Please Explain the Supply of Health Services from Physician and other Health personnel.?

The supply of healthcare goods and services is different from other commodities because it is composed of multiple inputs. And healthcare goods and services are generally inputs that need to be combined with each other to produced an end product which is better health. Thus, a patient in order to satisfy his need to be healthy because of being sick will most likely directly need the expert advice from Physician and other health personnel. Now, How does physician and other health personnel affects the sickly patient by supplying health services.?

Life-saving interventions must be delivered to those at greatest risk through health services. Health services provide the means for dispatching the tools and supporting the strategies needed to combat infectious diseases. These services are required to provide good-quality health care that is affordable, accessible, equitable and relevant to needs. If progress is to be made, vital components must include trained and well-motivated staff, laboratories and microscopes, health centres and facilities for storing medicines, and vehicles for visiting remote areas.

However, in most developing countries the public health system is poorly equipped to provide services that meet the main health needs of the population. Moreover, good quality private health care is often priced beyond the reach of the poor. The health systems of many developing countries are so weak that disease surveillance and reporting systems barely function, making it difficult to identify disease outbreaks and respond to the most urgent health needs.

RESOURCES FOR HEALTH SERVICES
Health services are frequently underfinanced in developing countries. The governments of some poor countries devote as little as US$ 10 per capita to health. In many African countries, external assistance accounts for a large share of government health budgets. In the early 1990s, 40% of Uganda's health budget was provided through donor assistance; Gambia met 84% of its health costs with foreign aid. Throughout the developing world, far greater amounts of money are often devoted to other areas such as military spending and the construction of prestigious public facilities.

Even when more money is forthcoming, resources alone are not sufficient. Governments must use these resources effectively and target them towards meeting the needs of the poor. In some countries, 60% or more of government health spending is devoted to urban hospitals serving just 10% of the population. In Ghana for example, the more affluent population account for three times more public health spending than the poor. In 10 developing countries, between 1992 and 1997, only 41% of poor people suffering from acute respiratory disorders ­ including tuberculosis ­ were treated in a health facility compared with nearly 60% of the affluent. In the same period, only 22% of births among the poorest 20% of people were attended by medically-trained staff, compared with 76% among the richest 20%.

Economic constraints ­ many of them imposed externally ­ often dictate difficult national budgetary decisions. Because of its burden of debt, Nigeria made cuts in recurrent expenditures such as payment for health-staff salaries and supply of essential drugs, in both urban and rural areas. Niger spends more than twice as much servicing debt as it does on primary health care. Adjustment policies designed to compensate for inadequate resources, inequality and poverty resulted in deep cuts in government spending on health and infrastructure and left Niger's poor and marginalized people with virtually no access to medical care.

The combined impact of AIDS, TB and malaria has further stretched health services beyond their limits. During the late 1980s and the 1990s, the AIDS epidemic spread rapidly in Africa. In addition to AIDS, TB and malaria added a massive socioeconomic burden on already-struggling public health systems. Countries with very high rates of AIDS were simply overwhelmed, while health professionals were dying faster from AIDS than they could be trained. In one Zambian hospital, for example, deaths among health care workers increased 13-fold in the past decade as a result of AIDS.

When the public sector fails to meet the health needs of the population, those living in poverty must often opt for more expensive private medical services. Out-of-pocket payments to private medical services and traditional healers can exceed public expenditure and can cost a small fortune compared to the patient's earnings. Up to 90% of household expenditure on health in India is spent on private-sector health care, with the poor paying proportionally far more than the rich. Much of this goes on drugs and treatments that are not medically justifiable or effective.

A shortage of health professionals and supplies
Health systems depend on people ­ professionals and support staff with the necessary education, training, skills and motivation to do their jobs effectively. However, there is often a mismatch: an oversupply of qualified staff with an undersupply of infrastructure, equipment and drugs ­ or vice versa.

Limited training and low pay for qualified health workers in many developing countries cause severe problems in service delivery. In Cameroon, the ratio of health professionals per acre is 1: 400 in urban areas and 1: 4000 in rural locations, requiring people to travel great distances to find health care in rural areas. This kind of imbalance is just as severe in rural areas of Cambodia, where 85% of the population lives, but where only 13% of health workers are based; and in Angola, where 65% of the population live in rural areas but only 15% of health workers, the vast majority of these having opted for better-paid jobs in urban areas.

In some countries, even where trained health staff are in place, primary care centres and district hospitals lack adequate facilities to diagnose infections and repeatedly run out of medical supplies and drugs. For example in Zambia, where the number of TB cases increased sixfold between 1992 and 1998, proper treatment was hindered because health facilities kept running out of TB drugs.

It is now widely recognized that protecting a community's health requires support beyond the responsibilities of doctors, nurses and professional medical staff. Health services can often be extended or diversified by using networks of volunteer health care providers. Religious organizations, other organizations (such as Rotary International, Zonta International and the Lions Club) and community organizations provide extensive networks of volunteers. They can be trained to offer basic services such as the observation of TB treatment, distribution of insecticide-treated nets and education on how to prevent infection from HIV. Businesses and factories can integrate the provision of health services into the work week of their employees. Schools offer an obvious forum for educating future generations on how to protect themselves and their families from deadly diseases. Yet these vast networks of human resources are often untapped by national health systems.

The death toll among women

Womens' deaths from infectious diseases & other life threatening conditions ('000)

Source: World Health Report, 2000

Poor access to services
In many developing countries groups that are marginalized because of their ethnic background, geographical location or gender are at higher risk of levels of infectious disease. For example, in north-eastern and south-eastern Brazil, (poor regions with large ethnic minorities) the death rate among children under-five for the poorest 20% of the population is now three times that for the richest 20% in the rest of the country.

A long history of gender discrimination also leads to inequalities that perpetuate women's lack of access to resources and services for themselves and their children. Almost 70% of the 1.2 billion people living in extreme poverty are women who experience more illness and are less likely to receive medical treatment before the illness is well advanced. In many cultures, the lower value assigned to women translates into higher levels of suffering, with nearly 33% of all causes of death among women being due to infectious diseases.

TEN STRATEGIC FACTORS FOR DELIVERING AND STRENGTHENING HEALTH SERVICES
In many developing countries, existing health services must be expanded, diversified and refocused to reach more people. New health services also have to be created where none currently exist. Where public health services are inadequate, they can be substantially expanded with services from the private and voluntary sectors. These sectors can also help develop innovative ways of diversifying services under government stewardship which will protect the interests of the poor and ensure that best public health practices are adopted. The following 10 strategies have been used by some countries to strengthen, extend and diversify their health services.

Debt-relief
A serious problem in the poorest developing countries is that public resources are too often diverted to debt repayment, leaving little to cover the health or other needs of the population. In Africa, more than one-third of national budgets are poured into debt repayments while less than one-tenth are spent on social services, including health. Help with this problem is increasingly being provided by the World Bank and the International Monetary Fund through the enhanced Highly Indebted Poor Countries (HIPC) initiative. The HIPC initiative focuses on 42 countries, 31 of which are also among the poorest in the world. The "enhanced HIPC initiative", which was launched in 1999, is now gathering momentum. This process promises faster, deeper and broader debt-relief. In some sub-Saharan countries national poverty reduction and social strategies include specific actions to prioritize health issues such as the control of HIV/AIDS, TB and malaria.

By July 2001, 23 countries had qualified for debt-relief amounting to US$ 34 billion from the World Bank. Taking into account debt cancellations by bilateral aid donors and reductions in commercial debt repayments, the overall debt-relief provided to these 23 countries amounts to US$ 53 billion, compared with an initial debt stock of US$ 74 billion. The debt service ratios of these countries will therefore be much lower than previously estimated. Equal