Let’s Change Our Direction On Global Health – How About Diagonally?

Global healthcare in the 21st century is in need of extensive action to address the complex issues that face the system today. These issues typically affect the most vulnerable populations across the world, which begs the question: what is the healthcare system supposed to achieve? By answering this question, we can gain a better understanding of the challenges found in global health and why some health issues receive more attention than others.

Part of the answer could possibly be found by taking a diagonal approach to global health. Maternal healthcare is a great example. By addressing issues like maternal mortality rates through a diagonal approach, other interconnected health issues can be addressed, such as child immunizations, health education, family planning and HIV testing. According to a recent study done by the Department of Maternal and Child Health at the UNC Gillings School of Global Public Health, HIV and malaria are major causes of maternal morality in Mozambique. Developing maternal health services in ways that address other major health concerns will make the healthcare system more efficient and improve the overall health of the community.

An integrated and diagonal approach to maternal health was also explored in 2011 during the two day Nairobi meeting on “Maternal Health Challenges in Kenya: What New Research Evidence Shows”, where policymakers, Kenyan health experts, as well as the Woodrow Wilson Center in DC and the African Population and Health Research Center partnered to discuss possible initiatives for improving maternal healthcare. During the discussion, it was acknowledged that in order to move forward, other issues like access to health care facilities, rural/urban divide, weak referral systems, and lack of skilled physicians also need to be addressed. Integration among the various health sectors is key. However, John Townsend, vice-president of the reproductive health program for Population Council, made a good observation – “Integration is a terrific issue, but when the health sectors are weak, putting more burden on a local community health worker does not usually make sense.” Townsend’s statement is something to keep in mind. However, vertical and horizontal approaches to healthcare have weaknesses. So, new approaches must be explored.

By taking a diagonal approach to global healthcare, other important issues and social determinants will be analyzed. It seems the only way forward is to move past the idea of vertical and horizontal approaches. The world we live in today is influenced by the effects of globalization and the growth of institutions. Our lives are more diverse, complex, and integrated – our approaches to systems like global healthcare should be, too.


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