Module One
Q1.1: How would you define and explain the purpose of a health system?
Healthcare systems are made up of many components that have a common aim to provide preventative approaches to illnesses and treatment to people inflicted with a disease. These components are Service Delivery, Health Workforce, Leadership and Governance, Financing, Information Technology, Medical Products, Vaccine and Technology. A health system can be organized in different ways, depending on the history, culture, politics, and resources of a country or region, however the components listed above are what is commonly found in most health systems. Due to the several components of a health system, it is a complex system. A complex system comprises many parts, relationships between the variables that describe the sections that are nonlinear and have feedback, but the overall behaviour is unpredictable. A health system can be evaluated by how well it achieves its goal of improving health outcomes, as well as how efficiently, equitably, and responsively it operates.
Q1.2: What is the Hippocratic Corpus and why is it important in the practice of medicine today?
Q1.3: What tools or approaches have you applied in dealing with conflict in team settings?
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Module 2
Q2.1: With reference to theoretical frameworks, what are the different dimensions of quality in health systems?
Maxwell's dimensions of quality are outlined as: Service Accessibility, Relevance, Effectiveness, Equity, Acceptability, Efficiency and Economy.
Quality is crucial for every aspect of the healthcare system. The quality level in one area affects the quality level in other areas. Quality has costs, but the costs of not meeting quality standards can be much higher. Poor quality care can be costly and harmful for patients, institutions and society. Health institutions may face unnecessary tests, overloaded resources and low staff morale. Patients may not follow treatment if they have poor quality and poor experiences. Poor quality can also cause other problems such as wrong diagnosis, ineffective treatment, repeated visits, longer illness or death.
Maxwell discovered the stated Dimensions of Quality, which then constituted the STEEEP framework. These Quality Dimensions serve as benchmarks against which performance is judged, and they advocate for a patient-centred approach to care delivery. The STEEEP framework strives to offer safe, timely, efficient, effective, equitable, and patient-centred treatment. The Donabedian Model likewise offers a patient-centred approach to evaluating care quality. Structure, Process, and Outcome are the three steps. Structure refers to all of the components that influence the setting in which care is provided, including facilities, Human resources, and equipment. It also covers the infrastructure and facilities that enable health care providers to offer care. This can be used to examine how quality influences health care institutions. Process refers to actions that fall under the purview of health care, such as diagnosis, treatment, preventative care, and patient education. The state of patients after obtaining treatment, the healthcare status, behaviour or knowledge, and patient satisfaction are all examples of outcomes. This can be used to assess how quality impacts patients.
Q2.2: What impact did ‘Hospital Medicine’ have on the ways in which medicine in taught and practiced today?
Q2.3: What strategies have you applied in effectively communicating your ideas and providing fair and constructive feedback?
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Module 3
Q3.1: What are the dimensions of data quality?
Data is a collection of facts. There are six dimensions of data quality: accuracy, completeness, consistency, timeliness, validity, and uniqueness. (Sarfin, 2022)
“Data values are as close as possible to real values, All required data values are present, Data values within a column comply with a rule, Data represent the reality from a required point in time, Distinct values appear only once, and Data conforms to the format, type, or range of its definition.” (IBM, 2023)
Q3.2: How have pandemics shaped and influenced health systems in South Africa?
Q3.3: With regards to the criteria that are used to rank the evidence of sources, what factors need to be considered when determining the academic rigour of a source?
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Module 4
Q4.1: How would you briefly describe the policy process?
Policies go through processes before implementation to ensure that resources are not wasted and that it will not fail. The first step of the policy process is agenda setting. Agenda setting is when political and social organizations, community members and experts well-versed on the problem meet and discuss possible solutions. The second step is policy formation. Policy Formation is when governments and stakeholders consult with the relevant actors and are knowledgeable of what was discussed in agenda setting. The third step is policy adoption, which is when a policy is drafted and accepted. In this step stakeholders are able to reject, accept, make changes or implement the policy. The fourth step is Policy implementation. The policy is accepted by the government and stakeholders and resources are allocated to implement the policy. The policy is put into action by the healthcare workforce. The final step is policy evaluation. This is to identify where the policy failed to succeed and why. Policies are monitored, evaluated, and reported on a regular basis to ensure that implementation of the policy is worth the resources and is achieving the intended objectives.
Policies are important and history shows the importance of policy analysis. Policy analysis can prevent policies being made that have detrimental effects in the future. Research Conceptualization cross-cutting content links to the researched information that policies require and how much effort is needed to come up with a solution to a problem that a policy addresses. Especially when there are stakeholders and Institutions involved who have independent opinions.
Q4.2: At the start of South Africa’s democracy, many brilliant policies were created. What are the factors that impacted the poor implementation of many of these policies?
Q4.3: What is the difference between formal research and simply gathering information?
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Module 5
Q5.1: What are the main differences between public health and population health?
Public health is a collective effort from the various interest groups (e.g., individuals, stakeholders, health agencies, etc.) which aims to create and improve the conditions that can help keep populations healthy. Public health is about disease prevention, health promotion, and ensuring safety and health of communities in the external environment. Public Health focuses on the health outcomes of whole populations and not individuals. Public health designs and implements interventions based on sciences such as epidemiology, biostatistics, clinical microbiology and infectious diseases, occupational health and environmental health (To name a few).
Population health is the foundation upon which Public Health is built, population health is studying the circumstance which cause certain determinants of health to be prevalent in communities. Population Health also observes individuals to understand how conditions affect health. Population health traces negative health outcomes in communities to its exposure in order to understand the exposure pathway.
Q5.2: With reference to the concept of informed consent, what are the key ethical concerns that need to be considered when conducting research on vulnerable populations?
Q5.3: What distinguishes quantitative research designs from qualitative research designs?
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Module 6
Q6.1: What are some the main challenges regarding the production and retention of human resources for health in South Africa?
Insufficient stewardship for Health planning across the entire healthcare system; There is no HRH information system to allow for HRH to be integrated, and inadequate or failure in HRH governance (Health Systems Trust, 2018). Provincial departments of health lack the efficiency and skills to manage human health resources. (Health Systems Trust, 2018)
Healthcare workers move to private health organisation or to foreign countries where they may find better pay, working conditions and opportunities to develop skills that allow them to advance in their career.
There is a problem in the education that is provide to students in medical school, it is not standardised or coordinated, thus some medical professionals are not able to work in certain settings such as rural areas.
Q6.2: What are the key ethical arguments surrounding the implementation of NHI?
Q6.3: What do you think is meant by the “quality of research” and what parts of the
research process is it applicable to?
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Module 7
Q7.1: What distinguishes the primary healthcare approach from primary care?
Healthcare services provided by general medical physician and nurses is referred to as Primary Care. Primary care is the care provided when a patient first enters the health system. This care serves to diagnose and treat in its early stages and refer to patient to higher levels of the healthcare system should their health continue to deteriorate. Primary Care is concerned with the prevention of illness and is focused on treating individual patient or families. (Dookie and Singh, 2012)
Primary Health Care (PHC) is a public health care approach that originated from social medicine and aims to address health inequalities. It is a philosophy which promotes health consciousness and through this aims to improve health by meeting the basic needs of individuals. The way primary health care manifest in communities is different, it is all dependent on socioeconomic determinants that are found in said community. PHC is not only concerned with the health of individuals and families but also populations, it is able to do this because communities are the target group for interventions. PHC incorporates social and economic systems into health and healthcare along with principles of equity. (Dookie and Singh, 2012)
Q7.3: How would you describe the COPC process?
Q7.4: What is the difference between health advocacy and activism?
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