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Short case study Intro to determinants of health Based on work of Amartya Sen - Development as Freedom
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The Prime MinisterialConsultation(a case study)(a case study)(a case study)
University of Waterloo, September 2009
John Hoey [email protected]
slideshare.net/hoeyj
All resemblances to a particular person or country are entirely coincidental
The Prime Minister is preparing his last days in office prior to calling an election.
Although critics claim that what follows is a obvious gambit to gain votes in more liberal parts of the country, the PM insistshis actions are entirely humanitarian.
He has proposed that his country, for the first time in its short history meet international targets for humanitarian aid.
At present his country donates 0.4% of GDP for humanitarian external aid.
This is far from the agreed international target of 0.7%. And, most of his countries humanitarian aid is ‘targeted’.
Thus, for example, the ‘gift’ of 100,00 lawnmowers from a manufacturer in Brockville, (name of country) to Nomadic tribes in the Gobi desert.
The PM Proposes to contribute 0.7% of GDP for humanitarian aid, all of it untargeted.
He wants the aid to be obvious. A condition is that it be restricted to 3 countries, those in most need.
He has asked an expert group to make a proposal on where to direct the aid.
The expert group has submitted the proposal.
The PM asks for your opinion on the countries selected. “Which ones should get the cash?” he says.
You are a recent graduate from the University of Waterloo MPH program doing a summer internship at the office of the PM.
He has asked an expert group to make a proposal on where to direct the aid.
The expert group has submitted the proposal.
The PM asks for your opinion on the countries selected. “Which ones should get the cash?” he says.
You are a recent graduate from the University of Waterloo MPH program doing a summer internship at the office of the PM.
Humanitarian Aid Calgary Group Proposal to PM
Crude*
*Crude Oil Deposits in trillions of barrels - Needing Development
*Crude Oil Deposits in trillions of barrels - Needing Development
Which countries would you choose?How would you choose?
Which countries would you choose?How would you choose?
80
60
40
20
GDP/Capita
80
60
40
20
GDP/Capita Life Expectancy
Amartya Sen Development as Freedom, Random House, New York, 1999
Amartya Sen Development as Freedom, Random House, New York, 1999
Health ~ factors that influence well-being
Medical Care
Economy
Environment
Expertise
Food, housing
Physical Social
Health
Accesibility
Justice
Jobs Credit
Genetics
Neighbourhoods
LawSecurity
Culture School
We might have discussed - perhaps we did:
Criteria for decision making in health
1. What tools are available?National health/death statisticsHealth survey dataetc..
2. Measures of efficacy/effectiveness of programsMultiple outcomes/competing or synergistic?
3. Cost effectiveness 4. Feasibility5. Political risk/benefit6. Sustainability7. Models for program development and evaluation
Some reference material
Amartya Sen Development as Freedom, Random House, New York, 1999
Shepperd S. et al. Can we systematically review complex medical interventions? PLoS Med 6(8): e1000086. doi:10.1371/journal.pmed.1000086