BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative

Archive for October, 2018

To improve the quality of health and meet global health standards, many countries around the world continue to seek better ways of organizing, financing and delivering health care and services. Major components and concerns of health to be improved include equity, quality, accessibility, cost, efficiency and effectiveness. Consequently, privatization, globalization and liberalization have become important political agenda in these countries. Privatization may be achieved by a change in ownership, either by decentralization or dis-investment as well as by contracting public services to private agencies or by allowing the private sector to manage public health facilities. Liberalization or deregulation means the activities organized by the State would be provided by the private sector, an example is allowing government doctors to do private practice after office hours or allowing private doctors to use public facilities.

In recent years, private investments in healthcare have become essential for public health systems to meet present and future health challenges. The growing engagement of private sector investments has raised several concerns about equity, quality, accessibility, cost, efficiency and effectiveness. Thus, it is important to compare the aims and objectives of both as well as evaluate their relevance. Comparing the private and public health sectors is tough and involves several multidimensional factors given that their goals are significantly different. Private health sectors are exclusively individually-owned and profit oriented while the public sectors are government-run and social-service oriented. Since the aim of private sector is primarily profit, its focus is on the curative services, whereas, public sector provide preventive and highly specialized medical care services. The private sector is easier to manage and can be more efficient once the financial responsibilities of patients are met, they also such as in India, the private sector tends to focus on services which are easy to make quick profit and the public sector may have to carry the unprofitable activities. Public sector, on the other hand, aims to provide health care services for all citizens using a universal health system where contributions are made by citizens based on their income. This equity-based system enables the public sector to provide services irrespective of age, social class, income and geographical location.

Given the relevance of each sector, a mixed public and private system is obtainable in most countries- in India for example; the private sector plays significant roles in the health care delivery system- accounting for about 57% of the total number of hospitals and 32% of hospital beds. In this case, health care delivery is jointly provided by the public and private sector which requires a public-private partnership. The government must make efforts to use the private health sectors to achieve their aims through collaborations, support, subsidies and partnerships. Major policy concerns about private sectors include the existence of suitable regulations to monitor and control resource allocation, equal distribution of services in geographic locations, quality of services and funding. To address these issues, private healthcare facilities including hospitals, nursing homes and clinics must be registered by the appropriate authority so as to be properly monitored. In Addition, there is need to have regulations for equal distribution of services in different geographical regions as well as poor and underprivileged populations- this can be achieved by tax rebates on income or profit in these locations and licensing of private institutions. To ensure quality care, measures such as accreditation, laws that protect the rights of patients, periodic monitoring of facilities and services and continuing training of healthcare workers. Government should support private health systems dedicated to the improving public health by offering incentives that may include provision of logistics and supplies such as free or subsidized drugs, equipment, vaccines, IEC materials and maintenance of equipment related to national health programs. These will empower private health systems and enable them put patients, and not financial gains, at the forefront of their services.

It is no longer news that Cannabis or Marijuana is now legal in Canada. This new law comes with several implications including health, social, political and economic. We will attempt to discuss some of the political and economic implications here in.

First off, let us clarify the two most common political terms used around this new law- decriminalization and legalization. Decriminalization is the removal of the criminal penalties associated with or imposed for personal marijuana use even though the manufacturing and sale of the substance is illegal. On the other hand, legalization is the termination or abolishment of laws banning the possession and personal use of marijuana for adults and includes decriminalization.

The recent legalization and undeniable public acceptance of using recreational cannabis has raised considerable public concern and has been very controversial due to moral, ethical, public health, legislative and logistic issues associated with it. Results from past public opinion polls showed that majority of Canadians will be happy if marijuana is decriminalized or legalized. Specifically, a poll conducted in 2015 by the Forum Research revealed that 68% of Canadians favor decriminalization and legalization of marijuana.

Legalization will enable the Canadian government to regulate the production, sale and use of marijuana just like tobacco and alcohol.

The proponents of the legalization argue that the use of marijuana is not associated with income generating crime because it is an insignificant constituent of budgets and presents less danger in terms of possibility of overdose, risk of tragic intoxicated behavior and risk of addiction. Contrarily, the opponents of legalization argue that it will increase use, abuse and accessibility to minors.

Economically, one of the major economic effects of legalizing cannabis is a possibility of increased government revenue through the taxation imposed on cannabis and its products. The current legalization is creating a completely new industry- probably a whole new economy, and will likely generate new companies, jobs and stock market earnings, in both businesses and the society as a whole.

According to a report by the Canadian Imperial Bank of Commerce (CIBC), the legalization of cannabis could create an industry with an annual profit of $10 billion, of which the government will collect at least 50% – depending on the tax rate for such potential industries.

Despite possible drawbacks and many uncertainties surrounding the fledgling legalization, it would substantially reduce the Government’s spending on the enforcement of the federal cannabis laws and allow saving the tax money which was previously spent on prohibition, arrests, criminalization and law enforcement. Statistics Canada reported that there were 73,000 marijuana-related criminal offences (67% of all police-reported drug offences) in 2013.

The decriminalization of cannabis will also reduce the size of Canada’s black market and all its consequences for the society. However, it may concurrently result in public health problems such as increased uptake of the drug, more road accidents and injuries as a result of driving under the influence. These problems all have economic consequences.

To ensure that the government actually saves money by reducing cannabis-related arrests, legalization should be accompanied by comprehensive strategies to keep the drug away from minors as well as increase public awareness and knowledge sharing about the harmful effects of the drug.

The term work-life balance refers to the balance needed by individuals to maintain stability and equilibrium between work and other aspects of life. Work-life balance does not mean an equal balance because it’s impossible and impractical to spend the same number of hours for work and social or personal activities. However, it means attaining a daily fulfillment in each quadrant of life: Work, Family, Friends and Self. Balance is important to maintain efficiency, effectiveness and a positive mental health; consequently, there is need to manage the times allocated for work and other aspects of life. Important aspects of life besides work include personal matters, family affairs, social events and leisure activities.

The difficulty in striking a balance between work and life is a challenge faced by a good number of people. In Canada, 58% of workers report being overloaded by their multiple roles- work, school, family, friends, physical health, volunteer and community service. In 2010, the National Health Interview Survey Occupational Health Supplement data showed that 16% of American workers had difficulty balancing work and family. These findings were more prevalent among workers in certain age groups, races, educational levels, careers and marital status. For instance, middle aged workers (30–44 years) had the highest number of individuals reporting imbalance in work and life. Additionally, non-Hispanic black workers at 19% reflected the highest rate of people who reported imbalance in work and life, compared to 16% of non-Hispanic white workers and 15% of Hispanic workers. Workers who possess a bachelor’s or advanced degree also faced greater challenges attaining a work-life balance compared to workers who possess lower educational qualifications. Based on marital status, divorced and separated workers faced higher challenges attaining work-life balance compared to married workers widowed workers, and never married workers. Workers in certain careers and industries such as agriculture, forestry, fishing, and hunting reported lower prevalence of work-life imbalance compared to workers in other areas. More so, professional and highly skilled workers such as legal and medical professionals reported a higher rate of work-life imbalance. On the other hand, a lower rate was observed for workers in office and administrative support fields.

The major determinants of work-life imbalance include gender, hours of work, career ambition and family composition. Differences resulting from gender are based on the fact that in most cases, men prioritize work in order to gain the financial competence to provide for their families as well as maintain their social status, whereas women in most cases prioritize their families rather than work. Long hours at work leads to an imbalance because work takes the time needed to be spent doing other important things such as attending to family needs and resting. Family composition, structure and responsibilities also influence work-life balance because families with demanding needs require members to spend less time at work in order to maintain work-life balance while families with less demanding needs allow members the flexibility to spend more time at work and still achieve some balance. For instance, parents of growing children may need to spend less time at work as they have to cater for their kids. Symptoms of work-life imbalance are loss of control, guilt about neglecting other duties, difficulty concentrating and fatigue.

Irrespective of the many challenges of achieving work-life balance, it is essential to our mental health. Therefore, it remains our individual responsibility to take control and understand our lives enough in order to maintain a healthy balance in every aspect. According to Canadian Mental Health Association (CMHA), tips for maintaining balance include taking breaks, setting priorities and goals, exercising, budgeting, delegating and saying no to some activities.

Antibiotic resistance, also known as antimicrobial resistance or drug resistance is a situation where microorganisms resist the effects of antibiotics designed to kill them. When antibiotics lose their effectiveness, we lose the ability to treat infections and control public health threats. Many medical procedures such as joint replacements, organ transplants, cancer therapy and treatment of chronic diseases are dependent on the possibility to combat infections using antibiotics. Therefore, it is important that these antibiotics retain their effectiveness to ensure the success of these procedures and treatments.

The discovery of Antibiotics remains one of the wonders and breakthroughs of the 20th century. In 1928, Penicillin- the first ever commercial antibiotic was discovered by Alexander Fleming to combat micro-organisms. Subsequently, many other antibiotics have been discovered and used as drugs in the treatment, management and cure of several microbial infections and diseases. The effectiveness and importance of antibiotics cannot be overstressed; however, antimicrobial resistance has been a constant hindrance to their effectiveness.  The unique and unusual genetic capabilities and aptitude of microbes takes advantage of the abuse and overuse of antibiotics. These organisms use resistance genes and horizontal gene transmission to develop several mechanisms of resistance for antibiotics developed and used clinically, agriculturally and otherwise.

Antibiotic resistance occurs when microbes develop the capacity to survive drugs designed to kill them. Infections caused by antibiotic-resistant germs difficult and sometimes impossible, to treat. They often require longer hospital stays or visits, additional follow-ups and other expensive alternatives. Antibiotics have been abused in so many ways including using them when not necessary, overusing them in treating all types of infections, taking too much of them and imbuing them into different agricultural systems, animals, and food products. These various forms of abuse have unlocked the potential for bacteria to evolve into resistant strains that can survive antibiotic that previously could destroy them. Microbes- like most creatures will always find survival strategies and device innovative ways to resist new drugs. In fact, more organisms share their resistance with one another, making it harder to deal with them. To achieve a complete restoration of therapeutic use and effectiveness of antibiotics, there is a need to reduce and end antibiotic resistance. Specifically, one way to achieve this is through creative approaches in the discovery of new antibiotics and their controlled introduction to treatment.

Antibiotic resistance affects people at any stage of life; it also affects health and agriculture- making it one of the most critical public health problems in the world. In the US, about 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result annually. People at greater risk of these infections are especially those already suffering chronic illnesses.

Health insurance is a significant concept in global health due to its relevance in every part of the world. It is broadly described as insurance that covers all or part of an individual’s expenses resulting from disability, ill health or injury. Health insurance considers and calculates each individual’s probability of incurring medical expenses; spreads it over the same probability for a group of individuals and then estimates the overall risk of health care and health system expenses in that group. Subsequently, a routine financing structure – usually a monthly premium, is developed by the insurer for the group to raise the funds needed to pay for the specified health care benefits in the insurance contract or agreement. Hence, health insurance is not really free health care; it is a system where individuals pay for healthcare as a society- by making different degrees of contributions thus reducing the overall cost and risk of being bankrupted by medical bills. Most of the time, these benefits are administered by a central organization such as the government, business agency or not-for-profit group.

The need for an effective and efficient health insurance plan cannot be overemphasized, and is crucial to maintaining a healthy world. One major advantage and aim of health insurance is to uphold the global health goal of promoting equity in health care- given that the right to health is a fundamental human right. This ensures that individuals and families who may be living in poverty can still get the health services and care they need, even though they would otherwise not be able to afford it. Other pros of health insurance include promoting affordable healthcare while balancing out-of-pocket costs, increasing safe and great quality healthcare options, encouraging innovation and competition in the health sector, improving access to healthcare, expanding service and choices of care options, encouraging individuals to seek medical care and strengthening the healthcare workforce to meet the diverse needs of patients.

Despite the many benefits, one significant drawback of health insurance is that sometimes, it is not flexible and doesn’t cover all or part of the costs of very expensive medical services and care. This means that despite having an insurance plan, people can still go bankrupt if they suffer long-term ill-health that is quite expensive to manage and is not covered by their insurance agreement.

In Europe, nearly all the countries have universal health care (UHC), although there may be small variations across countries. Europe’s UHC is often referred to as “free health care” system due to its effectiveness and efficiency, even for foreigners. However- typical of health insurance, it is not exactly free. Europe’s health insurance system is delivered through a variety of national systems which are publicly funded through taxation.

In North America, health insurance is broad and diverse across the different countries. In the US for example, private and social insurance programs such as Medicare amasses resources and spreads the financial risk of medical expenses across the population. There are many health insurance plans in the US- including private and public plans which provide different levels of financial protection and scope of coverage. Irrespective of the various plans, over 40% of insured Americans reported that their health insurance plans did not sufficiently meet their needs. Canada’s universal health-care system is publicly provided and covers most health-care services as long as an individual possess a valid government-issued health card. This universal health-care system is funded by taxes, differs by province or territory and may vary in the medical costs and conditions covered.

In Africa, Nigeria has a National Health Insurance Scheme (NHIS) which operates under a prepayment system known as capitation. Registered members receive a monthly bill irrespective of whether or not that person used the NHIS’s services. The amount paid is dependent social factors such as income which promotes equity in the receipt of health services. The objective of NHIS in Nigeria is to reduce socioeconomic barriers to achieving universal access to health care and service. The downsides of NHIS include lack of organization, high financial cost, poor health care service and infrastructure, uneven distribution of hospitals and healthcare professionals.