Health Systems, Policies, and Programs IPBH-3005 (3 Credits / 45 class hours)

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1 Health Systems, Policies, and Programs IPBH-3005 (3 Credits / 45 class hours) SIT Study Abroad Program: Argentina: Public Health in Urban Environments PLEASE NOTE: This syllabus is representative a recent semester. Because courses develop and change over time to take advantage of unique learning opportunities, actual course content varies from semester to semester. Course Description The Health Systems, Policies, and Programs seminar introduces students to the social organization of healthcare in Argentina. The course examines the development of the healthcare system as part of the social, political, and economic fabric of Argentine society. Students study social movements and initiatives to improve health and well-being both historically and in the contemporary moment. Using a comparative approach, they also study how the healthcare system is organized and how it addresses different needs, focusing on quality, cost, and access, among other factors. The health system profile is presented and discussed at varying geographical levels of analysis (national, provincial, and local) and with reference to varying administrative sectors (private, public, and the social security system). Students also consider how the different components and options within the larger system fit together and how different stakeholders continue defining the public health agenda. By considering the Argentine healthcare system through an interdisciplinary lens and with respect to these different questions, students construct an understanding of the complexities of how health needs are met in large urban areas. Expected Learning Outcomes By the end of the course, students should be able to: Identify the key features of the history of public health in the context of the Argentine development process. Define the basic concepts related to health systems and public health policies in Argentina. Discuss the Argentine healthcare system from popular, social, economic, and human rights perspectives. Debate the linkages among Argentina s epidemiological profile and the health needs of the population with the national health system s policies and programs in different contexts. Critically analyze the responses of the Argentine health system and public policies to address the population s health needs and to cope with the different risks affecting quality of life in urban environments. Copyright SIT, a program of World Learning 1

2 Analyze the political process in defining the public health agenda and the roles played by different stakeholders. Language of Instruction The academic content of this course is taught predominantly in Spanish; all orientation and logistical issues are provided in English. Course Schedule *Please be aware that topics and excursions may vary to take advantage of any emerging events, to accommodate changes in our lecturers availability, and to respect any changes that would affect student safety. Students will be notified if this occurs. Module I: The Establishment of the Argentine Health System from a Historical Perspective Module 1introduces students to the Argentine healthcare system. The different stages of the development of the healthcare system are analyzed in the context of historical and socioeconomic processes, including the consolidation of the State; immigration and urban transformations; industrialization and expansion of public health services; and the increasing importance of the private health sector. Session 1: Introduction to the principle historical processes in the formation of contemporary Argentina. Session 2: The formation of the national health system during the different periods of Argentine history and nation building. Session 3: Contemporary Argentina: recent history and key points for understanding the current healthcare system. Session 4: Introduction to the national healthcare system and its organization. Session 5: Introduction to national health policy and its implementation across different sectors. Session 6: Discussion-Debate Session 7: Visits to the different hospitals of Buenos Aires as historical points of reference. Langsam, M. (2001). Health care policies in Argentina: An historical overview (Master s thesis). Oxford University, Oxford. Read Chapter 2, pages Perrone, N., & Teixido, L. (2011). Estado y Salud en Argentina. Maestría en Salud Pública, 9(7), Retrieved from Cetrańgolo, O., UNDP Argentina, Pan American Health Organization, & CEPAL Buenos Aires. (2011). Aportes para el desarrollo humano en Argentina El sistema de salud argentino y su trayectoria de largo plazo: logros alcanzados y desafíos futuros. Copyright SIT, a program of World Learning 2

3 Buenos Aires: Organización Panamericana de la Salud, Oficina Regional de la Organización Mundial de la Salud. Retrieved from no%20-%20%20pnud%20ops%20cepal%20version%20final.pdf Further Readings: Belmartino, S. (2005). La atención médica argentina en el siglo XX: Instituciones y procesos. Buenos Aires: Siglo Veintiuno Editores Argentina. Lima Quintana, L., Levcovich, M., & Díaz-Muñoz, A. R. (2012). Las reformas de los sistemas de salud del reino Unido, Estados Unidos y Países Bajos. De la década del 90 al siglo XXI. Buenos Aires: Ediciones Fundación Sanatorio Güemes. Nari, M. (1996). Las prácticas anticonceptivas, la disminución de la natalidad y el debate médico, In M. Z. Lobato (Ed.), Políticas, médicos y enfermedades, lecturas de historia de la salud en la Argentina (pp ). Buenos Aires: Editorial Biblios. Romero, J. A. (2002). A history of Argentina in the twentieth century. University Park: The Pennsylvania State University Press. Read Chapters 4 and 8. Module 2: Healthcare Policies and Programs in Interior Urban Centers Module 2 covers health as a public good, the role of the state and public policies in the search of health and well-being. Also included are how public policies influence popular access to health goods and social services and the debate on health and equity: alternative policies to reduce inequality. The module includes lectures, reading workshops, and debates with stakeholders. Session 1: Introduction to health policy and its application in Mendoza. Session 2: Introduction to health policy and its application in Tucumán. Multiple sessions: During the extended excursions to Mendoza and Tucumán, students visit and meet with various NGOs, health clinics, universities, and receive lectures on the application of health programs and policies in the urban centers of the interior of the country. Cuadernillo de Florencia Varela Cuadernillo Mendoza Cuadernillo Tucumán Module 3: The National Healthcare System: Structure and Organization Module 3 discusses the different complexity levels in healthcare, and organization of Service Networks. Included are primary healthcare, and articulation of health services and social services. The module is based on lectures, field visits, and debriefings. Visits include health service centers of different complexity levels, centers that integrate health and social services, and NGOs. Session 1: Healthcare in complex service networks. Session 2: Visits to Hospital del Cruce (complexity II), Hospital Mi Pueblo, CAPS, and Centro Comunitario Angelleli. Copyright SIT, a program of World Learning 3

4 Session 3: Primary healthcare, its integration into medical school curricula, and its links with the community. Session 4: Visits to primary healthcare center La Consulta, Centro Integrador Comunitario, municipality of Maipu, and Centro OSEP. Session 5: Reproductive health programs: their implementation and their integration with other provincial, municipal, and civil society programs. Session 6: Visits to Clinica Las Mercedes and Policlinica Villalonga. Cuadernillo Mendoza Cuardernillo Tucumán Gogna, M., Centro de Estudios de Estado y Sociedad, & Inter-American Development Bank. (2004). Las reformas en el sector salud en la Argentina y Chile: Oportunidades y obstáculos para la promoción de la salud sexual y reproductiva. Buenos Aires: Centro de Estudios de Estado y Sociedad. Read Chapters 3 and 4. Gonzalez, G. G., Madies, C., & Fontela, M. (2012). Médicos: La salud de una profesión: Entre los ideales de una vocación y los obstáculos para ejercerla. Buenos Aires: Ediciones Isalud. Read Introducción and Chapter 4. Further Readings: Jones, I. R. (2003). Health promotion and the new public health. In Scambler, G. (Ed.), Sociology as Applied to Medicine (5 th ed.) (Chapter 17). Edinburgh: Saunders. Gonzalez, G. G., & Tobar, F. (2004). Salud para los argentinos: Economía, política y reforma del sistema de salud en Argentina. Buenos Aires: ISALUD. Read Chapters 4 and 5. Module 4: Public Policy and Health: Challenges to Equity Module 4 provides a general orientation to health policies of the last decade. Policies and programs at provincial and local levels are explored through visits to Mendoza and Tucumán Provinces and to Ciudad de Buenos Aires and Florencio Varela municipalities. Students also study the role of civil society and community projects in population health conditions. The visits include presentations, discussion groups, and reflections. Session 1: The role of the State and public policy in health status and wellbeing. Session 2: Health policy and equality. Session 3: Discussion-Debate Stiglitz, J. (1986). Economics of the public sector. New York: W.W.Norton. Read pages Copyright SIT, a program of World Learning 4

5 Cetrańgolo, O., UNDP Argentina, Pan American Health Organization, & CEPAL Buenos Aires. (2011). Aportes para el desarrollo humano en Argentina El sistema de salud argentino y su trayectoria de largo plazo: logros alcanzados y desafíos futuros. Buenos Aires: Organización Panamericana de la Salud, Oficina Regional de la Organización Mundial de la Salud. Retrieved from %20%20pnud%20ops%20cepal%20version%20final.pdf Further Readings: Devoto, F. (1998). Reformas en la política de salud en Argentina durante los años noventa con especial referencia a la equidad. Buenos Aires: Centro de Estudios para el Cambio Estructural. Maceira, D. (2009). Inequidad en el acceso a la salud en la Argentina. Documento de Políticas Públicas, Análisis 52. Buenos Aires: Centro de Implementación de Políticas Públicas para la Equidad y el Crecimiento. Educational Excursions Excursions typically include: City of Buenos Aires: CeSAC 41 La Boca (primary health care level) Florencio Varela: Hospital del Cruce (third health care level) Florencio Varela: Hospital Mi Pueblo (second health care level) Florencio Varela: La Esmeralda Center (primary health care level) Mendoza: Centro de Integración Comunitaria de Maipú (Center that integrates health and social services) Centro de Atención Primaria La Consulta (primary health care level) Tucumán: Maternidad de las Mercedes (third health care level) and Policlínica Villalonga. La Plata: Global Age-Friendly Cities Project NGOs working in the city of Buenos Aires, Florencio Varela, La Plata, Mendoza, and Tucumán Evaluation and Grading Criteria Assignments: Pre-departure assignment Based on the recommended bibliography, students will be required to complete a 2-page essay answering a question related to the history of the Argentinean health system. Group discussion papers Students will meet with an assigned group to critically discuss issues concerning Argentina s health system, policies, and programs raised in lectures, excursions, and debriefings. Based on these discussions, students will write a series of papers providing critical analyses of the themes discussed. Mid-term Students will be required to reflect with a written exam on certain aspects of Argentina s health system and current health policies. Copyright SIT, a program of World Learning 5

6 Assessment: Pre-departure Assignment: Question 1 10% Group Discussion Papers 45% Mid-term 35% Participation 10% Grading Scale: % A Excellent 90-93% A % B % B Above Average 80-83% B % C % C Average 70-73% C % D % D Below Average below 64 F Fail Student Expectations and Policies Class Participation Participation in class refers to attendance, punctuality, attentive listening and active engagement in all lectures, discussions, field trips, and other activities. It also means polite, respectful, and appropriate behavior. Readings Students are responsible for all required readings, and should be prepared to bring them to bear in class. The readings will aid students in placing classes in their context, to engage lecturers, to generate questions for class discussions, and to deepen their knowledge of particular course topics. Assignments Timely completion of all assignments is expected. Late hand-ins will be penalized. All assignments are evaluated according to organization, analytical quality, depth of understanding, argumentation, and presentation of evidence. Please refer to the SIT Study Abroad handbook for policies on academic integrity, ethics, warning and probation, diversity and disability, sexual harassment, and the academic appeals process. Copyright SIT, a program of World Learning 6