CASE STUDIES

Attack rate- The numer of cases of a disease diagnosed in an area, divided by the total population, over the period of an epidemic.

Case-mortality rate- The number of people dying from a disease divided by the number of those diagnosed as having the disease.

Crude death rate- The number of deaths per 1,000 people in 1 year.

Infant mortality- The number of deaths of children under the age of 1 year expressed per 1000 live births per year.

Mortality- The death of people. It is measured by a number of indices including death rate, infant mortality, case mortality and attack rate.

Morbidity- Illness and the reporting of disease.

• The country has a total population of 1.6 million and 24% are infected with HIV.
• The goverment has tried to manage the spread of the disease by focusing on prevention, and in 2002 it came the 1st African country to provide fee anti-retroviral drugs.
• Life expectency in the country has dipped to below 40 years in 1950 and in 2006 stood at 34 years.
• It was expected to be 74 years in 2010 if not for the AIDS pandemic, but in 2010 it is now 29 years old
• The economy has been effected as it has lost its workforce. Making it unable to develop.

• In the end of the twentieth century, Thailand had a huge problem with AIDS, with the most vulnerable groups of intravenous drug users and commerical sex workers.
• HIV spread to the heterosexual and non-intravenous drug using population, due to low condom use, high premarital and extramarital male contact sex workers.
• In 1999 1million people were infected with HIV, with 100000 developing AIDS.
• The Thai goverment responded in a postitive way. With its "100% condom programme" and National AIDS Committee.
• They set up a hard-hitting television, radio and poster campaign.
• Commerical sex workers were targeted with a supply of 60 million free condoms a year. Resulting in a 90% of males now use condoms.
• The programme has been now appear to be in decline.

• In 1984-5 Ethiopia had its worse drought, dramatic pictures of starving people were brought to the attention of the richer western world by Live Aid.
• The drought caused; It led to unusual movements of people live stock as herders moved in search of water and fresh pasture.
• As a result of these migrations, too much pressure was put on those areas that had sufficient water pasture.
• The lack of food and water took heavy tool on herders and thousands of cattle, sheep, camels and goats died.
• The death of livestock led to a deterioration in peoples nuteition status.
• Food prices began to rise.
• 1000's of families abandoned their land and headed for the cities. Many camps for these internally displaced persons had to be set up. One camp contained 13,000 people.
• Large amounts of foreign aid were required to run these camps; The rate of malnutrition was estimated at over 50%

Emergent e.g India

• Healthcare is seen as an item of personal consumption.
• Physician operates as a solo entrepreneur.
• Professional associations are powerful.
• Private owned facilities.
• Direct payments to doctors
• There is little state role in healthcare.

Pluralistic e.g USA

• Healthcare viewed as consumer product
• Phyisican operates as solo entrepreneur
• Professional associations are powerful
• Private and public ownership of facilities
• State's role in healthcare is minimal and in direct

Insurance/Social security e.g France

• Healthcare is an insured and graranteed consumer product
• Doctors operate as a solo entrepreneurs as a members of professional associations, which are strong.
• Private and public owned facilities
• Payment for services mostly indirect
• State's role in healthcare is evident but in direct.

NHS e.g UK

• Healthcare is a state supported service
• Doctors operate as solo entrepreneurs and as members of professional associations, which are strong
• Facilities and mainly publicly owned
• States role in healthcare is central and direct.

• Wirral PCT, is reposible for deciding on the health services needs of the population of the wirral and securing the continual provision of the services required. It achieves this by providing primary care and community services itself and commissioning secondary care from the other three trusts.
• Wirral hospital NHS trust, is responsible for most operations and major specialist treatments for wirral residents
• Cheshire and Wirral partnership NHS trust, is a specialist trust working across wirral and cheshire. The PCT commissions specialist mental health, learning disabilities, drug and alcohol services from the Partnership Trust for people of the wirral
• Clatterbridge Centre for Oncology NHS foundation trust, is a specialist regional cancer centre. It provides cancer services to patients in Cheshire, Mersyside and the Ilse of Man. The PCT commissions services from the Clatterbridge Centre so Wirrla residents can benefit from the centre's expertise.