Date: 2025-03-14 Page is: DBtxt003.php txt00000509
HEALTH
OXFAM ... GLOBAL HEALTH CHECK
Announcement of this new Oxfam initiative to have dialog about global health
OXFAM ... GLOBAL HEALTH CHECK
Announcement of this new Oxfam initiative to have dialog about global health
Peter Burgess COMMENTARY
This is a response (written in September 2011) related to the following message below:
Dear ColleaguesAdditional commentary ... December 2022 (about 11 years later)
I am glad to see this initiative. A good dialog about important matters is a step in the right direction ... but what are important matters? I argue that the purpose of any economic activity, including academic study and dialog is to improve quality of life, but my impression of the modern world is that most resources are actually allocated to profit and self-serving wealth creation, and the society at large 'be damned'. I refer to this as the 'capitalist market economy' which has no ability to do anything except what is profitable, when what we need is a 'value market economy' where resources get allocated to economic activities that do the most to add value, satisfy critical needs and improve quality of life.
In the case of the health sector, there has been wonderful progress in the science, but the sector is in disarray when it comes to the application of the science in an affordable cost effective way to those that need health services. There are dysfunctionalities at both the rich end of the sector (USA for example) and at the economic 'base of the pyramid' (BOP). I have been critical for years about the management information used within the health dialog and specifically the lack of cost accounting information on one side and the lack of specific health impact on the other.
Observing socio-economic development over a period of several decades I have concluded that performance is a function of place as well as the specifics of the intervention. I am on record that there could be a tenfold improvement in performance if interventions were optimized to suit the location ... and of course there need to be place specific data to keep track of this.
I will follow the Global Health Check ... it might be interesting
Peter Burgess
@truevaluemetric
www.truevaluemetrics.org
I have revisited this piece of the TVM archive and find that the embedded weblink for Global Health Check does not apprear to exist. This is one of the reasons that I determined to develop the TVM archive where information gets stored according to a TVM determination of its utility.
One of the things that is interesting about health and the health sector, and in particular global health is that there is massive technological progress and disturbingly weak performance in terms of healthcare delivery and the health of the global population.
The is not unique to the healrh sector ... much the same has happened in nearly every aspect of the enviro-socio-economic (ESE) system and the issue ... actually multiple issues ... are rarely talked about either by the media or in academia.
TVM has concluded that the progress and performance of the global ESE system can be substantially improved with the application of improved management metrics along the lines being advocated by TVM. Metrics like national level GDP growth, corporate profits and stock market prices need to get much less attention and much more attention needs to paid to the state of nature (the environment) and society (people). It is now more than 40 years since the correlation between quality of life (wages) for people and profits for corporations and investors started to diverge ... and in this four decades, thosie with wealth, power and influence have done virtually nothing to change things. As a result the economy and society have reached record levels of inequality. Worse, all the signs suggest that these same people with wealth, power and influence will do little or nothing in the face of all the issues related to climate change and the degradation of the environment.
Better management metrics can make a difference. TVM replicates the core structure of double entry accounting that addresses econmic performance to address the activities that relate to the environment and to society as well. TVM also incorporates some concepts associated with responsibility that have been used within corporate management in the past. This idea of 'responsibility accounting' was not popular because it made a lot of low-performars people at the top of the corporate ladder very nervous.
Finally, for now, the TVM framework for accounting and accountability removes the responsibility for reporting about an economic activity from the company and people doing the activity to an outside independent actor and actors. This idea is not well developed, but it is clear that much of what is actually very important remains hidden with a corporate bubble, and these corporate bubbles are getting bigger and more opaque all the time ... but all of these big corporate entities are made up of multiple ... often thousands ... of quite observable operations. Old style management accounting does not work in this situation, but modern data processing tools now make it possible to do such accounting and analysis.
Peter Burgess
Written by Anna Marriott
September 15, 2011
To Peter Burgess peterbnyc@gmail.com
From Anna Marriott AMarriott@oxfam.org.uk Fri, Sep 2, 2011 at 10:44 AM
Reply-To: 'African Networks for Health Research and Development (AFRO-NETS)'
To: phm-exchange
Please join Global Health Check, a new online space designed to provoke debate and conversation on health financing and service delivery. Global Health Check is edited by Anna Marriott, Health Policy Advisor for Oxfam GB, and in the coming weeks the site will feature contributions from a variety of authors.
This first post for Global Health Check reviews recent evidence on the impact of removing user fees for mothers and children in Sierra Leone one year after the policy was first introduced. To read the post online visit Global Health Check: http://www.globalhealthcheck.org/
Here is the first post, on our exciting new platform:
*One year on: the impact of removing health care user fees in Sierra Leone
While there are still some commentators who seem stuck on the question of whether removing fees for health care in poor countries is a good idea at all - thankfully there are others who have moved on to the much more critical question of not whether this should happen - but how.
The recent World Health Report on Health Financing for Universal Coverage leaves no doubt that user fees are a bad idea. In the Director General’s own words, they constitute 'by far the greatest obstacle to progress' on the path to universal access.
Learning how to successfully remove fees is best done by looking at those countries that have made that bold step forward. The introduction of free care for pregnant women and children in 2010 in Sierra Leone – a post-conflict nation with a crumbling and severely under-resourced health system and one of the highest rates of maternal deaths in the world - provides very relevant lessons for the numerous other low-income countries facing similar challenges.
Anna Marriott
Health Policy Advisor
Development Finance and Public Services Team Oxfam GB
mailto:AMarriott@oxfam.org.uk
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AFRO-NETS, an e-forum on health research and development in Africa, is moderated by an expert, and hosted by the FHI360-SATELLIFE Center for Health Information and Technology (www.healthnet.org)