Week 12:
Core Domain: Health Policy
❏ How do policies come into existence? Who develops them? Whose interests do they represent? What factors influence the types of policies that come into existence in your home and family?
Formal public policy, as developed by governments, is intended to influence the many actors working within a sector or system and the procedures and processes built into it, in ways that guide them to work together to achieve common goals and purposes. In general, public policies seek to generate ‘public value’; that is, they seek to produce things of value to the public at large in any country and to build public institutions, such as hospitals and clinics, that operate in ways that the public judges as fair and accountable.
The policy process is a highly dynamic, interrelated and contextually sensitive one, which absorbs a wide variety of influences, including, social, political, economic, environmental, industrial and other factors. This is often a fluid process, as policy-makers respond to the multifaceted nature of demands.
The values that my family holds factors into the types of policies that come into existence.
❏ Why is there often a gap between the intentions of policy and practice?
As a result of the multifaceted and complex nature of the policy process, the gaps between policy intentions and practice remain a pertinent concern. As contexts, priorities, research methods and population needs are continuously evolving, the ability to learn, adapt and provide evidenced-based approaches to governance and leadership is paramount to the proposals of Health Policy and Systems Research (HPSR).
❏ What role does research play in informing policy making decisions?
Health policy and systems research has evolved considerably over the past two decades, where its sphere of influence has broadened and become more complex. However, its central focus remains to inform and influence health policies and systems, to pursue health goals, with the objectives of equity and quality improvements (Peters, 2018). Health policy and systems-based research, therefore, focus their efforts on a number of factors, including:
Research focused on health services as well as the promotion of health.
Concerns for global and international issues as the promotion of health.
Research on or of policy which addresses the politics of health systems and health systems services.
Promotes work that explicitly seeks to influence policy.
Competency: Research
❏ What do you think the difference between formal research and simply gathering information is?
Formal research is to gather information in order to present it or make an argument. Simply gathering information is for knowledge is for discussions and explanatory purposes. Compared to the informal gathering of information you do daily, formal research concerns many people, processes and systems. In general, all formal research contributes to our collective knowledge and is used and applied practically to find, design and implement solutions.
❏ What role does research play in addressing real- world problems?
Research is essentially the process of asking questions and finding answers in pursuit of creating knowledge. When knowledge is acquired then problems can be solved.
❏ What is the relationship between epistemology and ontology in research paradigms?
Ontology asks what is reality and how do we know it's real. Epistemology asks what counts as knowledge.
History of Medicine
❏ What do you understand by the term social-structural violence?
Social-Structural Violence is when the is unrest with government entities, or who ever is in charge, which results in violence from the community in order to bring about change.
❏ Which indicators should we use to show health disparities between different population groups?
Indicators related to health.
Week 13:
Core Domain: Health Policy
❏ How are new policies formed?
For policies to be formed, there needs to be a public concern or a set of problems to address.
❏ Who should be involved in creating new policies?
The problems that any policy seeks to address often requires on-going engagement with stakeholders affected by the problem. Stakeholders such as health researchers, social scientists, healthcare workforce, and organisations such as WHO, NICD, CDC, DOH etc. can inform policy formation.
❏ What factors should be taken into account when implementing a new policy?
Public policy formulation commences after a complete agenda has been established and due consultative processes have been followed, where governments and other relevant agencies have consulted with the identified actors and acquired all the necessary information. In this phase, solutions to the problem are shaped through engagement with the different stakeholders. Stakeholders such as health researchers, social scientists, healthcare workforce, and organisations such as WHO, NICD, CDC, DOH etc. can inform policy formation.
Competency: Research
❏ Why do you think that using a technique to focus your research and research writing is recommended?
Research writing should always start with a clear research focus. However, for research to be focused, it needs to be well conceptualised. This conceptualisation involves creating a suitable research problem and selecting an appropriate research methodology and conceptual framework.
❏ What do you think is the best approach for asking and receiving feedback on any piece of research writing?
Having it peer reviewed by multiple people.
❏ Would you approach how you collaborate remotely as a team differently for this presentation report after your experiences in the previous module?
No
History of Medicine
❏ The Bill of Rights in the Constitution of South Africa talks about the progressive realization of the right to access health. What does it mean to progressive realize a right?
That the change is happening but at a slow and steady pace.
❏ At the start of South Africa’s democracy, many brilliant policies were created. What factors led to the poor implementation of many of these policies?
The destructive policies by the apartheid system for decades makes problems very complex to solve along with the HIV/AIDS epidemic means that good polices were poorly implemented
❏ What role did the Constitution of South Africa play in the fight for Antiretroviral Therapy in South Africa?
The Treatment Action Campaign (TAC) emerged from this crisis. Along with several leading HIV doctors, including Dr Ashraf Coovadia, the TAC brought a class-action lawsuit against the government’s position. This was heard by the Constitutional Court, the highest court in South Africa. When the Constitutional Court case was won in 2002, in favour of access to antiretroviral treatment, healthcare professionals responded with alacrity. At this point, a new era of health activism is born.
Week 14:
Core Domain: Health Policy
❏ How can policies support health systems to generate specific outputs and outcomes?
Policy analysis is a useful process that helps policy-makers and analysts identify possible policy solutions to problems or unintended consequences that emerge through the development and implementation of policies. In doing so, decision-makers are able to compare different possible solutions and choose the most cost-effective, efficient, and feasible one.
❏ When a policy is implemented, but shows no improvement, what steps can be taken?
A new policy will with solutions t the problems that made the first policy fail.
❏ What are the biggest challenges facing the successful implementation of policies in South African healthcare systems today?
Fragmentation, lack of human resources and finances.
Competency: Research
❏ Are you managing to collaborate remotely as a team more efficiently compared to the previous module?
Yes.
❏ What strategies are you and your team implementing to ensure the successful completion of your Group Report 1?
Meting up regularly for at least 2 hours and dividing the work.
History of Medicine
❏ Do you feel the District Health Systems works well in South Africa?
No, the system is ineffective and inefficient.
❏ What impact has the HIV pandemic had on the health systems, both positive and negative?
HIV/AIDS prevents progress towards a more equitable health system because it demands a lot of resources to address. It also helped make it necessary for life saving medicines to be freely available from the government meaning it helped the creation of the district health system.
❏ What lesson can we learn from the history of health systems in South Africa in preparation for National Health Insurance?
The health system should focus those who are discriminated the most and experience inequality the most.
Overall Module Reflection:
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