Topic outline
General
UutisetForum
SUBMIT YOUR LEARNING DIARY FOR MODULE 1-3 HERE
Learning diary definition below:
A learning diary is a piece of writing that presents the content of the lectures as well as your own interpretation and questions. A learning diary is not the same as your raw lecture notes. Lecture notes should, however, be used as the backbone of your diary to help you determine the key issues and questions in a particular context. From your learning diary, the teacher will be able to see whether the main arguments of the lectures have “gotten across.” A learning diary helps you become more conscious of the learning process: facts are given a more comprehensive examination, conclusions are drawn, and reasoning methods are developed. In writing your learning diary, you can also refer to scientific texts outside the lectures to support your arguments. During the lectures you should mark key points in your lecture notes while writing down remarks and questions that should be processed further in the learning diary.
Course assignment/learning diaries here
Welcome to the course - practical information
Hello all!
A very warm welcome to this course, brought to you through Asianet, with University of Turku, University of Tampere, with Engage Korea and our wonderful partners from Fudan University, China and RD Gardi Medical College, India and University of the Philippines.
Please note that not all the lectures are uploaded at the start of the course... They will come! However, I wanted to use this opportunity to emphasise that you should try to take your time with the content. Learning does not happen in a second, it takes time to learn, integrate and connect your learning to previous learning. You have until May 11 to complete these different sessions - about a day a week learning is expected from you. You can do this quicker or slower, as long as you submit your final assignment on 11th May. I will check submissions on 12th May at 08:00.
Before we start, please view this video to get acquainted with the sustainable development goals. After the millennium development goals, which were criticised for disease specific and working in vertical systems, silos, without sufficient interconnections, the UN came up with these. Health, equity, and gender are major themes within these goals, and they are integrally related to what we're going to be discussing during this course.
Another absolutely key reading is the attached reprint of Michael Marmot's social determinants of health - a publication from 1999 but still relevant today (see the attached). Please keep its contents in mind while going through the lectures and readings.
Please note that for practical matters the lecture videos on Obesity in China and all lecture videos on North Korea can be accessed via the Moodle e-learning platform of the University of Turku. You will find the relevant links to the UTU Moodle pages under the respective sections. In case you encounter any technical difficulties in accessing the Moodle platform, you can directly contact sabine.burghart@utu.fi.
Please don't hesitate to contact me if you have questions!
Salla - salla.atkins@tuni.fi
Syllabus and assessmentPage
Welcome! Watch this first!"File
Marmot: Social determinants of healthFile
Asianet course descriptionFile
Module 1: Public health challenges
This module focuses on key public health challenges in the Asian region, with examples from different countries.
It's important to remember that while we discuss Asia as a region, each country has a different context. Population demographics, politics, infrastructure, health system and distribution of health staff all differ from country to country, and within country.
This course can therefore highlight examples from different settings, to start you thinking about these issues - but cannot claim to be an exhaustive resource of pure truth.
As an interesting tool to use when thinking about the global issues of health, and particular countries, have a look at Gapminder. This interactive tool: https://www.gapminder.org/tools/#$chart-type=bubbles
That resource gives you an opportunity to think and play around with country incomes, different health conditions and the environment, and even compare two different countries for their outcomes! It's not formally part of the course, but if you're interested in this field it has its uses. Gapminder also has a number of other different tools - including dollar street and the gapminder test - that allow you to explore the world - and look at how we might have misconceptions about it.
For the formal content, the first lecture is presented by me, introducing you to health systems, what they are and key issues to consider. In the second lecture we get introduced to maternal and child health in China. The third then gives you a taste of the optional fourth module, by discussing public health and health systems in North Korea (UTU Moodle). In the last lecture for this module we focus then on a particular public health issue, obesity, and its effects and prevalence in China.
UPDATE 11/3/2019 - Dale brought up a very important issue on the use of traditional healing and traditional healthcare's relationship to UHC. For this, I wanted to include this suggested reading on UHC, Asia and traditional healthcare services.
Module 1 discussion forum
Integrating traditional and complementary servicesFile
1.1. Overview of health and health systems in Asia: Associate professor Salla Atkins
The countries that encompass Asia are varied in demographics, in economies, histories, geographies and also health systems.
While it is not possible to enumerate and lump together all Asian countries into one, this presentation attempts to highlight trends that can be seen in the Asian/Pacific region. The lecture will also introduce central concepts that you can use later in the course.
Readings:
Balabanova, D., McKee, M., & Mills, A. (Eds.). (2011). ‘ Good health at low cost ’ 25 years on: What makes a successful health system? London: London School of Hygiene and Tropical Medicine. (Read chapter 6,8 and 9, rest if you want to!)
Bloom, G. (2019). Service Delivery Transformation for UHC in Asia and the Pacific. Health Systems & Reform, 5(1), 7–17. https://doi.org/10.1080/23288604.2018.1541498
UHC 2030 International Health Partnership. (2017). Healthy systems for universal health coverage -a joint vision for healthy lives. International Health Partnership, 1–28. Retrieved from https://www.uhc2030.org/fileadmin/uploads/uhc2030/Documents/About_UHC2030/mgt_arrangemts___docs/UHC2030_Official_documents/UHC2030_vision_paper_WEB2.pdf
Bloom service deliveryFile
HSS for UHCFile
Atkins - health systems and healthFile
Balabanova et alFile
1.2. Maternal and child health in China, Associate professor Jiang Hong
China is one of the countries progressed considerably in relation to the millennium development goals in 2015. The country has, still, some work to be done in ensuring equity for expectant mothers particularly in rural, hard-to-reach areas. This lecture introduces you to key issues in maternal and child health in China.
The lecture is posted on the Tampere University server. When clicking the link below, you will encounter a page that is completely in Finnish.
Enter the password in this section on the page:
And click the button "lähetä".
You can access the lecture from the Tampere server here:
https://moniviestin.uta.fi/videot/yhteiskuntatieteiden-tiedekunta/terveystiede/kurssit-2018/china-national-safe-motherhood-program
The password is safemo18. Please don't share this password further.
Required readings (two optional pdfs also appended below):
1. Victora CG, Requejo JH, Barros AJD, Berman P, Bhutta Z, Boerma T, et al. Countdown to 2015: A decade of tracking progress for maternal, newborn, and child survival. Lancet. 2016;387(10032):2049–59.
2. Veitch K. Medical law and the power of life and death. Int J Law Context. 2006;2(2):137–57.
3. National Health and Family Planning Commission C. Success Factors for Women ’ s and Children ’ s Health National Health and Family Planning Commission , China. Geneva; 2015.
4. The world health organization. World Health statistics 2016: monitoring health for the SDGs. Geneva; 2016. (Read chapters 4 and 5)
Jiang et al universal accessFile
Country policy reportsFile
Countrdown to 2015File
World health statisticsFile
MDGs to SDGsFile
1.3. Public health & health systems in North Korea, Dr. John Grundy
Dr. John Grundy, Adjunct Research Fellow at the Department of Public Health and Tropical Medicine of James Cook University Australia.
General
SUBMIT YOUR LEARNING DIARY FOR MODULE 1-3 HERE
Learning diary definition below:
A learning diary is a piece of writing that presents the content of the lectures as well as your own interpretation and questions. A learning diary is not the same as your raw lecture notes. Lecture notes should, however, be used as the backbone of your diary to help you determine the key issues and questions in a particular context. From your learning diary, the teacher will be able to see whether the main arguments of the lectures have “gotten across.” A learning diary helps you become more conscious of the learning process: facts are given a more comprehensive examination, conclusions are drawn, and reasoning methods are developed. In writing your learning diary, you can also refer to scientific texts outside the lectures to support your arguments. During the lectures you should mark key points in your lecture notes while writing down remarks and questions that should be processed further in the learning diary.
Welcome to the course - practical information
Hello all!
A very warm welcome to this course, brought to you through Asianet, with University of Turku, University of Tampere, with Engage Korea and our wonderful partners from Fudan University, China and RD Gardi Medical College, India and University of the Philippines.
Please note that not all the lectures are uploaded at the start of the course... They will come! However, I wanted to use this opportunity to emphasise that you should try to take your time with the content. Learning does not happen in a second, it takes time to learn, integrate and connect your learning to previous learning. You have until May 11 to complete these different sessions - about a day a week learning is expected from you. You can do this quicker or slower, as long as you submit your final assignment on 11th May. I will check submissions on 12th May at 08:00.
Before we start, please view this video to get acquainted with the sustainable development goals. After the millennium development goals, which were criticised for disease specific and working in vertical systems, silos, without sufficient interconnections, the UN came up with these. Health, equity, and gender are major themes within these goals, and they are integrally related to what we're going to be discussing during this course.
Another absolutely key reading is the attached reprint of Michael Marmot's social determinants of health - a publication from 1999 but still relevant today (see the attached). Please keep its contents in mind while going through the lectures and readings.
Please note that for practical matters the lecture videos on Obesity in China and all lecture videos on North Korea can be accessed via the Moodle e-learning platform of the University of Turku. You will find the relevant links to the UTU Moodle pages under the respective sections. In case you encounter any technical difficulties in accessing the Moodle platform, you can directly contact sabine.burghart@utu.fi.
Please don't hesitate to contact me if you have questions!
Salla - salla.atkins@tuni.fi
Module 1: Public health challenges
This module focuses on key public health challenges in the Asian region, with examples from different countries.
It's important to remember that while we discuss Asia as a region, each country has a different context. Population demographics, politics, infrastructure, health system and distribution of health staff all differ from country to country, and within country.
This course can therefore highlight examples from different settings, to start you thinking about these issues - but cannot claim to be an exhaustive resource of pure truth.
As an interesting tool to use when thinking about the global issues of health, and particular countries, have a look at Gapminder. This interactive tool: https://www.gapminder.org/tools/#$chart-type=bubbles
That resource gives you an opportunity to think and play around with country incomes, different health conditions and the environment, and even compare two different countries for their outcomes! It's not formally part of the course, but if you're interested in this field it has its uses. Gapminder also has a number of other different tools - including dollar street and the gapminder test - that allow you to explore the world - and look at how we might have misconceptions about it.
For the formal content, the first lecture is presented by me, introducing you to health systems, what they are and key issues to consider. In the second lecture we get introduced to maternal and child health in China. The third then gives you a taste of the optional fourth module, by discussing public health and health systems in North Korea (UTU Moodle). In the last lecture for this module we focus then on a particular public health issue, obesity, and its effects and prevalence in China.
UPDATE 11/3/2019 - Dale brought up a very important issue on the use of traditional healing and traditional healthcare's relationship to UHC. For this, I wanted to include this suggested reading on UHC, Asia and traditional healthcare services.
1.1. Overview of health and health systems in Asia: Associate professor Salla Atkins
The countries that encompass Asia are varied in demographics, in economies, histories, geographies and also health systems.
While it is not possible to enumerate and lump together all Asian countries into one, this presentation attempts to highlight trends that can be seen in the Asian/Pacific region. The lecture will also introduce central concepts that you can use later in the course.
Readings:
Balabanova, D., McKee, M., & Mills, A. (Eds.). (2011). ‘ Good health at low cost ’ 25 years on: What makes a successful health system? London: London School of Hygiene and Tropical Medicine. (Read chapter 6,8 and 9, rest if you want to!)
Bloom, G. (2019). Service Delivery Transformation for UHC in Asia and the Pacific. Health Systems & Reform, 5(1), 7–17. https://doi.org/10.1080/23288604.2018.1541498
UHC 2030 International Health Partnership. (2017). Healthy systems for universal health coverage -a joint vision for healthy lives. International Health Partnership, 1–28. Retrieved from https://www.uhc2030.org/fileadmin/uploads/uhc2030/Documents/About_UHC2030/mgt_arrangemts___docs/UHC2030_Official_documents/UHC2030_vision_paper_WEB2.pdf
1.2. Maternal and child health in China, Associate professor Jiang Hong
China is one of the countries progressed considerably in relation to the millennium development goals in 2015. The country has, still, some work to be done in ensuring equity for expectant mothers particularly in rural, hard-to-reach areas. This lecture introduces you to key issues in maternal and child health in China.
The lecture is posted on the Tampere University server. When clicking the link below, you will encounter a page that is completely in Finnish.
Enter the password in this section on the page:
And click the button "lähetä".
You can access the lecture from the Tampere server here:
https://moniviestin.uta.fi/videot/yhteiskuntatieteiden-tiedekunta/terveystiede/kurssit-2018/china-national-safe-motherhood-program
The password is safemo18. Please don't share this password further.
Required readings (two optional pdfs also appended below):
1. Victora CG, Requejo JH, Barros AJD, Berman P, Bhutta Z, Boerma T, et al. Countdown to 2015: A decade of tracking progress for maternal, newborn, and child survival. Lancet. 2016;387(10032):2049–59.
2. Veitch K. Medical law and the power of life and death. Int J Law Context. 2006;2(2):137–57.
3. National Health and Family Planning Commission C. Success Factors for Women ’ s and Children ’ s Health National Health and Family Planning Commission , China. Geneva; 2015.
4. The world health organization. World Health statistics 2016: monitoring health for the SDGs. Geneva; 2016. (Read chapters 4 and 5)
1.3. Public health & health systems in North Korea, Dr. John Grundy
Dr. John Grundy, Adjunct Research Fellow at the Department of Public Health and Tropical Medicine of James Cook University Australia.
Professor Grundy has been visiting the DPRK regularly since the mid-2000s and he is an internationally renowned expert on, among others, public health in North Korea and the country's public health system.
**This lecture video can be accessed via the Moodle e-learning platform of the University of Turku. Go to the UTU Moodle page https://moodle.utu.fi/course/view.php?id=15882. Log in via "External or Norssi account" in the right bottom corner (course key: NKhealth319).
Required readings:
John Grundy History, International Relations, and Public Health - The Case of The Democratic People’s Republic Of Korea 1953 – 2015 (North Korea) Korea’s Economy Vol. 31 2017 http://keia.org/sites/default/files/publications/koreaseconomy_ch8_history_international_relations.pdf
**This lecture video can be accessed via the Moodle e-learning platform of the University of Turku. Go to the UTU Moodle page https://moodle.utu.fi/course/view.php?id=15882. Log in via "External or Norssi account" in the right bottom corner (course key: NKhealth319).
Required readings:
John Grundy History, International Relations, and Public Health - The Case of The Democratic People’s Republic Of Korea 1953 – 2015 (North Korea) Korea’s Economy Vol. 31 2017 http://keia.org/sites/default/files/publications/koreaseconomy_ch8_history_international_relations.pdf
J Grundy, D Hipgrave, B A Biggs, Public health and international partnerships in the Democratic People's Republic of Korea PLOS Medicine. 2015 Published: December 29, 2015DOI: 10.1371/journal.pmed.1001929 http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001929
J Grundy, P Annear, K Bowen, BA Biggs The Responsibility to Protect: Inequities in international aid flows to Myanmar and the Democratic People’s Republic of Korea and their impact on maternal and child health Asia Studies Review May 2012 http://www.tandfonline.com/doi/abs/10.1080/10357823.2012.685449#.VPKFQ_mSwko
Grundy J, Moodie R, “An Approach to Health System Strengthening in the Democratic Peoples Republic of Korea (North Korea)” International Journal of Health Planning and Management 2008; 23: 1–17
1.4. Obesity in China - university lecturer Outi Luova
The video lectures of this section can be accessed via UTU Moodle here:
https://moodle.utu.fi/course/view.php?id=15978.
The lectures were recorded in 2013 but the contents are still valid. The information about the current situation is provided by recent articles which you also find on the UTU Moodle page.
The first lecture “Obesity Crisis in China” is obligatory material, and the second lecture “Food safety in China” is optional.
When logging in UTU Moodle, use the "Log in as a guest" option in the right bottom corner.
Course key: China
Module 2: Health systems and human resources for health
Health systems cannot function without human resources. This module introduces both concepts - continuing on the theme of health systems with examples from China and India, and then zeroing in on human resource challenges and medical education. Human resources for health are one of the key building blocks of health systems. Without human resources, many of the health interventions we have today, from health promotion and prevention to more complicated surgery, would not happen. The WHO introduced a workforce strategy of 2030 in 2016 - you can watch their promotional video here (if you have access to youtube): . Hopefully this makes you think about how important it is to have equitable access to skilled health professionals.
Yet, human resources are inequitably distributed globally - with high income countries having the lion share of human resources, and drawing human resources from lower income countries. Within countries this inequity gets re-emphasised, with most trained skilled health personnel opting for cities instead of rural areas; private sector healthcare instead of public sector healthcare; externally funded disease programmes, and so on.
This module introduces health systems in China and India, followed by more specific case examples of human resources for health. After all, health systems don't function without appropriate human resources.
Lecture 1 focuses on the health system in China. While the lecture discusses the Chinese health system, it introduces you to issues that you should consider when looking at other countries' health systems.
Lecture 2 focuses on the Indian health system - use this opportunity to compare with China. How do these differ? What other information do you need to compare?
Lecture 3 discusses engaging the Democratic Republic of North Korea in medical education
Lecture 4 focuses on human resources in India: specifically informal providers. The idea of this presentation is to give a contextual example of health system challenges and their interrelatedness - and their eventual impacts on people who use the health systems.
2.1 Health System in China
This section of your course is presented by Dr Yang from Fudan University, China. He presents the different facets of the Chinese health system, discussing key successes and challenges.
China is one of the most populous countries in the world a country that has experienced extremely rapid development over the past few decades. Yet in the news we see nearly daily threats to population health, including air pollution.
Required readings:
1. Xiao, Y., Husain, L., & Bloom, G. (2018). Evaluation and learning in complex, rapidly changing health systems: China’s management of health sector reform. Globalization and Health, 14(1), 112. https://doi.org/10.1186/s12992-018-0429-7
2. Patel, V., Xiao, S., Chen, H., Hanna, F., Jotheeswaran, A. T., Luo, D., … Saxena, S. (2016). The magnitude of and health system responses to the mental health treatment gap in adults in India and China. The Lancet, 388(10063), 3074–3084. https://doi.org/10.1016/S0140-6736(16)00160-4
Optional readings:
1. Meng, Q., Fang, H., Liu, X., Yuan, B., & Xu, J. (2015). Consolidating the social health insurance schemes in China: towards an equitable and efficient health system. The Lancet, 386(10002), 1484–1492. https://doi.org/10.1016/S0140-6736(15)00342-6
2. Hanson, K., Fu, Y., Hu, D., Zhang, M., Liu, X., Martinez-Alvarez, M., … Zhu, W. (2017). Development of village doctors in China: financial compensation and health system support. International Journal for Equity in Health, 16(1), 1–7. https://doi.org/10.1186/s12939-016-0505-7
2.2. Health system in India, Associate professor Vishal Diwan
This lecture presents an overview of health systems in India. Please use the readings below to familiarise more with the Indian situation - a large nation with a large number of states.
The last paper is through a link, it should be accessible to all.
So far, I believe all of the papers are open access, so I've appended them here.
Readings:
1. Dandona, L., Dandona, R., Kumar, G. A., Shukla, D. K., Paul, V. K., Balakrishnan, K., … Swaminathan, S. (2017). Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study. The Lancet, 390(10111), 2437–2460. https://doi.org/10.1016/S0140-6736(17)32804-0
2. Patel, V., Parikh, R., Nandraj, S., Balasubramaniam, P., Narayan, K., Paul, V. K., … Reddy, K. S. (2015). Assuring health coverage for all in India. The Lancet, 386(10011), 2422–2435. https://doi.org/10.1016/S0140-6736(15)00955-1
3. Reddy, K. S., Patel, V., Jha, P., Paul, V. K., Kumar, A. K. S., & Dandona, L. (2011). Towards achievement of universal health care in India by 2020: A call to action. The Lancet, 377(9767), 760–768. https://doi.org/10.1016/S0140-6736(10)61960-5
Optional reading:
1. Challenges to Healthcare in India - The Five A's Indian J Community Med. 2018 Jul-Sep; 43(3): 141–143. doi: 10.4103/ijcm.IJCM_194_18 Use this link to access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166510/?report=printable
2.3. The DPRK Medical Education System, Prof. Dr. Charlie Sands
Dr. Charlie Sands is Professor and Graduate Dean, Division of Medical Sciences, Dean of the College of Pharmacy, Pyongyang University of Science and Technology, Pyongyang, DPRK. Until his retirement he has been Professor at McWhorter School of Pharmacy, College of Health Sciences, Samford University, Birmingham, Alabama, USA
**This lecture video can be accessed via the Moodle e-learning platform of the University of Turku. Go to the UTU Moodle page https://moodle.utu.fi/course/view.php?id=15882. Log in via the "External or Norssi account" in the right bottom corner (course key: NKhealth319).
Required Readings:
World Health Organisation (2016) WHO Country Cooperation Strategy DPRK 2014-2019, New Delhi: WHO
DPRK Ministry of Public Health (2017) Medium Term Strategic Plan for the Development of the Health Sector DPR KOREA, Pyongyang: Ministry of Public Health
2.4. Informal providers in India - Associate professor Salla Atkins
One of the effects of the paucity of healthworkers globally, migration of healthworkers to countries, sectors, or settings with better salaries, better quality of life or for other workers, is the quality of care that people particularly in rural areas receive. The maldistribution of healthworkers - a phenomenon that is not unique to the Asian setting, affects mostly the rural areas.
This research that I am presenting as a case study, describes peoples' preferences in choosing their healthworker in village settings in central India. I keep wondering about the degree to which this is really a choice. Do people choose to opt for providers that they know are more poorly trained than formal providers? Perhaps they have beliefs about the effectiveness of traditional healers, for example. Or are they driven to this choice, by poverty, by poor infrastructure, by lack of providers where they are?
Please note a correction to the first slide: There is a gap of 18 million healthworkers estimated in 2030- the total need is 40 million(I had conflated these) - and in the text in the last slide - training informal providers does not necessarily equate quality care.
When presenting this research earlier on another course (and yes, I've updated it since), the participants, mainly medical doctors asked me what formal providers should do. Should they give services for payments in kind, chickens or grains? My answer at the time was that it would be unreasonable. More reasonable could be a health insurance that is available to all - and other insurance forms that also allow for covering the indirect costs of treatment, such as transport. More reasonable could be to look at policy options for getting health providers to the villagers. But as you know these decisions are part of health system governance, these decisions are done within the larger financing framework. What do you think is a reasonable option? Please reflect on this in the discussion forum.
Please see the readings below.
Readings:
1. Sudhinaraset, M., Ingram, M., Lofthouse, H. K., & Montagu, D. (2013). What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review. PLoS ONE, 8(2). https://doi.org/10.1371/journal.pone.0054978
2. Gautham, M., Shyamprasad, K. M., Singh, R., Zachariah, A., Singh, R., & Bloom, G. (2014). Informal rural healthcare providers in North and South India. Health Policy and Planning, 29(SUPPL. 1), 20–29. https://doi.org/10.1093/heapol/czt050
Optional readings:
1. Iles, R. A. (2019). Government doctor absenteeism and its effects on consumer demand in rural north India. Health Economics (United Kingdom), (December 2018), 1–17. https://doi.org/10.1002/hec.3858
2. Das, J., Chowdhury, A., Hussam, R., & Banerjee, A. V. (2016). The impact of training informal health care providers in India: A randomized controlled trial. Science, 354(6308). https://doi.org/10.1126/science.aaf7384
Module 3: Environmental health
We cannot deny the impact that our environment has on our health. In the context of rapid urbanisation and rapid development, the environment can have huge impacts on how we life and on our health. At the same time, the environment is key to social determinants of health - those who are poor or discriminated against usually live in a poorer environment.
Creative commons image owned by CSLmedia Productions
The below readings give you a good overview of the environment and health, and some more specific issues. The lectures in this module, however, span from flooding to water, sanitation and hygiene, antimicrobial resistance (very important in health today!) and finally ending in an one health approach describing how we are inextricably connected with our environment.
Just for fun (and not part of your formal assessment), here's a quiz from National Geographic on pollution. Look out for the question about indoor air pollution, very important for human health. https://www.nationalgeographic.com/environment/global-warming/pollution-quiz/
Optional Readings
Textbooks
Environmental Health: From Global to Local (Public Health/Environmental Health) 3rd Edition. Ed. by Howard Frumkin (2016)
Environmental Health. Fourth Edition. Dade W. Moeller (2011). Harvard University Press.
Essentials of Environmental Health, Second Edition. Robert H. Friis (2012)
Classic book
Diamond, Jared. (1997) Guns, Germs and Steel: The Fates of Human Societies. New York. W.W. Norton. [Suom. Tykit, taudit ja teräs; 2003]
Relevant Articles
Impact of regional climate change on human health. Patz, J.A., Campbell-Lendrum, D., Holloway, T., Foley, J.A. 2005 Nature 438(7066), pp. 310-317
Climate change and human health: Present and future risks. McMichael, A.J., Woodruff, R.E., Hales, S. 2006 Lancet 367(9513), pp. 859-869
The Lancet commission on pollution and health: https://www.thelancet.com/commissions/pollution-and-health
Das, Horton: Pollution, health and the planet: time for decisive action: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32588-6/fulltext (register; it's free of charge)
Holmes et al 2018: Understanding the mechanisms and drivers of antimicrobial resistance. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00473-0.pdf
3.1 The environment and health - Dr Jutta Pulkki
Several approaches exist to safeguard health in the era of eco-system crises. In this lecture three most influential concepts at the moment, One Health, EcoHealth, and Planetary Health, are presented and compared revealing their similarities and differences. As these approaches seem, however, to ignore the root reasons why the ecosystem crisis - and thus new threats to human health - are occurring in a first place, also more or less unknown eco-social approach to health is presented.
The purpose of the lecture is to add knowledge regarding the important approaches in the field and to offer conceptual tools to discern the knowledge of the interlinkage of health and ecological issues.
The lecture is posted on the Tampere University server. When clicking the link below, you will encounter a page that is completely in Finnish.
Enter the password in this section on the page:
And click the button "lähetä".
You can access the lecture here:
https://moniviestin.uta.fi/videot/yhteiskuntatieteiden-tiedekunta/terveystiede/kurssit2019/pghes07/
The password is: healthsystems
Readings:
Roger, F., Caron, A., Morand, S., Pedrono, M., de Garine-Wichatitsky, M., Chevalier, C., … Binot, A. (2016). One Health and EcoHealth: the same wine in different bottles? Infection Ecology & Epidemiology: The One Health Journal.
Lerner, H., & Berg, C. (2017). A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health. Frontiers in Veterinary Science, 4(September), 1–7. https://doi.org/10.3389/fvets.2017.00163
Hancock, T. (2015). Population health promotion 2.0: An eco-social approach to public health in the Anthropocene. Canadian Journal of Public Health, 106(4), e252–e255. https://doi.org/10.17269/cjph.106.5161
3.2. Flooding - Dr Carlos Gundran
This presentation was made by Dr Gundran from the Philippines when he was visiting Tampere University.
Extreme weather conditions are likely to increase, and with that, flooding. Flooding can cause drowning in the first place, but it can also increase other health conditions and cause other injuries. Dr Gundran is an expert in disaster medicine and kindly put together this lecture to give you an idea of what impacts flooding has on health and health systems.
The lecture is posted on the Tampere University server. When clicking the link below, you will encounter a page that is completely in Finnish.
Enter the password in this section on the page "anna polkuavain" and click the button "lähetä"
You can access the recordings of this lecture through this link:
Section 1: https://moniviestin.uta.fi/videot/yhteiskuntatieteiden-tiedekunta/terveystiede/kurssit-2018/floods
password tulvat811
Readings for this lecture:
1. World Health Organization Western Pacific Region. (2018). Environmental health in selected asian countries. Manila: WHO Regional Office for the Western Pacific. - Read climate change and healthy cities OR choose three countries to study from this document
2. Saulnier, D. D., Brolin Ribacke, K., & Von Schreeb, J. (2017). No Calm after the Storm: A Systematic Review of Human Health Following Flood and Storm Disasters. Prehospital and Disaster Medicine, 32(5), 568–579. https://doi.org/10.1017/S1049023X17006574
3.3. Water, Sanitation and Hygiene - Associate professor Vishal Diwan
This presentation discusses the important environmental issue of water, sanitation, and hygiene. Over 1000 children die every day from preventable diseases related to water and sanitation. Rapid urbanisation and lack of appropriate infrastructure contribute towards sanitation and hygiene challenges, particularly in low-and middle-income countries.
This is something that we don't often think of, particularly here in the Nordics, where water and sanitation facilities are in abundance and we've perhaps too few people, not too many! In Asia, however, this remains an important environmental challenge.
Readings alongside this lecture:
1. Campbell, O. M. R., Benova, L., Gon, G., Afsana, K., & Cumming, O. (2015). Getting the basic rights - the role of water, sanitation and hygiene in maternal and reproductive health: A conceptual framework. Tropical Medicine and International Health, 20(3), 252–267. https://doi.org/10.1111/tmi.12439
2. Dangour, A. D., Watson, L., Cumming, O., Boisson, S., Che, Y., Velleman, Y., … Uauy, R. (2013). Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutrition status of children. Cochrane Database of Systematic Reviews (Online). 8, CD009382. Cochrane Database Syst Rev, (8). https://doi.org/10.1002/14651858.CD009382.pub2.www.cochranelibrary.com
Optional readings:
1. Troeger, C., Forouzanfar, M., Rao, P. C., Khalil, I., Brown, A., Reiner, R. C., … Mokdad, A. H. (2017). Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet Infectious Diseases, 17(9), 909–948. https://doi.org/10.1016/S1473-3099(17)30276-1
2.World Health Organization (WHO). (2018). Water , Sanitation And Hygiene strategy 2018-2025. Geneva.
3.4. Antimicrobial resistance - Associate professor Vishal Diwan
Antimicrobial resistance is a key challenge in health systems today. If we don't have antibiotics, we return back to a time where common infections and injuries could kill. Resistance is growing, due to poor antibiotic stewardship and irresponsible use. This presentation by associate professor Diwan gives an overview of this issue in India.
Required readings:
Larsson, D. G. J., Andremont, A., Bengtsson-Palme, J., Brandt, K. K., de Roda Husman, A. M., Fagerstedt, P., … Wernersson, A. S. (2018). Critical knowledge gaps and research needs related to the environmental dimensions of antibiotic resistance. Environment International. https://doi.org/10.1016/j.envint.2018.04.041
Berendonk, T. U., Manaia, C. M., Merlin, C., Fatta-Kassinos, D., Cytryn, E., Walsh, F., … Martinez, J. L. (2015). Tackling antibiotic resistance: The environmental framework. Nature Reviews Microbiology. https://doi.org/10.1038/nrmicro3439
Suggested readings:
Kümmerer, K. (2009). Antibiotics in the aquatic environment - A review - Part I. Chemosphere. https://doi.org/10.1016/j.chemosphere.2008.11.086
Kümmerer, K. (2009). Antibiotics in the aquatic environment - A review - Part II. Chemosphere. https://doi.org/10.1016/j.chemosphere.2008.12.006
Finley, R. L., Collignon, P., Larsson, D. G. J., Mcewen, S. A., Li, X. Z., Gaze, W. H., … Topp, E. (2013). The scourge of antibiotic resistance: The important role of the environment. Clinical Infectious Diseases. https://doi.org/10.1093/cid/cit355
===========
OPTIONAL MODULE 4 STARTS HERE: Health in North Korea
Students can earn an extra credit (1 ECTS) on a topic of their choice (see instructions below) by submitting a 1,500 word essay for the optional module (Module IV).
**All lecture videos of this module can be accessed via the Moodle e-learning platform of the University of Turku.
Go to the UTU Moodle page https://moodle.utu.fi/course/view.php?id=15882.
Log in via "External or Norssi account" in the right bottom corner (course key: NKhealth319).
=======================
How to write an essay
An essay is a research report, which sets out a cogent and structured argument on a particular subject. A well-considered structure and a clear approach are the very basis for a good essay. An essay invariably begins with a research question, which the student seeks to answer.
Good essay writing lies in the quality of your argument and the level of analysis you employ. Your essay must therefore go beyond mere description and narrative. It is not enough just to tell a story, or just to compile some facts pertinent to your topic, or to merely recount what you have read about the topic. Your essay should present your own thoughts on the problem you are writing about.
An argument is a statement or point of view on your research question(s), backed up by adequate evidence. The quality of the argument is measured by how persuasive it is. At all times you need to support your answer to the research question with an argument, rather than simply regurgitating the facts.
When writing an essay, you should be prepared to spend extra time for finding sources. Footnotes as well as a full bibliography or list of references shall be included.
Basic essay structure:
Introduction:
This includes a clearly stated thesis/argument and a research question or set of research questions.
The thesis/argument and research question set the tone of the entire essay. Thus, the introduction must make readers immediately aware of the point being made
Body/Main Text:
This contains the argument, complete discussion, and supporting evidence.
It stays on target and thoroughly supports the thesis/hypothesis. Wandering arguments will distract the reader.
Organization is the key to the body/main text because it provides direction and guides the flow of your writing.
The body/main text contains a succession of paragraphs, each of which includes a topic sentence, develops one main idea, and has a transition sentence linking it to the next paragraph.
Conclusion:
This recaps the thesis statement and the essay’s main points. You need to drive your point home one more time.
Here is the place to present a closing statement of your position, make suggestions for future research, or present alternative ways of approaching the subject.
======================
North Korea module discussion forum
4.1 Health development in DPRK and the contribution of international assistance, Dr. Eigil Sorensen
Dr. Eigil Sorensen MD, MPH, M.Sc.(EPID) of the Faculty of Public Health of Thammasat University, Thailand. Dr. Sorensen served as the WHO's first Representative in the DPRK after the WHO's full country office was established in Pyongyang in 2001.
Readings:
Democratic People‘s Republic of Korea. SOCIO-ECONOMIC, DEMOGRAPHIC AND HEALTH SURVEY 2014.Central Bureau of Statistics, Pyongyang, DPRK & United Nations Population Fund
Situation analysis of children and women In the Democratic People’s Republic of Korea– 2017. UNICEF, 2016.
DEMOCRATIC PEOPLE’S REPUBLIC OF KOREA MULTIPLE INDICATOR CLUSTER SURVEY 2017. UNICEF DPRK. June 2018.
World health statistics 2018: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2018.
Towards Sustainable and Resilient Human Development. The strategic framework for cooperation between the United Nations and the Government of the Democratic People's Republic of Korea 2017-2021.
DPRK Socio-Economic Demographic and Health Survey 2014File
UNICEF 2016File
UNICEF 2018 Korea DPR 2017 MICSFile
WHO 2018 World Health StatisticsFile
DPRK UN Strategic Framework 2017-2021File
4.2 HOPE B DPRK: Hepatitis Overview and Program to trEat, Dr. Alice Lee
Dr. Alice Lee, a Gastroenterologist and Hepatologist, is Associate Professor at University of Sydney & Macquarie University. She is also senior staff specialist at Concord Repatriation General Hospital and Co-Founder and Director of Hepatitis B Free. Furthermore, she serves as Hepatitis Program Director with Christian Friends of Korea. In 2017, Dr. Lee received the Hepatitis NSW (HNSW) Cheryl Burman Award for her work on viral hepatitis in the Asia-Pacific Region. She has directed prevention and treatment programs, educated health workers and collaborated with researchers and health officials not only in North Korea but also, among others, in Myanmar and Japan.
Readings:
Lee, Alice Unah; Heidi Linton, Marcia Kilsby and David C. Hilmers, “A Program to Treat Hepatitis B in North Korea: A Model of Antiviral Therapy in a Resource-Poor Setting, Gut and Liver, Vol. 12, No. 6, November 2018, pp. 615-622
LeeFile
Hepatitis B – Explained by AURL
NGO Engagement: Strengthening North Korea's health sector, Heidi Linton
Heidi Linton is Executive Director of the non-profit organisation Christian Friends of Korea (CFK, https://www.cfk.org/). CFK has been providing support to more than 30 care centers including the National Tuberculosis Reference Laboratory (NRL), 7 provincial tuberculosis (TB) and hepatitis hospitals, and nearly 18 TB and hepatitis rest homes located throughout the DPRK. More information about CFK's projects can be found in the article by Linton:
LintonFile
SUBMIT YOUR ESSAY FOR MODULE 4 HERE
Deadline: 11 May 2019 (EEST UTC +3)
Essay on North KoreaAssignment
Students can earn an extra credit (1 ECTS) on a topic of their choice (see instructions below) by submitting a 1,500 word essay for the optional module (Module IV).
**All lecture videos of this module can be accessed via the Moodle e-learning platform of the University of Turku.
Go to the UTU Moodle page https://moodle.utu.fi/course/view.php?id=15882.
Log in via "External or Norssi account" in the right bottom corner (course key: NKhealth319).
=======================
How to write an essay
An essay is a research report, which sets out a cogent and structured argument on a particular subject. A well-considered structure and a clear approach are the very basis for a good essay. An essay invariably begins with a research question, which the student seeks to answer.
Good essay writing lies in the quality of your argument and the level of analysis you employ. Your essay must therefore go beyond mere description and narrative. It is not enough just to tell a story, or just to compile some facts pertinent to your topic, or to merely recount what you have read about the topic. Your essay should present your own thoughts on the problem you are writing about.
An argument is a statement or point of view on your research question(s), backed up by adequate evidence. The quality of the argument is measured by how persuasive it is. At all times you need to support your answer to the research question with an argument, rather than simply regurgitating the facts.
When writing an essay, you should be prepared to spend extra time for finding sources. Footnotes as well as a full bibliography or list of references shall be included.
Basic essay structure:
Introduction:
This includes a clearly stated thesis/argument and a research question or set of research questions.
The thesis/argument and research question set the tone of the entire essay. Thus, the introduction must make readers immediately aware of the point being made
Body/Main Text:
This contains the argument, complete discussion, and supporting evidence.
It stays on target and thoroughly supports the thesis/hypothesis. Wandering arguments will distract the reader.
Organization is the key to the body/main text because it provides direction and guides the flow of your writing.
The body/main text contains a succession of paragraphs, each of which includes a topic sentence, develops one main idea, and has a transition sentence linking it to the next paragraph.
Conclusion:
This recaps the thesis statement and the essay’s main points. You need to drive your point home one more time.
Here is the place to present a closing statement of your position, make suggestions for future research, or present alternative ways of approaching the subject.
======================
4.1 Health development in DPRK and the contribution of international assistance, Dr. Eigil Sorensen
Dr. Eigil Sorensen MD, MPH, M.Sc.(EPID) of the Faculty of Public Health of Thammasat University, Thailand. Dr. Sorensen served as the WHO's first Representative in the DPRK after the WHO's full country office was established in Pyongyang in 2001.
Readings:
Democratic People‘s Republic of Korea. SOCIO-ECONOMIC, DEMOGRAPHIC AND HEALTH SURVEY 2014.Central Bureau of Statistics, Pyongyang, DPRK & United Nations Population Fund
Situation analysis of children and women In the Democratic People’s Republic of Korea– 2017. UNICEF, 2016.
DEMOCRATIC PEOPLE’S REPUBLIC OF KOREA MULTIPLE INDICATOR CLUSTER SURVEY 2017. UNICEF DPRK. June 2018.
World health statistics 2018: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2018.
Towards Sustainable and Resilient Human Development. The strategic framework for cooperation between the United Nations and the Government of the Democratic People's Republic of Korea 2017-2021.
4.2 HOPE B DPRK: Hepatitis Overview and Program to trEat, Dr. Alice Lee
Dr. Alice Lee, a Gastroenterologist and Hepatologist, is Associate Professor at University of Sydney & Macquarie University. She is also senior staff specialist at Concord Repatriation General Hospital and Co-Founder and Director of Hepatitis B Free. Furthermore, she serves as Hepatitis Program Director with Christian Friends of Korea. In 2017, Dr. Lee received the Hepatitis NSW (HNSW) Cheryl Burman Award for her work on viral hepatitis in the Asia-Pacific Region. She has directed prevention and treatment programs, educated health workers and collaborated with researchers and health officials not only in North Korea but also, among others, in Myanmar and Japan.
Readings:
Lee, Alice Unah; Heidi Linton, Marcia Kilsby and David C. Hilmers, “A Program to Treat Hepatitis B in North Korea: A Model of Antiviral Therapy in a Resource-Poor Setting, Gut and Liver, Vol. 12, No. 6, November 2018, pp. 615-622
NGO Engagement: Strengthening North Korea's health sector, Heidi Linton
Heidi Linton is Executive Director of the non-profit organisation Christian Friends of Korea (CFK, https://www.cfk.org/). CFK has been providing support to more than 30 care centers including the National Tuberculosis Reference Laboratory (NRL), 7 provincial tuberculosis (TB) and hepatitis hospitals, and nearly 18 TB and hepatitis rest homes located throughout the DPRK. More information about CFK's projects can be found in the article by Linton:
SUBMIT YOUR ESSAY FOR MODULE 4 HERE
Deadline: 11 May 2019 (EEST UTC +3)
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