TERM PAPER ON VALIDITY, PRECISION, ACCURACY,

BASIC ERRORS AND COMMON BIAS IN EPIDEMIOLOGICAL

STUDY

DEPARTMENT OF

BY:- ALEMTSAHAY UGASA

ID;-

March 10,2023

i
Table of Contents
Health Care Systems....................................................................................................................................1
Introduction.............................................................................................................................................1
Health System Models.................................................................................................................................1
Components of Health care Systems...........................................................................................................3
General Strategies.......................................................................................................................................4
Reference....................................................................................................................................................5

ii
Health Care Systems
Introduction
According to the World Health Organization a health system consists of all organizations, people
and actions whose primary intent is to promote, restore or maintain health. This includes efforts
to influence determinants of health as well as more direct activities that improve health. A health
system is, therefore, more than the pyramid of publicly owned facilities that deliver personal
health services but include the institutions, people and resources involved in delivering health
care to individuals.

A well-functioning health system working in harmony is built on having trained and motivated
health workers, a well-maintained infrastructure, and a reliable supply of medicines and
technologies, backed by adequate funding, strong health plans and evidence-based policies.
Health Care Systems differ from nation to nation depending upon the level of economic
development and the political system in place. Health care is a priority and source of concern
worldwide. Every country irrespective of its private, public or mixed health care system faces
challenges with regard to quality, delivery and cost of services.

Health System Models

While globally each country has some variation in their health care systems, overall they tend to
follow general patterns with four main models forming the basis for most health care systems
globally;

1. The Beveridge Model

Like other public services such as the police or education systems, this model of health care is
both provided and financed by the government through tax payments. In this system, healthcare
facilities can be owned by the Government, but may also be privately owned with Government
funding, with the majority of health staff in this model composed of government employees.

These systems tend to have low costs per capita, because the government, as the sole payer,
controls what healthcare providers can do and what they can charge with benefits generally
standardized across the country.

1
The primary criticism of this system is the tendency toward long waiting lists with everyone
guaranteed access to health services, often leading to over-utilization and the risk of increasing
costs.

2. The Bismarck Model

It is a health insurance plan that in principle must include all citizens, and is non-profit in nature,
although in practice tends to be available only to the working population with the allocation of
resources to those who contribute financially, so as such does not provide universal health
coverage. It is predominantly funded jointly by employers and employees through payroll
deductions.
Generally, it is a mixed model health system that incorporates a mix of private and public
providers and allows more flexible spending on healthcare. Providers and hospitals are generally
private, while insurers are generally public.

The primary criticism of the Bismarck model is how to provide care for those who are unable to
work or can't afford contributions, including ageing populations and the imbalance between
retirees and employees.

3. The National Health Insurance Model

This system combines elements of both the Beveridge and Bismarck Models of Healthcare.
Generally, funding comes from a government run insurance program that every citizen pays into,
as we see in the Beveridge Model, but it predominantly uses private sector providers.
This model provides universal insurance that doesn't make a profit or deny claims and as such
with no requirement for marketing, no financial motive to deny claims and no profit, these
universal insurance programs tend to be cheaper and much simpler administratively than For-
Profit or Private Insurance Models.
4. The Private Model
Disparities in health care due to socioeconomic status and ethnicity are found in all countries.
Currently, there are a limited number of countries globally that have established national health
care systems, with the majority of countries providing ad hoc national medical care, which is
provided on a private or pay for treatment basis.
This typically means that those with access to money get access to health care, while those that
do not have money do not have health care access. In many isolated or rural regions of the world,

2
hundreds of millions of people can go their whole lives without ever accessing health care
services.

Components of Health care Systems

The World Health Organization recommends supporting and strengthening a health system based
on the below framework. When you strengthen a health system, you improve the six health
system building blocks and manage their interactions in ways that achieve more equitable and
sustained improvements across health services and health outcomes.

PEOPLE are often listed as the seventh building block. “People” refers to individuals,
households, and communities as civil society, consumers, patients, payers, and producers of
health through knowledge, attitudes, behaviors, and practices.

Strengthening a health system takes a long time. Efforts must be tailored to a specific country.
Donors must be coordinated. Everyone involved must be committed to a longterm process. Here
is a basic checklist for what to think about when you analyze the building blocks and plan to
strengthen them in your own country:

 Service Delivery. Good service delivery comprises quality, access, safety and coverage.
 Health Workforce. A well-performing workforce consists of human resources
management, skills and policies.
 Health Information System. A well performing system ensures the production,
analysis, dissemination and use of timely and reliable information.

3
  Medical Products. Procurement and supply programs need to ensure equitable access,
assured quality and cost-effective use.
 Financing. A good health financing system raises adequate funds for health, protects
people from financial catastrophe, allocates resources, and purchases good and services
in ways that improve quality, equity, and efficiency.
 Leadership and Governance. Effective leadership and governance ensures the
existence of strategic policy frameworks, effective oversight and coalitionbuilding,
provision of appropriate incentives, and attention to system design, and accountability.

In Ethiopia the Government has formulated a twenty year health sector development strategy,
which will be implemented through a series of five year investment program.

General Strategies
I. Democratization and decentralization of the health service system.
II. Development of preventive, promotive, curative and rehabilitation services.
III. Development an equitable and acceptable standard of health service system that will
reach all segments of the population within the existing limited resources
IV. Enhancing political will and commitment to put health as one of the top government
agenda - Reorienting the health service delivery system.
V. Promoting and strengthening multisectoral collaboration and networking with all
concerned sectors

4
Reference
1. Gharanfoli, Sepehr Kemal, Kevin Self-Leadership, a universal or situational concept? A two-
sided perspective between International banks and IT companies - from employees’ point of view
,2021
2. Personality and self-leadership Article  in  Human Resource Management Review · June 1997
DOI: 10.1016/S1053-4822(97)90020-6
3. Overview of System Analysis & Design Author : Dr. Jawahar Vetter: Prof. Dharminder Kumar