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Health and healthcare in transition: dilemmas of governance

Approx. 22 hours to complete

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Course Summary

This course explores the complex issues surrounding governance and health, including ethical dilemmas, power dynamics, and resource allocation. Students will learn how to navigate these challenges and develop strategies for improving health outcomes through effective governance.

Key Learning Points

Understand the role of governance in shaping health outcomes
Explore ethical dilemmas and power dynamics in healthcare governance
Develop strategies for effective governance and resource allocation in healthcare

Learning Outcomes

Develop a nuanced understanding of healthcare governance challenges
Learn how to navigate ethical dilemmas and power dynamics in healthcare
Gain practical strategies for effective healthcare governance and resource allocation

Prerequisites or good to have knowledge before taking this course

Basic understanding of healthcare systems and policies
Familiarity with ethical principles and dilemmas

Course Difficulty Level

Intermediate

Course Format

Online
Self-paced
Video Lectures
Quizzes

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Health Policy and Management
Public Health Ethics

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Description

Our societies are changing. On one hand, unprecedented socio-demographic changes are underway: albeit unevenly across various settings, life expectancy continues to rise globally, facilitating the rise of numbers of people living with one or more chronic diseases. On the other hand, societies are undergoing major political transformations as well. Examples include the massive transition away from communism resulting from the dissolution of USSR and rise of participation societies in the EU, to name just a few.

In this shifting environment, the issue of health becomes particularly difficult to deal with. Current approaches to governing processes and structures that define people’s health often fall short in responding to the changing health needs of the populations and in being adequate to shifting societal conditions. How to ensure and improve the health of citizens in times of societal transitions? This course invites learners to explore this question using examples from multiple settings. Aim This course aims to equip learners with the knowledge and skills needed to assess, develop, and implement options for health policies, programs and services in ways that are responsive to changing population health needs and to societal contexts; and to provide learners with analytical insights into the interconnections between societal transformations, health, and governance to facilitate the development of more responsive and contextually adequate health and health governance approaches. After completion of this course you will be able to: 1. Recognize dilemmas in the governance of health and healthcare and the origins of these dilemmas 2. To be aware of different approaches in governance of health and healthcare; identify the trade-offs in these approaches for particular cases 3. Recognize actors and structures pertaining to the governance of health and healthcare on different levels 4. Identify problems in policies, programs, structures, and practices pertaining to the governance of health and healthcare in specific settings 5. Formulate and justify combinations in approaches to health and health governance suitable to various applications in specific settings This course was developed by a consortium of five universities: Maastricht University, National Research Tomsk State University, National University of "Kyiv-Mohyla Academy", National Pirogov Memorial Medical University, Vinnytsya, and Siberian State Medical University within the framework of BIHSENA project. BIHSENA stands for “Bridging Innovations, Health and Societies: Educational capacity building in the Eastern European Neighbouring Areas”. BIHSENA project has been funded with support from the European Commission. This course reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

Outline

Introduction to the course "Health and healthcare in transition: dilemmas of governance"
Welcome to the “Health and Healthcare in Transition: Dilemmas of Governance” Course
Course review
About the universities
About the course authors

Dilemma 1. Definitions: Governance vs Management vs Leadership in Health
1.1. Dilemma 1 Introduction
1.2. Governance
1.3. Different Views on Governance
1.4. Managers vs Leaders in Healthcare
1.5. Governance in the Netherlands: Internal Governance
1.6. Governance in the Netherlands: External Governance
1.7. Review
Smart Governance
Case Study on Leadership
Governance
Smart governance
Management and leadership
Case on leadership
Assessment

Dilemma 2. Health as a Political vs Apolitical Concept
2.1. Dilemma 2 Introduction
2.2. How Political are Health Policy and Governance?
2.3. Why Has Health Been Regarded as Apolitical?
2.4. Ethical Perspectives and Decision-Making in Health Governance
2.5. Case of Ukraine: Two Steps Forward, One Step Back
2.6. Review
Towards a Politics of Health
Competing Views on Health
Rights-based approach to health policy and governance
Approaches to health governance
Political determinants of health governance
Assessment

Dilemma 3. Public Participation vs Top-Down Steering
3.1. Dilemma 3 introduction “Contested evidence: how to make health care reimbursement decisions? “
3.2. Drug reimbursement controversies: a case of Lithuania.Winter school 2018 Public health in Ukraine; Edvinas Askolis
3.3. Why Engagement?
3.4. Different Forms of Knowledge
3.5. What Engagement?
3.6. Paradoxes of Participatory Experiments
3.7. Review
Different forms of knowing: conflict over herbicide between farmers and regulatory authorities in the UK
“We do not always need patient and public participation: example of risk governance”
Read and compare 2 cases
Patient and public engagement
Lay knowledge
Ecologies of participation
Risks of participatory events
Public participation and risk situations
Assessment

Dilemma 4: Focus on Whole-of-Society vs Focus on Health Services Provision
4.1. Dilemma 4 Introduction
4.2. Modern Challenges for Health Care
4.3. Whole-of-society and whole-of-government approach
4.4. Pursuing Better Health Care
4.5. Review
Case of Viet Nam
Conditions for Effective Intersectoral Governance
Poor performance of health systems
Whole-of-society approach
Towards effective and efficient healthcare systems
Effective intersectorial governance
Assessment

Dilemma 5. De Jure and de Facto Dimensions of Healthcare Governance
5.1. De jure and de facto dimensions in health care
5.2. De jure and de facto dimensions and its inconsistencies in childbirth in Russia
5.3. Fraud in health care in the Netherlands
5.4. Review
Inconsistencies of de jure and de facto dimensions in health care
Dimensions
Regulations and practices
Regulations and practices II
Fraud
Assessment

Dilemma 6. Change, Reforms and Stability in Health and Healthcare Governance
6.1. Understanding Change
6.2. Behaviors, Relationships and Ideas
6.3. Cases in the Change of Behavior, Ideas and Relationships
6.4. Choice of Health Insurance in Post-communist Countries
6.5. Key Features of Tax-based and Insurance-based Systems
6.6. Universal Health Coverage
Stability in Change and Changes in Stability
The Case of Health Care Reform in Estonia
Additional reading
Definition of health care financing
Introduction to Social Health Insurance in Post-communist Countries
Concluding message
Change
Primary healthcare reform in Estonia
Social health insurance
Definition of healthcare financing
Tax-based and insurance-based systems
Universal health coverage
Assessment

Summary of User Reviews

Learn about the challenges of health governance in this Coursera course. Users have praised the comprehensive content and engaging instructors. However, some have mentioned issues with the course structure and time commitment.

Key Aspect Users Liked About This Course

Comprehensive content

Pros from User Reviews

Engaging instructors
In-depth coverage of health governance issues
Real-world examples and case studies

Cons from User Reviews

Difficult course structure
Requires a significant time commitment
Some technical difficulties with the platform
Limited opportunities for interaction with instructors
Not suitable for beginners in the field

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