Allopathic medicine, or allopathy: The system of medical practice which treats disease by the use of remedies that produce effects different from those caused by the disease itself. Also called conventional, modern, or Western medicine.
Bilateral aid: Assistance given by one government directly to the government of another country. It is often employed strategically and directed according to political considerations, not only humanitarian ones.
Catastrophic health spending: Refers to health expenditure that is large relative to a patient’s capacity to pay. The payment itself need not be large, and, conversely, even large payments may not be deemed catastrophic if there are resources available to pay. Such resources may be the patient’s own or those available through external sources, such as insurance coverage. There is no consensus around the threshold for defining catastrophic health spending, and it varies throughout the literature. This report uses a more conservative approach, defining catastrophic health spending as that which exceeds 40 percent of a household’s income after basic subsistence needs are met. (Wyszewianski, 1986; Xu et al., 2003, 2007)
Child mortality rate, or under-five mortality rate: The number of children who die by the age of 5 per thousand live births per year.
Civil registration: The system by which a government records the vital events of its citizens and residents. The resulting repository or database is called civil register or registry, or population registry. The primary
purpose of civil registration is to create legal documents that are used to establish and protect the civil rights of individuals. A secondary purpose is to create a data source for the compilation of vital statistics.
Country ownership: The ability of a country’s government, communities, civil society and private sector to lead, prioritize, implement, and be accountable for a country‘s health response.
Directly Observed Treatment, Short-course (DOTS): The internationally recommended strategy for tuberculosis control. It is a standardized treatment.
Epidemiological transition: A theory that focuses on the complex change in patterns of health and disease and on the interactions between these patterns and their demographic, economic and sociologic determinants and consequences. The transition portion of the theory is concerned with changes in population growth trajectories and composition, especially in the age distribution from younger to older. It also takes into account the changes in patterns of mortality, including increasing life expectancy and reordering of the relative importance of different causes of death. This reordering involves a shift in population-level causes of illness and death from infectious to chronic disease.
Health: As defined by the World Health Organization, a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Health care: The diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments through services delivered by the medical and allied health professions. It refers primarily to the work done in providing primary care, secondary care, and tertiary care. In some health systems planning it may also include public health population based interventions. In this document, these types of interventions are included in health services.
Health diplomacy: The concept that global health has strategic value and is an important part of the foreign policy of the United States (IOM, 2009). It is one of the key objectives articulated in the Department of Health and Human Services’ Global Health Strategy. Health diplomacy requires: “engag[ing] on health issues with diplomatic partners, whether
individual countries or international organizations and strengthen[ing] peer-to-peer technical, public health, and scientific relationships” (HHS, 2011, p. 42).
Health, or service, infrastructure: Refers to the health care system, including hospitals, the financing of health care, including health insurance, the systems for regulation and testing of medications and medical procedures, the system for training, inspection and professional discipline of doctors and other medical professionals, public health monitoring and regulations, as well as coordination of measures taken during public health emergencies such as epidemics. For purposes of this report, it is synonymous with the term health system.
Health insurance: A mechanism by which money is raised to pay for health services by financial contributions to a fund; the fund then purchases health services from providers for the benefit of those who are covered by the scheme. Health insurance contributions may be combined with a payment for other social benefits, in which case the scheme is called social insurance. The payments may be voluntary or compulsory.
Health service: Any service aimed at contributing to improved health including population based services such as community education or vaccination as well as health care services such diagnosis, treatment, and rehabilitation of sick people. Health services can include health education, health promotion, and environmental services such as housing, sanitation, etc., which have a known health benefit.
Health system: The sum total of all the organizations, institutions, and resources whose primary purpose is to improve health.
Horizontal, or integrated, program: A type of health program that “incorporate[s] several health interventions as part of a comprehensive primary care approach, usually delivered through government health facilities” (Victora et al., 2004, p. 1542-3).
Implementation science/research: “The scientific inquiry into questions concerning implementation—the act of carrying an intention into effect, which in health research can be policies, programs, or individual practices (collectively called interventions)” (Peters et al., 2013a).
Maternal death: The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
Maternal mortality ratio: The number of maternal deaths per 1,000 live births.
Millennium Development Goals (MDGs): A set of eight goals and corresponding time-bound targets to improve health and the standard of living globally by 2015. The MDGs were derived from the UN Millennium Declaration, which was adopted by all 189 member states at the Millennium Summit of the United Nations in New York in 2000. Through this declaration, world leaders committed to a new global partnership to reduce extreme poverty and established a series of targets that became known as the MDGs. The goals are as follows: (1) to eradicate extreme poverty and hunger; (2) to achieve universal primary education; (3) to promote gender equality and empower women; (4) to reduce child mortality; (5) to improve maternal health; (6) to combat HIV/AIDS, malaria, and other diseases; (7) to ensure environmental sustainability; and (8) to develop a global partnership for development.
Multilateral aid: Assistance provided by a group of countries or an institution representing a group of countries, such as the United Nations or the World Bank, rather than by one specific country.
Out-of-pocket health expenditure: Any direct outlay by households for medical care and other goods and services whose primary intent is to contribute to improved health status. Out-of-pocket payments are those expenditures which are not reimbursable by insurers or other third parties; they can include official user fees (charges for service), co-payments, and deductibles as well as unofficial or informal payments. When measuring out-of-pocket health expenditure, the costs of transportation and related expenses are often not included.
Prepayment: A system of collecting funds for health expenses prior to the point-of-care. It may be in the form of taxes, insurance, or a combination of the two.
Primary (health) care: The medical care a patient receives upon first contact with the health care system, before referral elsewhere within the system.
Secondary (health) care: Hospitals and outpatient specialist clinics to which people go, after referral from primary health care services. These services are generally more specialized and further from where people live. They often include a greater range of diagnostic services such as X-ray and pathological laboratory services; they may also include specialized treatment such as operating theatres, radiotherapy and certain drug therapies not normally available in primary care.
Stock out: Refers to when a pharmacy or other medical facility temporarily exhausts its inventory of medicine. Such an event may affect one or more medicines; in the worst case scenario, it might affect all medicines. A stock-out may occur at one point in time, or it may take place over a period of days, weeks, or even months.
Surveillance: A key component of epidemiology, it can be defined as the ongoing collection, analysis, interpretation, and dissemination of health-related data. Surveillance is one of a number of methods used by epidemiologists to gather information on a disease.
Sustainability: According to USAID, the capacity of a host-country entity to achieve long-term success and stability and to serve its clients and consumers without interruption and without reducing the quality of services after external assistance ends. The ultimate goal is a health sector element that is entirely owned and operated by local institutions and structures.
Task shifting: The rational redistribution of tasks among health workforce teams. Specific tasks are moved, where appropriate, from highly qualified health workers to health workers with shorter training and fewer qualifications in order to make more efficient use of the available human resources for health care delivery.
Technical assistance: A type of aid whose object is to provide less-developed countries with the expertise needed to promote development. It may involve sending experts into the field to teach skills and to help solve problems in their areas of specialization. Conversely, scholarships,
study tours, or seminars in developed countries may be offered, giving individuals from less-developed countries the opportunity to learn special skills that they can apply when they return home.
Tertiary (health) care: Specialized care that offers a service to those referred from secondary care for diagnosis or treatment, and which is not available in primary or secondary care. This kind of care is generally only available at national or international referral centers. Tertiary care has become a common feature in certain specialties for rare conditions, or where the diagnostic or treatment facilities are scarce or require scarce combinations of resources, or which remain essentially the subject of research.
Universal (health) coverage: Defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. Its goal is “to ensure that all people obtain the health services they need without suffering financial hardship when paying for them” (WHO, 2012b).
User fees: Direct charges to users for health services. Such fees are a major component of out-of-pocket health expenditure, and the terms are used interchangeably throughout this report.
Vertical, or categorical, program: A type of health program that “deliver[s] selected interventions, often independently, with specialized management, logistics, and delivery mechanisms. These services could be delivered parallel to, or even outside, other essential interventions targeting the same populations” (Victora et al., 2004, p. 1543).
Vital statistics: Statistics on live births, deaths, fetal deaths, marriages, and divorces. The most common way of collecting information on these events is through civil registration, an administrative system used by governments to record vital events which occur in their populations.
