Dr Mrigesh Bhatia COW 1.04

This course is available on the MSc in Global Health Policy, MSc in Health Policy, Planning and Financing, MSc in Health and International Development, MSc in International Health Policy and MSc in International Health Policy (Health Economics). This course is available as an outside option to students on other programmes where regulations permit.

In recent years, debates in health policy have moved to consider a system-wide approach to understanding the demands and challenges of health in low and middle income settings. Importantly, systemic barriers remain to health care, centred around institutions, organisations and resources. In particular, a system-wide approach focuses on the importance of developing and strengthening broader healthcare infrastructure, rather than a focus on disease specific interventions. This course will be based around three key areas of the health system in low income settings; the physical, financial and human. The physical will consider the delivery of health in developing countries - examining the role of the public, for profit and non profit sectors, decentralisation (and recentralisation) and physical access to primary healthcare. The financing arm will consider options for financing healthcare in low income settings, including the role of user fees, results based financing and community financing schemes. The human element will analyse the acute shortages of health workers, brain drain and capacity building in the workforce. As part of this three pronged approach, this course will consider a range of health policies and health sector reforms which have been implemented to overcome challenges in resource poor settings. It will examine the assumptions upon which health system reforms are based, and an assessment of their success. Finally, the course will consider some case studies for health systems and policy analysis in developing countries, including maternal health and system resilience to health crises

This course will be delivered in no less than 30 hours and included lectures and seminars.

An essay of not more than 2,000 words.

Mills, A (2014) Health Care Systems in Low and Middle Income Countries, New England Journal of Medicine, 370 (6), 552-557; Crisp, N & Chen, L, (2014) Global Supply of Health Professionals, New England Journal of Medicine, 370 (10), 950-957; Hafner, T., & Shiffman, J (2013) THe emergence of global attention to health systems strengthening, Health Policy and Planning, 28 (1), 41-50; Shakariskvili, G, Atun, R., Hsiao, W., Burgess, C., & Lansang, M (2010) Converging health system frameworks: towards a concepts-to-actions roadmap for health systems strengthening in low and middle income countries, Global Health Governance, 3(2); Ottersen, T, Evans, D., Mossialos, E., Rottingen J-A, (2017) Global Health Financing towards 2030 and beyond, Health Economics, Policy & Law, 12 (2); Balabanova, D., McKee, M., Mills, A., Walt, G., & Haines, A., (2010) What can global health institutions do to help strenghten health systems in low income countries? Health Research Policy and Systems, 8,(1), 22, Kieny, M., Evans, D., Schemts, G & Kadandale, S, (2014) Health system resilience: reflections on the Ebola crisis in West Africa, Bulletin of the World Health Organisation, 92(12) 850, de Savigny, D., & Adam T, (2009) System Thinking for Health Systems Strengthening, Geneva Alliance for Health Policy and Systems Research; Buse; K & Hawkes, S., (2015) Health in the Sustainable Development Goals: ready for a paradigm shift? Globalisation and Health, 11(1)., 13. Pratt B & Hyder A (2015) Global Justice and Health Systems Research in Low and Middle Income Countries, Journal of Law, Medicine & Ethics, 43 (1), 143-161 

Exam (75%, duration: 2 hours) in the summer exam period.
Essay (25%, 2000 words) in the LT.