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Integrating Health Care and Public Health Systems

Integrating Health Care and Public Health Systems

System thinking tools can be used for several applications. An example of a system thinking tool is the causal loop diagrams (CLD). CLDs can capture the relationships between the variables of a system by utilizing associations between cause and effect (Abdelbari & Shafi, 2017). In public healthcare systems, the elements are related to each other. The relationships determine the outcomes and can help understand the healthcare systems under investigation.

The Components of the  Health Care System in Senegal

There are six core components of any healthcare system: healthcare workforce, service delivery, health information systems, financing, governance, and access to essential drugs (Manyazewal, 2017). Three types of healthcare providers offer healthcare services in Senegal. Public healthcare facilities are operated by the Ministry of Health (MoH), facilities are operated by the army, and private facilities are operated (Ministry of Health, 2011). The Ministry of Health manages more than 1200 healthcare centers, with over ninety percent of these facilities run by midwives or nurses. These public healthcare facilities have inpatient and outpatient departments managed by a medical officer. The public health care system operates in a pyramid form. The pyramid base contains rural maternities managed by midwives or nurses, followed by health referral centers, regional hospitals, and national hospitals (Mbathio, 2017). The referral system is up the pyramid.

Core Services in the Senegalese Health System  and Managers

There are three groups of healthcare providers in Senegal. The Ministry of Health runs public health facilities, facilities run by the armed forces, and private facilities (Morain et al., 2016). In Senegal, the healthcare centers are operated by either nurses or physicians. The facilities in the lower end of the pyramid are managed care nurses, while those at the top of the pyramid are managed by physicians. Senegal has nine national hospitals. These hospitals are the major referral facilities at the top of the pyramid. They offer specialized healthcare services. The national hospitals have both inpatient and outpatient departments. They offer services such as psychiatry, specialized curative services, orthopedic services, and spinal injury care.

The second tier in the pyramid is at the regional level. 13 regional hospitals offer referral healthcare services in the regions they serve. The next facilities are at the district level. These facilities offer both outpatients and inpatient services (Mbathio, 2017). The Senegalese Armed forces operate 44 healthcare centers. One of these healthcare facilities is a national hospital. There is one regional hospital, sixteen military base medical facilities, and the remaining ones being laboratories. Medical doctors manage the facilities under the military. They offer services similar to the facilities managed by the Ministry of Health, depending on the level in the pyramid.

Financiers of  the Health Care Services

The Senegalese government aims to address the high poverty levels and minimize out-of-pocket healthcare spending (Morain et al., 2016). There are three insurance schemes in Senegal that finance healthcare. Community-based insurances are for individuals who are in the informal sector. Others include compulsory insurance payments by employers and insurance for specific services and individuals. There are also private insurance companies that offer additional coverage for individuals (Mbathio, 2017).

The compulsory insurance payments are for salaried individuals, those who are retired, and students. This insurance scheme is financed by the national government, pension funds, and insurance companies. The ministry in charge of finance in Senegal has oversight authority over this insurance scheme. The scheme does not cover some drugs. This mandatory insurance only covers about thirty percent of Senegalese, and hence a large percentage of the Senegal population spend out-of-pocket for healthcare services.

Application of the Causal Loop Diagram to Better Address an Infectious Disease

Since time immemorial, humans have been contracting diseases from animals. More than half of infectious diseases recognized in the world have a zoonotic origin. The two most animals that are implicated are bats and monkeys.

The human population has been contracting zoonotic infections from animals since time immemorial. Approximately sixty percent of infectious diseases that affect human beings originate from animals such as monkeys and bats. Senegal was one of the nations in Africa that were hit hard by the Ebola virus. The Senegalese healthcare system can design a causal loop diagram to help them address infectious diseases such as the Ebola virus. The causal loop diagram for an infectious condition such as the Ebola virus requires individuals to be grouped into six categories. The categories include exposed, infected, immune individuals, dead infected, susceptible, and recovered individuals (Abdelbari & Shafi, 2017). Scenario analysis can then be utilized to assess the impact of control strategies on the disease outbreak.

The causal loop diagram has a lot of applications. It can be utilized to assess the effectiveness of certain preventive measures such as immunizations. Furthermore, it can assess the applicability of other disease preventive measures such as quarantine. It can also help in rigorous sensitization and education of the public on the healthcare effects effect posed by the outbreak of an infectious disease. The simulation results from causal loop diagrams show that education and sensitization of the public are more effective in controlling the outbreak of an infectious disease.

The causal loop diagram can also reveal that community health literacy can help promote awareness of the disease and thus minimizing the spread of the contagious illness. In addition, by using the causal loop diagram, it can be revealed that education and sensitization of the public transform their behavior and thinking. They thus attend funerals with caution and wear personal protective equipment to protect themselves from the infection. Education and sensitization strategies are more effective than immunizations in minimizing the spread of contagious infections (Abdelbari & Shafi, 2017).


Abdelbari, H., & Shafi, K. (2017). A computational Intelligence-based Method to ‘Learn’ Causal Loop Diagram-like Structures from Observed Data. System Dynamics Review, 33(1), 3- 33.

Mbathio, D. (2017). Financial Access to Dental Care Through Health Insurance in Senegal. Science Journal Of Public Health, 5(5), 359.

Morain, S., Kass, N., & Grossmann, C. (2016). What allows a health care system to become a learning health care system: Results from interviews with health system leaders. Learning Health Systems, 1(1), e10015.

Manyazewal, T. (2017). Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Archives of Public Health75(1).

Integrating Health Care and Public Health Systems

Benchmark -Integrating Health Care and Public Health Systems

When considering public health and health care systems and the services they provide, it is important to think about how these systems and services are integrated. Systems thinking tools are helpful to consider the various links, feedback loops, and decision points within a system to identify opportunities for improvement and increase efficiency.

For this assignment, select a low- or middle-income country of interest and assess its health system. In a 1,000-1,250-word paper, address the following:

  1. Apply a systems thinking tool, such as a causal diagram or process map, to identify opportunities for how gaps in public health services can be bridged through a strong health system.
  2. Describe the major components of the health system.
  3. Discuss core services the health system provides and who manages them (government, private sector, a mix of both, etc.).
  4. Discuss who is responsible for paying for those services or who funds the provided services.
  5. Conclude by explaining how the selected systems thinking tool can be applied to better address an infectious disease in the selected country.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite.

Benchmark Information

  • This benchmark assignment assesses the following programmatic competencies:
    • MA Public Health
    • 6: Apply systems thinking tools to a public health issue.


Integrating Health Care and Public Health Systems

Integrating Health Care and Public Health Systems

Due Date: 26-Jul-2021

Maximum Points: 150.0


Read “The Health Impacts of Globalisation: A Conceptual Framework,” by Huynen, Martens, and Hilderink, from Globalization and Health (2005). URL:

Read “Participant Guidelines: Systems Tools for Complex Health Systems: A Guide to Creating a Causal Loop Diagrams,” by de Pinho (Columbia University Mailman School of Public Health) (2015), located on the World Health Organization (WHO) website. URL:

Read “Guide: How to Process Map,” by the Agency for Clinical Innovation (2015). URL:

Read “Building From Common Foundations: The World Health Organization and Faith-Based Organizations in Primary Healthcare,” by Bandy et al. (2008), located on the World Health Organization website. URL:

Read “Globalization of Health Care: Designing, Developing, and Implementing a Just World Class Health System in a Frontier Market,” by Waruingi et al., from Journal of Global Health Care Systems (2013). URL:

Read “The Global Health System: Actors, Norms, and Expectations in Transition,” by Szlezak et al., from PLOS Medicine (2010). URL:

Read “Assessing the Health Impact of Transnational Corporations: Its Importance and a Framework,” by Baum et al., from Globalization and Health (2016).URL:

Read “Framing International Trade and Chronic Disease,” by Labonte, Mohindra, and Lencucha, from Globalization and Health (2011). URL:

Read “Declaration of Alma-Ata,” by the International Conference on Primary Health Care (1978), located on the World Health Organization (WHO) website. URL:

Read “A View of Health Care Around the World,” by Wallace, from Annals for Family Medicine (2013). URL:

Read “Health Care Systems in Low- and Middle-Income Countries,” by Mills, from New England Journal of Medicine (2014). URL:

Read “The WHO Health Systems Framework,” located on the World Health Organization (WHO) website. URL:

Read “Five Capitalist Democracies and How They Do It,” by Frontline (2008), located on the PBS website. URL:

Explore the Management Sciences For Health website. URL:



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