Health awareness ppt

good health habits ppt and health & safety ppt and health communication ppt
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Published Date:26-07-2017
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Yoko Akachi Research Fellow Lecture 8: Health Development Economics I, Autumn 2015Objective of today´s lecture • Take a quick look at where we are now in global health • Understand why health is relevant in development economics • Explore a complementary indicator other than GDP per capita to measure progress and wellbeing-the use of heightOutline • Global health and development – Mortality of children under age 5 • Why invest in health? – Relationship between wealth and health • Measuring health and well-being – Economics and human biologyMillennium Development Goals (MDGs) to Sustainable Development Goals (SDGs): the role of health Source: UNChange in child mortality (under age 5) rate between 1990 and 2015 Number of under-5 deaths fell from 13 million in 1990 to Source: WHO 6 million in 2013 globally Trends in the under-5 mortality rate and number of under-5 deaths Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation Lancet 2015, Available online 8 September 2015Development assistance for health by health focus area, 1990-2014 Source: Sources and Focus of Health Development Assistance, 1990–2014 JAMA. 2015;313(23):2359-2368. doi:10.1001/jama.2015.5825Gaps in achieving the MDG targets • This is just MDG 4. Less progress in addressing maternal mortality • Big picture: Links among development, inequality, and health? • Zooming in: – What interventions contributed to reductions in mortality? – How can the aid for health be used more efficiently? Source: WHOWhat key intervention coverage is associated with child mortality? Madagascar Key intervention coverage by region • Constructed a longitudinal, multi-level Antananarivo Antsiranana Fianarantsoa dataset with information on subnational .1 .08 .12 .07 .1 .08 .06 .08 level key intervention coverage and .06 .06 .05 .04 .04 .04 individual child health outcomes 1990 2000 2010 1990 2000 2010 1990 2000 2010 Mahajanga Toamasina Toliary .12 .14 .15 .12 .1 • 75 Demographic and Health Survey .1 .08 .1 .08 .06 (DHS) surveys 1991-2013 .05 .06 .04 1990 2000 2010 1990 2000 2010 1990 2000 2010 e Ya r su r e vy a ws s t r ae t d (mean) bednets3 (mean) bontoilet – DHS Surveys usually 5,000 -30,000 (mean) pipwater (mean) anc (mean) onlymilk (mean) vaccine households, typically conducted (mean) death Graphs by region every 5 years Source: DHS .5 .5 0 1 0 1 .5 .5 0 1 0 1 .5 .5 0 1 0 1• 552,433 child observations across 241 regions in 24 countries •𝐶𝑀=𝛼++𝛾𝐼+𝛿+𝛿+𝘀 𝑖𝑟𝑐𝑡𝑐𝑡𝑖𝑟𝑟𝑐𝑡𝑟𝑐𝑡𝑖𝑟𝑐𝑡 – CM is a binary indicator for whether or not child i from region r in country c and period t has died –𝐼 : intervention coverage variables for the 𝑟𝑐𝑡 respective region –𝛿,𝛿 :region and country-survey-year 𝑟𝑐𝑡 fixed effects Source: DHS, work in progress by –X : vector of individual level controls irct Steenland, Akachi, and Fink 𝛽𝑋Logistic regression models (Odds Adjusted Associations with Fixed Effects: Ratios) Odds ratios and 95% CI 1.106 0.934 1.311 % Bednets coverage 0.902 0.755 1.077 % Piped water coverage 0.627 0.454 0.866 % High quality sanitation coverage 0.780 0.631 0.964 % Full vaccination coverage 0.922 0.702 1.213 % Safe delivery coverage 1.057 0.802 1.392 % Modern contraception 0.754 0.586 0.969 % At least 1 ANC visit coverage 0.083 0.052 0.131 % Breastfeeding 6 months 2.696 0.446 16.291 % PMTCT coverage Adjusted for individual level maternal 5-year age category, maternal education level, urban residence, household electricity, television and radio ownership, in addition to region and country-survey- year fixed effects p.05, p.01, and p.001 Maximum number of iterations limited to 10 in the logistic regression models Source: DHS , work in progress by Steenland, Akachi, and FinkWhy invest in health? • Humanitarian and ethical arguments • Health as a human right • Health as a key to social cohesion and global security – HIV/AIDS, Ebola • Public health investment saves money – Cost of treatment and care • Health as a global public goodLinks among health, income, and poverty • Wealth to health – Increases in income per capita – Improvements in health technology, institutions and infrastructure Economic development could lead to better health of the population, • Health to wealth but the arrow is bidirectional: better – Microeconomic studies (e.g. health contributes to deworming, iron supplements) economic development – Improved health central to poverty reduction • Labor productivity, education, investment, demographic channelsChannels linking health to wealth • Labor productivity channel – A healthier workforce has more energy, better mental health, less absenteeism and thus more productive • Education channel – 1) enhances children´s ability to attend school 2)increase children´s cognitive ability to absorb knowledge and skills 3) provide additional incentives for parents to invest in education due to its high return • Investment channel – Longer life expectancy and increased incentives to save for future consumption needs Bloom and Fink 2013 • Demographic channelDemographic transition • When looking into development, you have to consider population growth rate and age structure • Countries are at various stages of the demographic transition • Countries can experience “demographic dividend” – Demographically driven, time- limited economic boom – e.g. East Asia in 1965-1990 David E. Bloom Science 2011;333:562-569 Published by AAASAge structure of (A) East/Southeast Asia and (B) Sub-Saharan Africa 1950 to 2050 David E. Bloom Science 2011;333:562-569 Published by AAASInvesting in reproductive, maternal, and child health • Barker hypothesis • Childhood health and nutrition can have a Childhood health strongly substantial impact on affect the health status and productivity as an adult both physical and cognitive development, and eventual health status and productivity as an And ultimately determines the health and well-being of the next generation adultInvesting in reproductive, maternal, and child health • Health investments in children and mothers (fetal growth) most important for human capital • Inter-generational effect (e.g. under nutrition of girls that become mothers affecting their children of either sexes (Sen and Osmani 2003)) • Investing in health of mothers and children means investing in the country’s economy and futureMeasuring progress and well-being • Real GNP or GDP per capita measured in USD • Real GDP or GDP per capita in international dollars i.e. Purchasing Power Parity (PPP) dollar estimates Commonly • Combined socio-economic and Complements? used political indicators measures • Life expectancy and mortality • Human Development Index (UNDP, 2004) Komlos and Snowden 2005Why is it difficult to measure progress and well-being? • Multidimensional nature of human experience – e.g. See Measuring poverty and Global Multidimensional Poverty Index from Túlio and Jukka´s slides from the past session • Conventional commodity-based indicators such as GDP per capita are imperfect-in fact all indicators are imperfect • Considering alternative and complementary perspectives can gain a fuller insight (Komlos and Snowden 2005)

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