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Strengths and threats to the survival of the military health system

In addition to above, private sector of health care also provides wide range of health services and is mainly profitable. On the other hand, non-profit organizations caring for many different programs are also widely spreading in Sudan and are functioning in coordination with the federal ministry of health.

These hospitals provided secondary care, consultations, and hospitalization when needed, while health clinics provided reproductive health, antenatal care, on top of other basic primary care services.

Furthermore, in collaboration with the FMOH, MSF conducted vaccination campaigns and operated some newly introduced mobile clinics concerned with education, vaccination, and child and women care [ 29 ].

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In general, the FMOH has always recognized the internal conflicts as a primary reason of health care decline [ 8 ]. This disruption of the health system is in the form of health infrastructure complete destruction or the need for maintenance and repair. This condition has been throughout the past decade and a study on health system indicated that many health facilities are not functional as a result of dilapidated buildings and lack of necessary equipment [ 28 ].

The Sudan has also made some health sector reforms in order to assure the health care is a right, universal, participatory, sustainable and provides equity in all levels [ 3031 ]. Resource Production Resource production of human, facilities, commodities and knowledge remains to be the mainstay of Sudan healthcare system.

Human resources for health HRH are very important asset for health systems worldwide and Sudan in particular [ 32 ]. Recently the HRH is all the time more recognized as a significant area for health system progress so that the planning can address the workforce issues. There was a strategic plan for HRH from 2012 to 2016 in Sudan: The aim of the strategic plans defined towards reaching the aim accordingly by prioritizing the issues in the human resources planning, production and training, distribution, management and improving the existing policies [ 21 ].

Training and production of health workforce in Sudan increased tremendously in the past 2 decades as a result of increased numbers strengths and threats to the survival of the military health system medical training schools both on the public and private sectors. There are over 100,000 health workers making over 20 different professions [ 21 ]. The picture of Sudan health workforce today shows almost equal distribution of female and male.

The age structure points to a rather young health workforce probably due to the recent expansion of medical education and health training [ 4 ].

The Ministry of Higher Education is responsible for pre-service training and production of health workers through a total of more than 13 universities with medical and health science facilities, and 250 allied health cadre's schools and institutes.

Medical Council is delegated with registration and licensing of doctors, pharmacists and dentists. Majority of health workers are employed by the civil service under the Federal and State ministry of health in addition to lower numbers in the army, police, universities and health insurance fund.

The number, ratio and type of health workers differ from state to another. The doctors to nurses ratio was 1: The proportion of medical doctors, nurses and midwives is 1. In spite of the increasing production of manpower every year to meet the needs of the healthcare system, still there is deficiency in the human resources [ 33 ]. The main problem is migration of trained professionals like most African countries, in addition to the poor management and rationale distribution of the existing physicians and paramedics [ 36 ].

When comparing Sudan with Cuba they both have equivalent level of economy. But Cuba is one of the countries with the lowest number of patient to doctor ratio in the world. First medical education in Cuba is free [ 38 ], all doctors interested in specializing must first serve two years working in primary care, and graduating doctors are not driven to specialize by salary incentives.

This Cuban approach towards medicine and medical education assures the human resources necessary to provide universal and preventative healthcare to all [ 39 ]. Following on the geographical pattern of health services inequitable and uneven distribution of the health workforce is prominent in Sudan.

More than one-third of the total health workforce is located in the capital city. The government of Sudan introduced a law of compulsory one year placement similar to the Cuban, nevertheless there is no enforcement of this policy [ 40 ]. Moreover, the non-conducive environment discourages the health professionals from continuing their posting in the rural areas which attributes to the high production with low employment [ 41 ].

In terms of knowledge, the research program for resource production part of the healthcare system in Sudan was established as the health system research unit at 1998 with the help of WHO but has minimal contribution to the system [ 42 ].

There are limited information regarding commodities for instance, drugs.

Economic Support Sudan is bestowed in terms of natural and human resources, but economic and social development have been below expectations. Likewise, the data on health financing and expenditure is deficient and incomplete. It makes it difficult for decision makers to plan, distribute and clearly see the deficient area. Regardless of the external threats such as brain drain, prolonged economic sanction and separation from South Sudan that brought down the economic support to achieve the goals, the weaknesses with in the healthcare system internally is not satisfactory [ 4344 ].

The government is upholding towards ensuring that resources for health are used for intended purposes and to safeguard that the financial management system meets national and international standards, and produces reports appropriate for making decisions [ 8 ]. The available information showed that the overall government health expenditure is very low and the health sector is under-funded [ 4 ].

As overall government expenditure, has increased largely due to growth in oil revenues, allocation to health sector in absolute terms have also increased until 2011. The total health expenditure as percentage of the GDP was 5.

The main resources for states health budget come from the ministry of finance. The national states support fund gives support to some states, which is automatically added to the state's budget.

Part of the budget comes from household's direct contribution through user fees or through health insurance premium [ 45 ]. In contrast the user fees for government health services were introduced in the mid-1990s, including exemptions for vulnerable groups and for emergency services. Like most African countries, the Sudan follows the out-of- pocket model and minimal national health insurance to some extent which benefit the better off.

This system resulted in gross disparities, that spending is highly skewed towards those who can afford only [ 45 ]. There are countries with minimal financial resource but still managed efficaciously by adapting different models. For instance, Cuba is the best example that practices the extreme Beveridge Model in which the government entirely control all the healthcare system and successfully accomplished so much with so little to came up with all health indicators [ 47 ].

This system assured equal distribution and the government acts mostly at the PHC stage making it easier for the expenditure by preventing the disease instead of treating [ 48 ]. The international assistance to the health sector in the past decade has not been significant but there were some international communities committed to work with the government for recovery and development including health services are managed by the World Bank.

Worm control and control of river blindnessnutrition and PHC and significant amount goes to other basic social services other than health [ 815 ]. Health Service Delivery The health services provided in Sudan follow the classical three basic arrangements, primary, secondary, tertiary health care. The importance of PHC is that it provides the essential care to all and improves the health status of the community as a whole [ 49 ].

In 2003 a package of health care services was introduced to the PHC facilities. This package included vaccination of children, nutrition, reproductive health RHintegrated management of childhood immunization IMCImanagement of common diseases and prescribing the essential medications [ 4 ].

  1. Military medical leaders express concerns over health care reform woodson described strategies that are now in place to make the military health care system better this allows us to support combat casualty care with unprecedented battlefield survival rates.
  2. This condition has been throughout the past decade and a study on health system indicated that many health facilities are not functional as a result of dilapidated buildings and lack of necessary equipment [ 28 ].
  3. International Encyclopedia of Public Health. As overall government expenditure, has increased largely due to growth in oil revenues, allocation to health sector in absolute terms have also increased until 2011.

This line of care is almost entirely provided by the public sector. On the other hand, both public and private sectors work together in the provision of the secondary and tertiary lines of care.

Though, the private sectors has been functioning mainly in urban areas [ 4 ]. In the last decade, the number of hospitals has been an increasing trend and it continues to be. It is agreed that a core component of primary health care is health promotion which is limited in Sudan while health problems suitable for health awareness campaigns are present including the enormous communicable diseases, malnutrition, and even the non-communicable diseases [ 50 ].

Furthermore, in regard to the services provided at the PHC, these services are not achieving optimum utilization rates [ 4 ]. For example, only 81. Although, these numbers are improving in comparison to the past, they are not ideal and further emphasis on coverage, availability, and accessibility is required [ 51 ]. Another notifiable weakness regarding PHC, is that unlike the secondary and tertiary services that are increasing in number, PHC units are decreasing either due to cessation of function or in comparison to the population growth [ 4 ].

Strengths and threats to the survival of the military health system

Lessons Learned The analyses of Sudan Health System revealed strengths and weaknesses that can be learned to improve the system; 4. Plans and Strategies The strength of the system is that they have several long-term and short-term policies and strategies but as it was seen that it was insufficient because there is no sustainability and no continuous updating of the implemented plans. Moreover, the deficiency of research and fragmented HIS didn't assist the government to act accordingly and identify the pitfalls of the system.

It is critical to have effective governance for developing strategic policies, designing, funding, and implementing plans for human resource. Stakeholder The involvement of Stakeholders like the army, police, universities agencies, NGO's, banks, countries donors and others has contributed to the system definitely in supporting and maintaining health economic supplies but building partnership with the communities and civil society organizations is of paramount importance in changing health scenario as public is considered to be the pillar of the health system.

Conclusion and Recommendations A healthcare system is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. The Sudan HSS formation goes back to more than one century but healthcare in Sudan is never without its problems. This paper tried to guise in to the system functionality internally and externally. The weaknesses are predominantly seen but this desperate state of affairs is down to combination of many factors.

One is lack of resources in general. The Sudan is not a wealthy country and the long-standing economic sanctions have also severely impacted the country's ability to run a functional, robust healthcare system along with constant attrition of health professional numbers.

Explain survival of the military health system, Operation Management

Another reason for the recent downward spiral in healthcare provision is the economic impact after the Sudanese post-secession economy dysfunction the one which had its staggering effect from one fiscal cliff to the next. The Sudan has under gone decentralization; however, historically, it has experienced challenges and issues in coordination between HRH policies and overall health planning, as well as difficulty in translating national level planning to all levels of a decentralized health care system.

Coordination between health and education sectors has been weak, resulting in misdistribution and imbalance in the production of health workers in certain professions. The healthcare strategy enforcement, appropriate resource allocation changes and improved communication system in different level of the system components are the main pathways to accomplish the goals that needs to be achieved. Recently Sudan has also achieved several goals. The country worked with WHO along with other alliance to establish the national HRH observatory and developing a national comprehensive and evidence based HRH policy for the health sector with engagement of all related stakeholders.

It also accomplished health-related millennium development goals MDGif not reach the goal it improved in a lot of senses. Sudan needs to work more on the strengths it has and use the opportunities available in order to improve the basic health indicators. In order to improve the current healthcare system in the Sudan, various actions may be considered.

Also, developing a communication system between all levels of policy making can allow for proper and timely decisions of continuation, amendment, or even termination of these policies.

  1. Operation management assignment help, explain survival of the military health system, discuss strengths and threats to the survival of the military health system summarize the tricare program and detail its options for enrolees what is tricare's greatest threat and how can it be avoided. On the other hand, both public and private sectors work together in the provision of the secondary and tertiary lines of care.
  2. Human resources for health HRH are very important asset for health systems worldwide and Sudan in particular [ 32 ].
  3. The country worked with WHO along with other alliance to establish the national HRH observatory and developing a national comprehensive and evidence based HRH policy for the health sector with engagement of all related stakeholders. For this assignment, you will complete section two of your Final Paper — Managed Health Care Quality — to address how the selected..
  4. For your initial post address the following steps.
  5. Khartoum Natl Heal Inf Cent. It also accomplished health-related millennium development goals MDG , if not reach the goal it improved in a lot of senses.

Second, it is also recommended to not only monitor the implementation of the ongoing activities and programs but to pay extra attention to the outcome evaluation. It is also encouraged to further promote the use of HIS, improve quality of data, and emphasize on importance of dissemination of findings.

Third, providing medical personnel with incentives, providing fundamental infrastructures, and increasing the paramedic to physician ratio to meet the standard can potentially reduce the high attrition rate of professionals. Lastly, upgrading the facilities of PHC delivery services and building newer units to meet new demands and population growth is recommended as well as applying a bottom up approach with major emphasis on community empowerment, disease prevention, and health promotion.

References 1 Roemer M. Joint financial managment Assessment. The analytical method in the process of planning and its application in the development of orthopaedic hospital department, Srpski arhiv za celokupno lekarstvo, Year: Glob Heal Work alliance.

South-South cooperation in the Primafamed project as strategy for development, Family Practice, Year: International Encyclopedia of Public Health. Khartoum Natl Heal Inf Cent.