Health Systems Context

Institutional Arrangement for Completion of Economics Trends Analysis Multisectoral /Intertersectoral Approach with wide country representation. Multisectoral /Intertersectoral Approach with wide country representation. Focal Points – Dep. of Planning / Statistics/Health Focal Points – Dep. of Planning / Statistics/Health –Sensitization –Terms of reference and implementation plans –Core Team with technical working group (Health,Statistics, Economics, Epidemiologist) –Working with Facilitators –PAHO –Capitalization on opportunities for In-country interdepartmental communication / collaboration for information sharing

Economic Situation: Poverty and Employment Opportunity to establish or strength health accounts Opportunity to establish or strength health accounts Standardized methodology in evaluating poverty? Standardized methodology in evaluating poverty? What are indicators for “relative poverty”? What are indicators for “relative poverty”? Ensure standardized definitions and indicators Ensure standardized definitions and indicators Ethnic grouping needs to be contextualized Ethnic grouping needs to be contextualized Indicators for table 8 needs to be more clearly defined i.e. formal vs. informal employment and extreme vs. relative poverty Indicators for table 8 needs to be more clearly defined i.e. formal vs. informal employment and extreme vs. relative poverty Usage of data for action must be the objective Usage of data for action must be the objective Limitations in ability to conduct trends analysis Limitations in ability to conduct trends analysis

Social Indicators Clarify crude rate of primary schooling (enrollment /completion) Clarify crude rate of primary schooling (enrollment /completion) Clarify school dropout level (primary school, high school etc) Clarify school dropout level (primary school, high school etc) Prevalence of Depression - limitations in data collection in some countries (persons seek care in private sector) but this is needed and efforts should be made to collect the data e.g. establishment of surveillance system. Prevalence of Depression - limitations in data collection in some countries (persons seek care in private sector) but this is needed and efforts should be made to collect the data e.g. establishment of surveillance system. Limitation of access to some population groups e.g. illegal immigrants whose social conditions have significant impact on health. Limitation of access to some population groups e.g. illegal immigrants whose social conditions have significant impact on health.

Social Health Determinants Constraints Constraints –Lack of Technical skills for impact analysis –Lack of M&E systems Enabling Environment Enabling Environment –Technical commitment –Need for political will –Civic demands (population / media) and positive pressure on the health system will enable data collection –Networking: »Media, interest groups, RHIs and other sectors, knowledge sharing