HEALTH ECONOMICS-min-merged

Explain national population policy, understand the concept of unmet need of family planning, classify fertility regulating method, comprehend barrier method, classify natural methods of fertility control, explain sterilization and its complication.

1. To impart evidence-based research-oriented medical education. 2. To provide the best possible patient care. 3. To inculcate the values of mutual respect and ethical practice of medicine.

Total fertility rate.

64.39.

The proportion of males and females in different age-groups.

Censuses, sample surveys, immigration records, vital registration records.

The society has to arrange for the care of the elderly, and the country’s health system must be organized accordingly.

A situation where no increase in living standards is possible due to fast population growth.

The number of immigrants per 1,000 population in a given year.

It helps tailor care to specific healthcare needs and identify groups needing attention.

It indicates the average number of years that a person can expect to live from the time of birth if they experience throughout their life the age-specific death rates currently prevailing.

Educational programs targeting specific population groups.

The country has to provide more schools, immunizations, and economic support for the young.

By finding the difference between new and old population, dividing by the old population, and multiplying by 100.

It is because of decline in fertility.

The difference between the number of immigrants and emigrants per 1,000 population in a given year.

Census, Projections, Registrations, Migration Reports, and Surveys.

Pt1 = Pt0(1+r)^t

It has improved by 5.52 years, from 60.1 years in 2000 to 65.6 years in 2019.

They can provide customized healthcare services addressing unique health needs.

Gr = N / t, where Gr is the growth rate, N is the change in population, and t is the period of time.

By subtracting the crude death rate from the crude birth rate.

The portion of demography that studies the size and age composition of populations and how they change over time.

T = 70/r (r=annual growth rate)

Either decennially or quinquenially, and repeated every 5 to 10 years.

Status of breastfeeding, menstrual history, associated medical conditions, couple's compliance potential.

Develop educational programs targeting specific population groups.

Sex Ratio = (Number of Males / Number of Females) x 100

The average number of years that a person could expect to live in 'full health' from birth, taking into account years lived in less than full health due to disease and/or injury.

The philosophical study of ethical problems arising from actions affecting future births and population size.

By using the rule of 70, which involves dividing 70 by the growth rate.

Absolute numbers.

Using the formula: (Births + Immigration) - (Deaths + Emigration) / Total population * 100.

When a couple has two births during their reproductive life, just enough to replace themselves.

A spectrum of the population at a specific point in time, covering economic, demographic, and social attributes.

A group of individuals or items that share one or more characteristics from which data can be gathered and analyzed, or a group of individuals living in the same area and sharing the same local conditions of the environment.

Safe, effective, acceptable, inexpensive, reversible, long-lasting, simple to administer, requiring little or no medical supervision.

Disability, impairment, and handicap.

India, 2000.

Bio-demographic factors, literacy, mode of delivery, mothers’ socio-demographic factors, and antenatal clinic attendance.

It is the approximate magnitude of the completed family size.

The number of persons living per square kilometer.

It allows practitioners to provide customized healthcare services based on the demographics of specific populations.

The change from high rates of births and deaths to low rates of births and deaths.

To estimate the doubling time, divide 70 by the percentage growth rate.

A graphical illustration that shows the distribution of various age groups in a population.

TFR = Sum of ASFR x 5 / 1000

2.1 births per woman, to compensate for child deaths.

As a process of collecting, compiling, and publishing economic, social, and demographic data pertaining to all individuals in a country at any specific point in time.

The scientific study of human population, focusing on changes in population size, composition, and distribution in space.

Refer to https://www.sciencedirect.com/science/article/abs/pii/S0277953619301534

As any loss or abnormality of psychological, physiological, or anatomical structure or function.

Proper spacing and limitation of births, advice on sterility, education for parenthood, screening for pathological conditions related to the reproductive system, genetic counseling, premarital consultation and examination, pregnancy tests, marriage counseling, the preparation of couples for the arrival of their first child, sex education, teaching home-economics and nutrition, providing adoption services, and providing services for unmarried mothers.

Broad Base - high birth rates, Narrow Top - small elderly population.

231,402,116.

The ethical problems arising when our actions affect who is born and how many people are born in the future.

It is reached when the Net Reproduction Rate (NRR) equals 1.0, indicating that surviving women in a hypothetical cohort have exactly enough daughters to replace themselves in the population.

Low population growth.

Information about the age and gender distribution of a population.

Rectangular-shaped with zero population growth.

Population size, sex ratio, dependency ratio, density, birth rate, death rate, natural growth rate, life expectancy at birth, mortality and fertility rates.

The number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates.

Fertility, mortality, marriage, migration, and social mobility.

Refer to https://blogs.einsteinmed.edu/why-family-planning-must-be-mandated-in-family-medicine-programs/#:~:text=Birth%20control%2C%20and%20family%20physicians,primary%20care%20and%20preventive%20medicine.

Generally assumed to be between 15 to 45 years.

Over 1 billion people live with some form of disability. The number of people with disability is dramatically increasing due to demographic trends and chronic health conditions. Almost everyone is likely to experience some form of disability at some point in life. People with disability are disproportionately affected during the COVID-19 pandemic. When people with disability access health care, they often experience stigma and discrimination, and receive poor quality services. There is an urgent need to scale up disability inclusion in all levels of the health system, particularly primary health care.

Maternal mortality, the avoidance of unwanted pregnancies, limiting the number of births and proper spacing, timing the births particularly the first and the last in relation to the age of the mother, morbidity of women of childbearing age, and preventing complications of pregnancy and abortion.

Maternal mortality, Under-five mortality, Neonatal mortality, Adolescent birth rate, Mortality due to unsafe water, sanitation and hygiene, Mortality due to air pollution (household and ambient).

High young dependency ratio.

Exploring when, how, and why populations grow based on empirically observed patterns.

Triangular shaped.

Factors that force a person to migrate out of an area.

X-axis: Age groups, Y-axis: Number or percentage of population.

Low birth rates.

It is equivalent to attaining approximately the 2-child norm.

Increasing the urban population & growth of cities.

The study of how and why populations change in size and structure over time, including factors such as rates of reproduction, death, and migration.

K.Park 25th edition, Chapter 9 Demography and Family Planning; ILYAS ANSARI 8th edition, Chapter 52 Family Planning and Child spacing.

The actual bearing of children.

Currently married couples where the wife is in the reproductive age.

Biological issues, organ level, person, function, and social concern.

Fetal mortality, health of the newborn at birth, and abnormal development.

Balance pyramid - Balanced sex ratio.

Births attended by skilled health personnel.

Poverty in a rising Africa.

Census, vital statistics, surveys, and online research sources.

Factors that encourage a person to migrate to a specific area.

It is built into the age composition of current populations and changes in reproductive behavior and mortality of generations yet to come.

Balance in the population proportion.

A rapid increase in the size of a population caused by factors such as a sudden decline in infant mortality or an increase in life expectancy.

Size of the population, rate of growth, age-sex structure, average size of household, movement of people, occupation distribution, urban and rural population size, wealth status, and family structure.

Roughly from 15 to 45 years, a period of 30 years.

Migration out of the country.

The percentage of eligible couples effectively protected against childbirth by approved methods of family planning.

In the case of leprosy, damage to nerves (primary impairment) leads to plantar ulcers (secondary impairment).

Neonatal, infant, and preschool mortality, child growth, development and nutrition, and vulnerability to diseases.

Singapore, 2000.

Child stunting, child wasting, child overweight, Access to safely managed drinking-water source, Access to safely managed sanitation, Clean household energy, Ambient air pollution.

Difficult questions and global challenges related to population and ethics.

Low growth rate.

Head of the family moving, transfer of job, marriage in case of females, business and economic deprivations, absence of or poor educational facilities, retirement and no re-employment, no housing shelter, divorce, fragmentation of agricultural land, and poor relationship with other members of the community.

It occurs due to the number of children per woman and the number of women in reproductive age.

War, fear of war, civil war, racial discrimination, oppression, overcrowding, natural calamities, economic factors, cultural factors, and environmental factors.

Equal proportion of males and females in the population.

Increase in fertility rates, early marriages, increase in longevity/decrease death rate, improvement in public health and medical services, improvement of MMR, lack of education, and migration.

Psychological, social, economic, demographic, spacing of children, family planning, nutrition, and other factors.

It is a model that describes the transition from high birth and death rates to low birth and death rates as a country develops from a pre-industrial to an industrialized economic system.

Migration from outside towards the country.

The percentage of women of reproductive age (15-49) who are using (or whose husband is using) a contraceptive method at a particular point in time.

Rocket-shaped / Narrow Base - Low Birth Rates, Slow population growth.

Continuing Clients, New Clients, Review client’s experience with method, Check that client is using method correctly, Discuss client's reproductive goals, Review client’s medical history, Review client’s contraceptive experience, Discuss client’s personal situation, Understanding personal circumstances, Remind client about side effects, Discuss client’s ability to tolerate side effects, Teach about alternative methods, Offer accurate information, Narrow down options, Teach about the preferred methods, Provide information of all available methods, Weigh pros and cons of continuing vs. switching, Explore client’s reason for choice, Examine provider’s influence on the decision, Weigh pros and cons of preferred methods for client, Explore client’s reason for choice, Examine provider’s influence on the decision, Choosing the best option, Reinforce instructions about method use, Provide additional supplies, Schedule future visits or further counseling, Teach how to use the method, Give directions for check-ups or resupply, Instruct how to respond to problems, Implementing the decision, Welfare concept is related to better quality of life.

Religious beliefs, low literacy rate, fear of side effects, fear of being infertile, lack of knowledge and motivation, lack of support from in-laws, lack of communication among married couples over this topic, and limited supplies of contraceptives.

It is the potential for economic gains when the share of the working-age population is higher than the non-working age group.

Future housing estates, schools, and jobs.

Earthquakes, excessive rainfall and floods, long persistent drought, weather severity, eruption of volcano, severe and repeated cyclones, and epidemics.

Increased demand for food, water, housing, energy, healthcare, transportation, leading to ecological degradation, increased conflicts, and a higher risk of large-scale disasters like pandemics.

The number of live births per 1000 population in a given year.

The stages include high stationary, early expanding, late expanding, low stationary, and declining. Each stage represents different population growth patterns.

Migration towards a geographical unit from within the country.

It does not take into account large-scale global challenges like pandemics or climate change, migration, and varying factors within a country which influence birth and death rates.

Large group of economically active population.

A sustained pattern comprising high fertility, low infant mortality, low death rates, and very little economic growth.

Increase food production, build more homes and schools, plan for more job opportunities, and implement birth control campaigns.

High job availability, higher wages, more exciting lifestyle, better living conditions, industry, and education.

Family planning, education, improving healthcare, and migration policies.

The number of live births per 1000 women of childbearing age in a given year.

The model does not account for cultural, social, and economic factors that can influence population growth. It also assumes a linear progression through stages, which may not always be the case.

Migration out from a unit to other units within the country.

The relationship between population growth and resources, specifically food supply, and the idea of an optimum population size that the world's food supply can support.

Balanced pyramid.

The total number of children a woman would have by the end of her reproductive period if she experienced the currently prevailing age-specific fertility rates throughout her childbearing life.

a) Undue burden on resources and space b) Poverty and unemployment c) Food scarcity and water crisis d) Housing issues and growth of slums e) Healthcare problems and illiteracy f) Corruption and mismanagement g) Growing crimes and conflicts h) Populism and ethnic tensions

Political freedom, racial harmony, greater safety and security, more exciting lifestyle, better medical care, security, family links, and better chances of marriage.

To see differences in fertility behavior at different ages or for comparison over time.

It suggests that population growth will outpace agricultural production, leading to widespread famine and societal collapse unless controlled by preventive checks (e.g., moral restraint, delayed marriage) or positive checks (e.g., disease, war, famine).

The combined effect of emigration and immigration.

There would be a reduction in living standards, coupled with events to curb the population.

Niger, with almost 7 children per woman.

Political freedom, greater safety and security, attractive climates, land fertility, and better sanitary conditions.

Demography is concerned with the size, breakdown, age and gender structure and dynamics of a population, and its robust methodologies are equally applicable to the demography of the health workforce itself. For example, in a world with an overall shortage of health workers, studying and understanding demographic characteristics of the workforce can help with future planning.

It refers to the continued growth of a population after replacement-level fertility has been achieved, due to a relatively high concentration of people in the childbearing years.

The combined effect of in-migration and out-migration.

The food supply would eventually be unable to keep up with population growth as the latter would double in 25 years.

Almost 3.2 births per woman.

It is important to understand the structure of a population in order to plan health and public health interventions, and population structures in advance. Demographic, epidemiological, and health transitions help explain dramatic shifts in population structure and patterns of disease that have taken place in most countries.

International migration crosses a boundary, is easier to control, regulated, and involves a difference in income. National migration occurs between states or provinces, has little control, and involves employment opportunities, education, and retirement.

It is the economic growth potential that can result from shifts in a population’s age structure, mainly when the share of the working-age population is larger than the non-working-age share.

It refers to the rate at which the population would grow if the current generation of childbearing women started producing children at replacement fertility.

An intervention to help women and families delay or space their pregnancies to achieve the healthiest outcomes for women, newborns, infants, and children within the context of free and informed choice.

Population dynamics - how populations change in response to the interplay between fertility, mortality, and migration, which is a pre-requisite for making forecasts about future population size. It also uses resource allocation and is the denominator for health and other population statistics.

Voluntary migration is the outcome of a choice, while involuntary migration is the outcome of a constraint.

It is calculated by subtracting the death rate from the birth rate and dividing by 10 to get the percentage growth rate.

The change that populations undergo from high rates of births and deaths to low rates of births and deaths.

Japan reached its peak population in 2009 despite its Total Fertility Rate (TFR) remaining below replacement levels since 1985, due to the inertia from Japan's youth entering reproductive years.

At least 24 months to reduce maternal, perinatal, and infant outcomes.

It helps in understanding how long it will take for a population to double at a particular growth rate, which is crucial for urban planning, resource allocation, and infrastructure development.

High birth rate, high death rate, little or no growth.

At least six months to reduce risks of adverse maternal, perinatal, and infant outcomes.

Famine/drought, communicable diseases/pestilence, poverty, wars, natural disasters.

To reduce risks of adverse maternal, perinatal, and infant outcomes.

People intended to produce more children to compensate lost ones, religious beliefs.

Factors for selecting an appropriate contraceptive.

High birth rate, falling death rate, high growth.

Receding pandemics, vaccines, better sanitation, antibiotics, literacy.

The demographic equation is represented as Pn = Po + (B - D) + (I - E), where Pn is the population at time n, Po is the population at the previous time, B is the number of live births, D is the number of deaths, I is the number of persons moving into the area, and E is the number of persons moving out of the area.

The decline in mortality.

The population at a particular time is calculated using the demographic equation: Pn = Po + (B - D) + (I - E), where Pn is the population at time n, Po is the population at the previous time, B is the number of live births, D is the number of deaths, I is the number of persons moving into the area, and E is the number of persons moving out of the area.

Declining birth rate, relatively low death rate, slowed growth.

The population in the future is calculated using the demographic equation: Pn = Po + (B - D) + (I - E), where Pn is the population at time n, Po is the population at the previous time, B is the number of live births, D is the number of deaths, I is the number of persons moving into the area, and E is the number of persons moving out of the area.

Literacy, late marriages, contraceptive prevalence.

Push factors are reasons that drive people to leave their place of origin, while pull factors are reasons that attract people to a new location.

Better health care, degenerative diseases.

Various measures of migration include net migration rate, immigration rate, and emigration rate.

Low birth rate, low death rate, very low population growth.

Urbanization leads to increased population density, changes in lifestyle, and challenges related to infrastructure and resource management.

Number of people is actually decreasing.

Population density refers to the number of people living per unit area, usually expressed as persons per square kilometer or square mile.

The model excludes the affect of migration, transition takes a long time, transition occurs without any governmental intervention, model cannot be applied to all countries, transition occurs when there is a widespread use of family planning measures.

Replacement level fertility is the level of fertility at which a population exactly replaces itself from one generation to the next, without migration.

Life expectancy is the average number of years a person is expected to live. It is calculated using statistical methods based on age-specific death rates.