Health care systems

1
Health care systems

• Health care systems are cultural systems.
• Health care systems include patterns of belief
  about the causes of illness, norms governing
  choice and evaluation of treatment,
  socially-legitimated statuses, roles, power
  relationships, interaction settings, and
  institutions.

2
Health care systems

• Kleinmans critique of medical professional
  specialists
• The ethnocentrism and scientism that dominate the
  modern medical and psychiatric professions (in
  both developed and and in developing countries)
• The bias of many health professionals in
  developing sicieties in restructuring health care
  delivery in their countries by copying an
  idealized model of professional care in
  technologically advanced societies.
• The longstanding tendency of clinicains to treat
  healing as if it were a a totally independent,
  timeless, cultre-free process to be understood
  either as an isolated special case or by
  comaprisons with clinical practices in
  psychoanalytic therapy, hypnosis, biofeedback,
  and the like.

3
Clinical reality

• Sick person
• Psychobiological reality underpinning symptoms
  and therapeutic effects
• Symbolic reality mediating sickness and care
• Clinical reality (the social structural and
  cultral context of sickness and care)
• Physical environmental context of sickness and
  care

4
External influences acting on health care systems

• Political factors
• Economic factors
• Social structural factors
• Historical factors
• Environmental factors
• Cultural factors

5
Inner structure of health care systems

• Popular sector
• Professional sector
• Folk sector

6
Sectors of health care systems

• The popular sector
• The lay, non-professional, non-specialist,
  popular culture arena in which illness is first
  defined and health care activities initiated.
• It is the nexus of the boundaries between the
  diffferent sectors.
• It is the largest of the three sectors

7
Sectors of health care systems

• The professional sector
• The organized healing professions (eg. Allopathic
  /western medicine, Chinese medicine, Ayurveda)
• The folk sector
• Non-professional, non-bureaucratic, specialists
  (eg. Shamans, diviners, herbalists, bonesetters
  etc.)