Health and healthcare in transition: dilemmas of governance

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National Research Tomsk State University

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This course module focuses on the main challenges and global shifts in the healthcare sector, which, in turn, create a demand for more systemic approaches to governance, management, and leadership. It appears to be difficult to differentiate these concepts (governance, management, and leadership) clearly due to their interrelations and complexity. This module will introduce different ways of defining and relating these concepts in order to illustrate challenges to finding a consensus between such definitions. First, you will delve into discussions about definitions of governance and about how to understand good governance. You will then also explore different leadership approaches in healthcare and to discern from specific examples how effective management can improve the performance of a healthcare facility.

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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.

转型中的卫生与医疗:治理难题:我们的社会正在发生变化。一方面,史无前例的社会人口变化正在发生:尽管在各种情况下分布不均,但全球的预期寿命仍在继续增加,这促进了患有一种或多种慢性疾病的人数的增加。另一方面,社会也在经历重大的政治变革。例子包括苏联解散和欧盟参与社会的兴起导致的从共产主义的大规模过渡,仅举几例。 在这种变化的环境中,健康问题变得特别难以解决。当前定义人们健康的管理流程和结构的方法往往不能满足人们不断变化的健康需求,并且不足以适应不断变化的社会状况。在社会转型时期如何确保和改善公民的健康?本课程邀请学习者使用来自多个设置的示例来探讨这个问题。 目标 本课程旨在为学习者提供评估,制定和实施卫生政策,方案和服务选择所需的知识和技能,以适应不断变化的人口卫生需求和社会背景的方式;并向学习者提供对社会转型,健康与治理之间的相互联系的分析见解,以促进发展更具响应性和更适合实际情况的健康与卫生治理方法。 完成本课程后,您将能够: 1.认识到健康和医疗管理中的两难困境以及这些两难困境的根源 2.意识到健康和保健管理的不同方法;在特定情况下确定这些方法的权衡 3.确认与健康和医疗保健治理有关的参与者和结构 4.识别与特定环境中的健康管理相关的政策,计划,结构和实践中的问题 5.制定和论证适用于特定环境中各种应用的健康与健康治理方法的组合 该课程由五所大学组成的财团开发:马斯特里赫特大学,国立研究托木斯克州立大学,国立“基辅-莫希拉学院”大学,国立比罗戈夫纪念医科大学,文尼察亚和西伯利亚国立医科大学在BIHSENA项目框架内。 BIHSENA代表“桥接创新,健康与社会:东欧邻国的教育能力建设”。 BIHSENA项目已获得欧盟委员会的资助。本课程仅反映作者的观点,对于其中所含信息的任何使用,委员会概不负责。

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