DS Timed Essay 2

©
The Hogwarts Framework
 Q.1

With reference to Human Rights Based Approach to Health

(HRAH); elaborate the four main questions which HRAH
must respond when doing situation analysis.
 Ans.
brief
• A human rights-based approach (HRBA) aims to
support better and more sustainable development
outcomes by analyzing and addressing the
inequalities, discriminatory practices (de jure
and de facto) and unjust power relations which
are often at the heart of development problems.
Among many the in health care prinicples
principles include:
– Availability: functioning public health and
health care facilities, goods, services and
programs in sufficient quantity
– Accessibility: such as the non-
discrimination, physical accessibility,
economic accessibility (affordability),
information accessibility
– Acceptability: respectful of medical ethics
and culturally appropriate, sensitive to age
and gender
– Quality: scientifically and medically
appropriate
points
A HRBA situation analysis The 2009 Guidelines
for UN Country Teams on Preparing a Common
Country Assessment (CCA) United Nations
Development Assistance Framework (UNDAF)
provide guidance on how to carry out a HRBA
situation analysis. In relation to health, such an
analysis responds to four main questions:
1. What is happening, where and who is more
affected? (assessment) For every health
challenge, identify the inter-related human rights
standards and the groups suffering from a greater
denial of rights.
2. Why are these problems occurring? (causal
analysis) Identify the underlying and root causes
of exclusion, discrimination and inequality.
3. Who has the obligation to do something about it?
(the role analysis) where we Identify individual
and institutional duty-bearers and their
corresponding obligations.
 Ans.
points
4. What capacities are needed for those affected,
and those with a duty, to take action? (capacity
analysis) Identify the skills, abilities, resources,
responsibilities, authority and motivation needed
by those affected to claim their rights and those
obliged to fulfil the rights.
conclusion
• Once capacity development assets and needs
have been identified, the central question is:
where and how can capacity development efforts
produce the greatest results?
• Its better to initiate an interagency process to
strengthen capacity to integrate a human rights-
based approach and advocate for health-related
human rights as a human rights approach to
health is critical to address growing global health
inequalities.
• Understanding health as a human right creates a
legal obligation on states to ensure access to
timely, acceptable, and affordable health care of
appropriate quality as well as to providing for
the underlying determinants of health, such as
safe and potable water, sanitation, food, housing,
health-related information and education, and
gender equality.
 Q.2

Work related ill health will constitute the next Pandemic in the
underdeveloped countries like Tanzania where industrialization
is now being emphasized. What are the issues? Elaborate with
examples.
 Ans.
brief
• work-related disease is a disease or a state of ill-
health one gets due to work /occupation he or
she has. i.e in, industry/factory, mines,
agriculture, in a service sector work place like a
hospital.
• The sources of these diseases in these places can
be raw material such as PVC or the process itself
e.g lifting heavy loads, wastes or the end
products and their consumption., the
environment itself can be harmful as
noise/radiations
• Occupational Problems can be , Acute-sudden as
burns/ fractures, Chronic-like blindnesss and
cancers
• …..According to President John Magufuli’s
speech during the inauguration of the new
Parliament at 2015, industrialization will be
priority to government.
points
• There is a greater inflow of hazardous industries
from the developed countries to underdeveloped
countries. i.e : Plastic factories
• There are lack of standards , proper regulations
in these countries, so throw-away industries are
accepted without problems which renders
diseases to the workers.
• Double standards on the part of factory owners.
With better standards in the developed countries
where regulations are strict but poor standards in
the poor countries.
• Appropriate information and warnings don't
come with the factories and their processes, plus
high illiteracy rate and low adherence to
instructions among the workers
 Ans.
points
• Lack of and poor implementation of labour
safety and industrial assessment regulations for
having a safe and healthy work environment,
together with lack of strong workers
movements/vogue to increased occupational
hazards.
• In effective work practices or engineering
controls which are not feasible in many of these
new industries including lack of appropriate
personal protective equipment must be used, e.g.
gloves, safety goggles, helmets and safety shoes
as the industries cut off spending.
conclusion
As a matter of social justice, human suffering
related to work is unacceptable. Moreover,
appreciable financial losses result from the
burden of work related diseases on national
health and social security systems. All these
adverse consequences, which are economically
costly to employers and to society, are
preventable through which are often of low cost:
• protect workers' health by controlling hazards in
the workplace and by introducing ergonomics
• advise workers and managers on health
promotion activities and on how to improve
working conditions
• Set up regulations to monitor the work
environment and workers' health with a view to
early identification of health risks and evaluation
of the effectiveness of health protection and
promotion programs.
 Q.3

Read Section 5 (Feasibility Assessment of Resource

Mobilization Methods) of the article by Mukesh et al
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.579.9268&rep=rep1&type=pdf
and answer the following questions:-
a. What are the principal methods for resource mobilization for
health
b. Taking the example of health insurance discuss the
advantages and challenges of using health insurance method
of resource mobilization.
 Ans.
a) brief
• In the context of health care, a mission common
to governments of most countries is to provide,
or cause to provide, health care for all citizens of
the country.
• Long term objectives include efficient provision
of quality health care that is accessible,
equitable, in a manner that is socially and
ethically acceptable. One of the principal
components for achieving it is finding ways and
means to finance the provision of health care.
Resource mobilization strategy refers to all
activities involved in securing the present and
the new additional resources for an
organization/government. The principal methods
of resource mobilization are:
– increased allocations from general government
revenue;
– specially targeted public revenue-raising efforts;
– user fees;
– social health insurance; private health insurance;
– contributions from private donors, and foreign
assistance
b) brief
• Health insurance is characterized by a group of
persons who contribute funds to a common pool,
usually held by a third party. These funds are then
used to pay for the health care costs of the
members of the pool.
• Depending upon who owns the third party fund
pool, insurance can be categorized as
“government” or “private”. Insurance plans may be
further characterized by groups covered, type of
management, size of the group (number of
enrollees), services covered , premiums et.c
points
This system offers the following advantages ;
• Improvements in Equity where benefits are
provided on the basis of need rather than on the
basis of income. Therefore, insurance systems
have the potential to ensure equity in the provision
of health care.
 Ans.
b) points
• Insurance systems have the potential to improve
sustainability since increased revenue
contribution may reduce the government’s
burden of financing the health system.
• Improvements in Revenue Mobilization as
Compared to tax based revenues and user fees,
insurance mechanisms have a greater potential to
contribute to revenue collection.
– First, insurance usually involves the mandatory
contribution of new funds
– Second, in many developing countries tax
avoidance is high; whereas since the insurance
contributions are kept separate and tied to specific
benefits, compliance may be higher
– Third, consumers of health care may often not
have readily available funds to pay user charges
• Health insurance can lead to improvements in
economic and social efficiency. Most purchasers
of insurance are risk averse, and are therefore
willing to pay for risk coverage. Provision of risk
coverage, therefore, is an efficient use of scarce
resources and for consumers to make least cost
choices of type and sources of health care
b) points
The challenges of the method include;
• the introduction of insurance may lead to an
increase in the supply of services, for in certain
payment systems (like fee per service) providers
face incentives to over supply services. This also
has the potential of increasing costs.
• introduction of third party insurance may lead to an
increase in the utilization of health services. When
the unit price of health care is very low there will
be a tendency among consumers to overuse health
care. This has the potential of increasing costs.
• Limited scope of coverage with operation in un-
regulated environment together with low
awareness by the public on how these different
schemes operates which rduces complience also
act as a constraint.
 Further Providers may have a tendency to supply
lower-than-optimal quality services. Provider also
risks a catastrophe if treatment provided is not paid
for.
 Q.4

Community participation is among key ingredients of good

governance. Discuss the available opportunities for community
participation in different levels of decentralized district health
service in Tanzania.
 Ans.
brief
• Community participation is a key principle in the
primary healthcare approach. The expected results
of community participation include better
governance of the health system; enhanced
community voice, empowerment of the
marginalised groups; responsiveness of service
providers and policy makers to citizens’ demands;
a reduction in corruption; and, ultimately, the
achievement of health outcomes including
enhanced quality of care, appropriateness of health
service delivery for users, and patient satisfaction
and utilisation of health services.
• In Tanzania, community participation is part of a
wider health sector reform of the early 1990s,
which aims at doing away with centralised health
system and replacing it with decentralised district
health system. Within these new structures, the
central government is pushing the responsibility
for planning and delivery of health services closer
to the communities, and the civil society and the
citizens are being asked to play a greater
participatory role in these processes.
points
• (Next 2 Slide)
conclusion
• The health committees’ influence on policy,
planning and budgeting is still limited. Due to
various factors such as inadequate training and
low public awareness thus affecting the
performance of the committees.
• A greater role in governance and oversight is
essential for effective and meaningful health
committees. To achieve impact, health
committees will require adequate training on the
following: roles and functions of the health
facility committee and the boards; interaction
between the committees and the communities
and the health workers; development of health
plans and budgets at the local and district level;
and monitoring and tracking.
Ans.
Ans.
 Resources

# Here are some must read resources we used to compile the answers, be sure
to check them and discuss with friends. Click on the blue links to open
them

Qn1. > http://www.who.int/hhr/news/hrba_to_health2.pdf

Qn2. > Occupational health: A manual for primary health care workers W.H.O
2001 (You Can Google it)
> Lecture Notes on Work and Health Related Issues – Prof. Kiwara
> https://www.tanzaniainvest.com/industrialisation

Qn3. > http://citeseerx.ist.psu.edu/viewdoc By Mukesh et al.

Qn4. > Community participation in the decentralised By Maluka et Al

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