effectiveness and efficiency in primary health care and access to appropriate care for all consumers, including after hours care

working with the health and medical professions and education sector to ensure the right health workforce and promote equitable access across Australia

funding a range of population health programs and campaigns to promote healthier lifestyles and prevent chronic disease

funding primary level mental health services and suicide prevention services and providing national leadership

regulating therapeutic goods and medical devices through the Therapeutic Goods Administration

developing and disseminating health and welfare information and statistics through the Australian Institute of Health and Welfare

supporting our high quality medical research sector with funding from the Medical Research Future Fund and the National Health and Medical Research Council

supporting and regulating private health insurance to maintain a strong private health sector which promotes choice

funding programs specifically for Aboriginal and Torres Strait Islander health, including community-controlled health care organisations

providing veterans' health care through the Department of Veterans' Affairs

providing safe, quality vaccines for the National Immunisation Program (NIP) and funding or jointly funding preventive health screening for bowel cancer, cervical cancer and breast cancer

enabling access to organ and tissue transplants, including through a nationally coordinated and consistent approach and system

enabling access to a secure supply of safe and affordable blood products through national supply arrangements and best practice standards

subsidising hearing services

coordinating the national response to health emergencies, including pandemics

ensuring a safe food supply in Australia and New Zealand

providing radiation protection to Australian people and the environment through nuclear safety research, policy, and regulation

providing national leadership in cancer control, with targeted research, cancer service development, education and consumer support.

The Health portfolio is also responsible for national sports programs, including programs to improve opportunities for community participation in sport and recreation, promote excellence in high-performance athletes, protect the integrity of sport, and coordinate Commonwealth involvement in major sporting events.

States and territories are responsible for:

managing and jointly funding public hospitals

delivering preventive services (including programs jointly funded by the Commonwealth) such as breast cancer screening and immunisation programs

community health services

providing community, hospital and crisis mental health services

public dental clinics

ambulance and emergency services

patient transport and subsidy schemes

food safety and handling regulation

regulating, inspecting, licensing and monitoring health premises.

Some shared arrangements are detailed in national agreements, such as under the Council of Australian Governments (COAG). They include:

funding public hospital services

preventive services, such as free cancer screening programs

registering and accrediting health professionals

funding palliative care

national mental health reform

responding to national health emergencies.

Local governments also play an important role in the health system. They provide a range of environmental and public health services, community-based health and home care services.

Medicare - the foundation of our health system

Medicare is Australia's universal health insurance scheme. It guarantees all Australians (and some overseas visitors) access to a wide range of health and hospital services at little or no cost.

Find out more on our Medicare page.

The cost of health care in Australia

The Australian Government spends a lot of money every year on many health and aged care services and sport programs. In 2017-18, the department is forecast to spend $87.9 billion on health and aged care in Australia.

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The Australian health system | Australian Government Department of Health

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Australia's health system is one of the best in the world. It provides quality, safe and affordable health care for you and your family. The Australian and state and territory governments share responsibility for running our health system.

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The idea of creating a rap song about the drug coumadin was envisioned by Dr. Gregory Stajich, Pharm.D., in the mid 90's while working at a hospital in Atlanta. The song was shelved for many years until combining forces with one of his pharmacy students, Josh Pendley, under the name "RxP".

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Saint Louis University Occupational Science and Occupational Therapy

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Physical Therapy and Occupational Therapy

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OT Problems, OT Rap about Occupational Therapy

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This is a rap about the profession of Occupational Therapy. This video is dedicated to the class of 2013. WE DEED IT!

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You're Welcome (Thank You Nurses) | A Moana Nurse Tribute Parody

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Saint Louis University Occupational Science and Occupational Therapy

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We're Gonna Be OTs (Lorde's Royals) with Lyrics - Occupational Therapy Student Anthem

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The writing you need to do for your assignments is different to every-day writing. It is more formal, objective and structured.

While different assignment types and subjects may have different writing conventions, academic writing has these common features

It has a formal tone

It uses third person rather than first person perspective (i.e. I or me)

It follows a specific theme or answers a specific question or questions, using a logical argument.

Academic writing should also

be well-organised with a recognised structure

be well-researched and referenced (acknowledging other writers and sources)

provide evidence showing you have thought about, researched and understand the topic

More about academic writing

Commonly used words

Often the words used in academic English aren't the same as the words used in everyday spoken or written English. The sites below contain some useful words and phrases to help you write academically.

The academic phrasebank - University of Manchester website (opens in a new window)

Academic writing phrases - Academic English UK website (opens in a new window)

Different subjects may have writing conventions

Even though the basic principles of academic writing are the same irrespective of the subject area, different academic disciplines may have different writing conventions. This means that different subjects may:

Use different words and/or phrasing, and words can sometimes mean something different, depending on the subject

Require a different writing style, such as a report-style of writing

Require a different structure and organisation to the assignment.

To find out what type or style of writing is required in your subject area check your course page, learning material and/or the set text for advice. If you're still not sure what's required ask your lecturer/tutor.

The websites below have more detailed information, but remember that the requirements may differ at different educational institutions:

Writing - Monash University website (opens in new window)

Writing scientifically - Engage website (opens in new window)

Writing in psychology - Purdue Online Writing Lab website (opens in new window)

Writing in the disciplines - University of Richmond website (opens in new window)

Reflective writing

As part of your studies you may also be required to write reflectively or show evidence of reflective thinking. This type of writing is more personal than most other academic writing. It usually involves analysing an event or idea, and explaining what something means to you and/or how it has affected you personally. Assignments requiring students to write reflectively include:

learning journals or diaries

portfolios

blogs

reflective essays.

More about reflective writing

Reflective writing - Deakin University website (opens in new window)

Reflective writing - University of New South Wales website (opens in new window)

Related information
Types of assignment How to make your writing better Copyright and disclaimer information

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The writing you need to do for your assignments is different to every-day writing. It is more formal, objective and structured. While different assignment types and subjects may have different writing conventions, academic writing has these common features It has a formal tone It uses third person rather than first person perspective (i.e.

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MY LINK

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Healthcare in Rwanda was historically of poor quality, but in recent decades has seen great improvement. Rwanda operates a universal health care system, and is considered to have one of the highest-quality health systems in Africa.

Butaro Hospital at Burera, Northern Province

In the pre-genocide era before 1994, Rwanda's healthcare was supported by the Bamako Initiative which was sponsored by UNICEF and WHO and adopted by African ministers of health in 1987. Progress was started towards decentralising the health management system, first to the Province level and then to the district level. Unfortunately this was disrupted by the 1994 genocide, which crippled the healthcare system alongside the economy. In the post genocide period, Rwanda has had an uphill climb in the recovery of its health system as well as its economy. It has since built one of the best healthcare systems in the region. In 2008, the government spent 9.7% of national expenditure on healthcare, compared with 3.2% in 1996.

Health insurance became mandatory for all individuals in 2008; in 2010 over 90% of the population was covered. In 2012, only about 4% were uninsured.

President Kagame made healthcare one of the priorities for the Vision 2020 development programme, boosting spending on health care to 6.5% of the country's gross domestic product in 2013, compared with 1.9% in 1996. The government has devolved the financing and management of healthcare to local communities, through a system of health insurance providers called mutuelles de santé. The mutuelles were piloted in 1999, and were made available nationwide by the mid-2000s, with the assistance of international development partners. The mutuelles are owned and managed at the level of Rwanda's thirty districts. There are separate national health insurance schemes for public servants and soldiers.

Premiums under the scheme were initially US$2 per annum; since 2011 the rate has varied on a sliding scale according to wealth, with the poorest citizens entitled to free health insurance and wealthiest paying premiums of US$8 per adult. As of 2014, more than 90% of the population was covered by the scheme. The government has also set up training institutes including the Kigali Health Institute (KHI), which was established in 1997 and is now part of the University of Rwanda. In 2005, President Kagame also launched a program known as The Presidents' Malaria Initiative. This initiative aimed to help get the most necessary materials for prevention of malaria to the most rural areas of Rwanda, such as mosquito nets and medication. Rwanda follows a universal health care model, which provides health insurance through the mutuelles de santé. The system is a community-based health insurance scheme, in which residents of a particular area pay premiums into a local health fund, and can draw from it when in need of medical care. Premiums are paid according to a sliding scale, with the poorest members of society entitled to use the service for free, while the wealthiest pay the highest premiums and are charged copays for treatment.

In 2012, about 45% of the system was funded by premium payments, with the rest coming from government funding and international donors.

Rwanda's healthcare system operates 499 health centers, 680 health posts which are mainly involved with the outpatient programmes such as immunizations and family planning services, a number of dispensaries, and 42 district hospitals. The country's villages are served by a network of thousands of community health workers. There are four national referral hospitals, which are Kigali University Teaching Hospital, Butare University Teaching Hospital, King Faisal Hospital Kigali and the Rwanda Military Hospital. The most advanced of them is King Faisal Hospital, which is operated on a for-profit model by the government but participates in the national health insurance system, and therefore accepts patients referred to it by other hospitals and clinics. It is the most advanced hospital in Rwanda, equipped with a CT and MRI machine, two dialysis machines, and a wide range of surgical capabilities.

Rwanda's clinics are equipped with basic medical equipment and a cupboard of essential medications. The district hospitals offer basic surgical services, and all have a minimum of 15 doctors. Those in need of more advanced and specialized care are referred to one of the four national referral hospitals. There are five cancer treatment centers in the country, the Rwanda Cancer Centre at Butaro Hospital and facilities at the four national referral hospitals.

There is a network of 58,286 Community Health Workers who provide primary care in the 14,837 villages and make referrals.

Rwanda has a shortage of medical professionals, with only 0.84 physicians, nurses, and midwives per 1,000 residents in 2013. The United Nations Development Programme (UNDP) is monitoring the country's health progress towards Millennium Development Goals 4-6, which relate to healthcare. A mid-2015 UNDP report noted that the country was not on target to meet goal 4 on infant mortality, despite it having "fallen dramatically"; the country is "making good progress" towards goal 5, which is to reduce by three quarters the maternal mortality ratio, while goal 6 is not yet met as HIV prevalence has not started falling.

Rwanda is participating in a seven-year program begun in 2013 that sees hundreds of medical educators and clinicians from 25 American medical institutions, including Harvard Medical School, Yale Medical School, and Duke Medical School, training Rwandan medical personnel and establish training and residency programs, which, after seven years, will be run by the Rwandan government with its own budget, teachers, and clinicians.

Evans, Ruth (20 January 2014). "Rwanda's health service evolution - podcast". The Guardian. London.

International Monetary Fund (IMF) (November 2000). "An approach to the Poverty Reduction Action Plan for Rwanda: The Interim PRSP" (PDF).

McNeil, Donald G. (14 June 2010). "In Desperately Poor Rwanda, Most Have Health Insurance". The New York Times. New York, N.Y.

Rosenberg, Tina (3 July 2012). "In Rwanda, Health Care Coverage That Eludes the U.S." The New York Times. New York, N.Y.

United States Agency for International Development (USAID) (II) (8 December 2014). "Health Insurance Expands Care For Rwanda's Poorest". Archived from the original on 4 March 2016.

World Bank (V). "Health expenditure, public (% of GDP), 2010-2014".

World Bank (VI). "Health expenditure, public (% of GDP), 1995-1999".

World Health Organization (WHO) (2009). WHO Country Cooperation Strategy, 2009-2013: Rwanda (PDF). ISBN 978-92-9031-135-5. Archived from the original (PDF) on October 19, 2010.

World Health Organization (WHO) (2008). "Sharing the burden of sickness: mutual health insurance in Rwanda". Bulletin of the World Health Organization. 86 (11): 817-908. ISSN 0042-9686. Archived from the original on November 13, 2008.

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Healthcare in Rwanda was historically of poor quality, but in recent decades has seen great improvement. Rwanda operates a universal health care system, and is considered to have one of the highest-quality health systems in Africa.

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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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To ensure equitable healthcare to every residing human in Bangladesh, an extensive network of health services has been established following the administrative web of Bangladesh. It is a circuitous form of healthcare network spread across the country ranging from policy-making bodies to healthcare facilities down to the community level.Infrastructure of healthcare facilities can be divided into three levels: Medical University, Medical College Hospitals, Specialized Hospitals exist at Tertiary Level.

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Week 12 (tute 9) Student Template alternative activity (1)

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Week 12 (tute 9) alternative activity slides

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2018 Post-course - HLTH1000 Professions, People, and Healthcare

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