Macroeconomic Perspectives on Demand and Supply

RESEARC H Open AccessIraqi health system in kurdistan region: medicalprofessionals’ perspectives on challenges andpriorities for improvementNazar P Shabila1*, Namir G Al-Tawil1, Rebaz Tahir2, Falah H Shwani2, Abubakir M Saleh1, Tariq S Al-Hadithi1AbstractBackground: The views of medical professionals on efficiency of health system and needs for any changes arevery critical and constitute a cornerstone for any health system improvement. This is particularly relevant to IraqiKurdistan case as the events of the last few decades have significantly devastated the national Iraqi health systemwhile the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims toexamine the regional health system in Iraqi Kurdistan from medical professionals’ perspectives and try to define itsproblems and priorities for improvement.Methods: A survey questionnaire was developed and administered to a convenience sample of 250 medicalprofessionals in Erbil governorate. The questionnaire included four items; rating of the quality of services andavailability of resources in the health institutions, view on different aspects of the health system, the perceivedpriority needs for health system improvement and gender and professional characteristics of the respondents.Results: The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspectsof services and resources in the health institutions as weak or very weak including the availability of the requiredquantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools(68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on theoverall health system. The weak role of medical research, the weak role of professional associations in controllingthe system and the inefficient health education were identified as important problems in the current health system(87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption ofsocial insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting healthinsurance system (76.1%) and periodic scientific evaluation of physicians and other health staff (69.8%).Conclusion: Medical professionals were generally unsatisfied with the different aspects of the health system inIraqi Kurdistan region. A number of problems and different priority needs for health system improvement havebeen recognized that require to be studied in more details.BackgroundThe major objective of a country’s health system is toassure the health of the general public through offeringgood quality and prompt services according to theneeds of the population [1]. The health system needs togo through a process of continuous changes andimprovement in order to be able to cope with differentchanges in the health and population environments andto appropriately respond to different challenges andneeds [2].The history of formal health care system in Iraq beganin early 1920s, but the Iraqi Ministry of Health (MoH)was established in 1952 and its organizational structurewas formalized in 1959. This organizational structurehas changed little since its establishment [3,4]. Thehealth care Macroeconomic Perspectives on Demand and Supply Macroeconomic Perspectives on Demand and Supply By: OpenStaxCollege Macroeconomists over the last two centuries have often divided into two groups: those who argue that supply is the most important determinant of the size of the macroeconomy while demand just tags along, and those who argue that demand is the most important factor in the size of the macroeconomy while supply just tags along Say’s Law and the Macroeconomics of Supply Those economists who emphasize the role of supply in the macroeconomy often refer to the work of a famous French economist of the early nineteenth century named Jean-Baptiste Say (1767–1832) Say’s law is: “Supply creates its own demand.” As a matter of historical accuracy, it seems clear that Say never actually wrote down this law and that it oversimplifies his beliefs, but the law lives on as useful shorthand for summarizing a point of view The intuition behind Say’s law is that each time a good or service is produced and sold, it generates income that is earned for someone: a worker, a manager, an owner, or those who are workers, managers, and owners at firms that supply inputs along the chain of production The forces of supply and demand in individual markets will cause prices to rise and fall The bottom line remains, however, that every sale represents income to someone, and so, Say’s law argues, a given value of supply must create an equivalent value of demand somewhere else in the economy Because Jean-Baptiste Say, Adam Smith, and other economists writing around the turn of the nineteenth century who discussed this view were known as “classical” economists, modern economists who generally subscribe to the Say’s law view on the importance of supply for determining the size of the macroeconomy are called neoclassical economists If supply always creates exactly enough demand at the macroeconomic level, then (as Say himself recognized) it is hard to understand why periods of recession and high unemployment should ever occur To be sure, even if total supply always creates an equal amount of total demand, the economy could still experience a situation of some firms earning profits while other firms suffer losses Nevertheless, a recession is not a 1/4 Macroeconomic Perspectives on Demand and Supply situation where all business failures are exactly counterbalanced by an offsetting number of successes A recession is a situation in which the economy as a whole is shrinking in size, business failures outnumber the remaining success stories, and many firms end up suffering losses and lying off workers Say’s law that supply creates its own demand does seem a good approximation for the long run Over periods of some years or decades, as the productive power of an economy to supply goods and services increases, total demand in the economy grows at roughly the same pace However, over shorter time horizons of a few months or even years, recessions or even depressions occur in which firms, as a group, seem to face a lack of demand for their products Keynes’ Law and the Macroeconomics of Demand The alternative to Say’s law, with its emphasis on supply, can be named Keynes’ law: “Demand creates its own supply.” As a matter of historical accuracy, just as JeanBaptiste Say never wrote down anything as simpleminded as Say’s law, John Maynard Keynes never wrote down Keynes’ law, but the law is a useful simplification that conveys a certain point of view When Keynes wrote his great work The General Theory of Employment, Interest, and Money during the Great Depression of the 1930s, he pointed out that during the Depression, the capacity of the economy to supply goods and services had not changed much U.S unemployment rates soared higher than 20% from 1933 to 1935, but the number of possible workers had not increased or decreased much Factories were closed and shuttered, but machinery and equipment had not disappeared Technologies that had been invented in the 1920s were not un-invented and forgotten in the 1930s Thus, Keynes argued that the Great Depression—and many ordinary recessions as well—were not caused by a drop in the ability of the economy to supply goods as measured by labor, physical capital, or technology He argued the economy often produced less than its full potential, not because it was technically impossible to produce more with the existing workers and machines, but because a lack of demand in the economy as a whole led to inadequate incentives for firms to produce In such cases, he argued, the level of GDP in the economy was not primarily determined by the potential of what the economy could supply, but rather by the amount of total demand Keynes’ law seems to apply fairly well in the short run of a few months to a few years, when many firms experience either a drop in demand for their output during a recession or so much demand that they have trouble producing enough during an economic boom However, demand cannot tell the whole ... Copyright 2011  Pearson Canada Inc. 24 - 1 Chapter 24 Aggregate Demand and Supply Analysis Copyright 2011  Pearson Canada Inc. 24 - 2 Aggregate Demand • Aggregate Demand - The relationship between the quantity of aggregate output demanded and the price level when all other variables are held constant • Based on the quantity theory of money – Determined solely by the quantity of money • Based on the components parts – Consumption, investment, government spending and net exports Y AD = C + I + G + NX Copyright 2011  Pearson Canada Inc. 24 - 3 Quantity Theory of Money Approach to Aggregate Demand M =quantity of money P= price level Y= aggregate real output (real income) P x Y = total nominal spending on goods and services V = the average number of time per year that a dollar is spent Multiplying both sides by M we derive the equation of exchange which relates money supply to aggregate spending M x V = P x Y Changes in aggregate spending are determined primarily by changes in the money supply M YxP V = Copyright 2011  Pearson Canada Inc. 24 - 4 Deriving the Aggregate Demand Curve • Changes in the price level induce changes in the aggregate output demanded and hence movement along the AD curve (points A, B, and C in Figure 24-1) • In the quantity theory, changes in the money supply are the primary source of changes in aggregate spending and thus shifts the AD curve. Copyright 2011  Pearson Canada Inc. 24 - 5 Aggregate Demand Curve Copyright 2011  Pearson Canada Inc. 24 - 6 Behaviour of Aggregate Demand’s Component Parts Y AD = C + I + G + NX The aggregate demand curve is downward sloping because P ↓ → M/P ↑ →i ↓ → I ↑ → Y AD ↑ and P ↓ → M/P ↑ →i ↓ → E ↓ → Y AD ↑ Copyright 2011  Pearson Canada Inc. 24 - 7 Factors that Shift Aggregate Demand • An increase in the money supply shifts AD to the right because it lowers interest rates and stimulates investment spending • An increase in spending from any of the components C, I, G, NX, will also shift AD to the right Copyright 2011  Pearson Canada Inc. 24 - 8 Factors That Shift the Aggregate Demand Curve I Copyright 2011  Pearson Canada Inc. 24 - 9 Factors That Shift the Aggregate Demand Curve II Copyright 2011  Pearson Canada Inc. 24 - 10 Aggregate Supply • Long-run aggregate supply curve (LRAS) – Determined by amount of capital and labor and the available technology – Vertical at the natural rate of output generated by the natural rate of unemployment • Short-run aggregate supply curve (SRAS) – Wages and prices are sticky – Generates an upward sloping SRAS as firms attempt to take advantage of short-run profitability when price level rises [...]... Run Aggregate Supply Short Run Aggregate Supply Factors that Shift Short Run Aggregate Supply I • Costs of production – – – – Tightness of the labor market Expected price level Wage push Change in production costs unrelated to wages (supply shocks) Factors that Shift Short Run Aggregate Supply II Equilibrium of AS and AD in the Short Run Equilibrium of AS and AD in the Long Run I Equilibrium of AS and. .. result of past high unemployment – Natural rate of unemployment shifts upward and natural rate of output falls below full employment – Expansionary policy needed to shift aggregate demand [...]... DDT It is just one of the many battlegrounds in humanity’s long fight against malaria 14 PERSPECTIVES ON DISEASES AND DISORDERS CHAPTER 1 Understanding Malaria VIEWPOINT 1 An Overview of Malaria Carol A Turkington and Rebecca J Frey Photo on previous page The female Anopheles gambiae feeds on human blood Mosquitoes use the blood for egg production, but it may also carry the malaria infection.  (Sinclair... fected person and then passes the infection on to the next human it bites It is also possible to spread malaria via contaminated needles or in blood transfusions This is why all blood donors are carefully screened with questionnaires for possible exposure to malaria Complementary Roles Played by Humans and Mosquitoes in the Malaria Infection Cycle Malaria It is possible to contract malaria in non-endemic... analysis PERSPECTIVES ON DISEASES AND DISORDERS 21 Malaria Anyone who becomes ill with chills and fever after being in an area where malaria exists must see a doctor and mention their recent travel to endemic areas A person with the above symptoms who has been in a high-risk area should insist on a blood test for malaria The doctor may believe the symptoms are just the common flu virus Malaria is often... falciparum malaria in Africa, South Africa, India, and southeast Asia are now resistant to chloroquine In Thailand and Cambodia, there are strains of falciparum malaria that have some resistance to almost all known drugs A patient with falciparum malaria needs to be hospitalized and given antimalarial drugs in different com22 PERSPECTIVES ON DISEASES AND DISORDERS Understanding Malaria binations and doses... air conditioned hotels on tourist itineraries in urban or resort areas are at lower risk than backpackers, missionaries, and Peace Corps volunteers Some people in western cities where malaria does not usually exist may acquire the infection from a mosquito carried onto a jet This is called airport or runway malaria PERSPECTIVES ON DISEASES AND DISORDERS 25 VIEWPOINT 2 Malaria Is One of the Oldest and. .. means of controlling malaria Travelers to high-risk areas should use insect repellant containing DEET for exposed skin Because DEET is toxic in large amounts, children should not use a concen24 PERSPECTIVES ON DISEASES AND DISORDERS Understanding Malaria tration higher than 35% DEET should not be inhaled It should not be rubbed onto the eye area, on any broken or irritated skin, or on children’s hands It... eludes researchers For National Geographic reporter Finkel, writing about malaria had a personal dimension: Finkel himself contracted the illness while traveling in northern Thailand in 2002 SOURCE:  Michael Finkel, “Stopping a Global Killer,” National Geographic, July 2007 Reproduced by permission 26 PERSPECTIVES ON DISEASES AND DISORDERS Understanding Malaria W e live on a malarious planet It may... thousands of Allied forces contracted malaria in the South Pacific and the Allies responded by spraying the region with DDT to combat the high rates of infection among the troops So it was with these successes in mind that WHO began its seemingly monumental task of coordinating a global malaria campaign One of the early target countries was the island nation of Borneo in Indonesia, which had 10 PERSPECTIVES. .. insecticide-treated bed net Prevalence of respiratory symptoms and cases suspicious for tuberculosis among public health clinic patients in Afghanistan, 2005–2006: Perspectives on recognition and referral of tuberculosis cases Yolanda Barbera ´ Lainez 1 , Catherine S. Todd 2 , Ahmadullah Ahmadzai 1 , Shannon C. Doocy 3 and Gilbert Burnham 3 1 International Rescue Committee, Kabul, Afghanistan 2 Division of International Health & Cross-Cultural Medicine, University of California San Diego, La Jolla CA, USA 3 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore MD, USA Summary objectives To assess diagnosis and management of suspected pulmonary tuberculosis (TB) among patients with respiratory complaints attending Comprehensive Health Centers (CHCs) in Afghanistan. methods Consecutive consenting patients presenting with respiratory complaints at 24 health centres in eight provinces were enrolled between November 2005 and February 2006. Demographics, health histories, clinic provider and study representative exam findings and diagnoses, and diagnostic test results were recorded. Correlates of TB-suggestive symptoms (defined as cough >2 weeks and ⁄ or haemoptysis) were assessed by logistic regression. results There were 1401 participants; 24.6% (n = 345) were children (age 17 or under). The TB-suggestive symptoms of cough >2 weeks and ⁄ or haemoptysis were reported by 407 (31.3%) and 44(3.3%), respectively, with 39 participants reporting both symptoms. Of 413 participants reporting TB-suggestive symptoms, only 178 (43%) were diagnosed as having suspected TB; 22.0% received no clinical diagnosis. Suspected TB was significantly associated with having a household member residing in a refugee camp within the last 2 years (OR = 6.0; 95% CI: 4.1–8.7), seven or more people sleeping in the same room (OR = 1.9; 95% CI: 1.4–2.6) and cooking with a wood fire in the sleeping room (OR = 1.6; 95% CI: 1.2–2.2) in univariate analysis. conclusions Diagnostic sensitivity by the health worker for possible cases of pulmonary TB was low, as 22% of persons with suspected tuberculosis received no diagnosis. Further, some common ⁄ chronic respiratory ailments were under-diagnosed. There is great need for improved practical training and continuing education in pulmonary disease diagnosis for clinical health workers. keywords Afghanistan, tuberculosis, respiratory symptoms, cough, sputum smear accuracy Introduction Globally, respiratory disease accounts for 19% of deaths, many avoidable through risk behaviour reduction and prompt diagnosis and treatment (WHO 2000). Among nine developing countries surveyed, respiratory problems comprised 18% of presenting complaints in primary health clinics (WHO 2004). Most reflect acute respiratory infec- tions, responsible for 25% of infectious disease deaths in developing settings (Scherpbier et al. 1998). Pulmonary tuberculosis (TB) is the leading cause of infectious disease mortality globally, with 80% of cases concentrated in 22 low-income countries (Corbett et al. 2003, World Health Organization 2004). Diagnosis of pulmonary TB is a multi-step process, requiring clinical acumen and diagnostic procedures. Criteria for TB-suggestive cases (productive cough >2 weeks and ⁄ or haemoptysis) may be non-specific and result in diagnostic delay by either providers or patients in initiating appropriate investigations (Ward et al. Hepatitis PERSPECTIVES On Diseases & Disorders Jacqueline Langwith Book Editor 1st EDITION Perspectives on Diseases and Disorders Hepatitis 9780737745535_PDD.indd 1 11/3/09 8:31 AM Christine Nasso, Publisher Elizabeth Des Chenes, Managing Editor © 2010 Greenhaven Press, a part of Gale, Cengage Learning Gale and Greenhaven Press are registered trademarks used herein under license. For more information, contact: Greenhaven Press 27500 Drake Rd. Farmington Hills, MI 48331-3535 Or you can visit our Internet site at gale.cengage.com All Rights ReseRved. 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An Overview of Hepatitis 15 Thelma King Thiel Liver inflammation, or hepatitis, has many causes. However, most hepatitis is caused by one of several viruses. 2. Hepatitis A Causes a Short-Lived but Potentially Serious Disease 25 Larry I. Lutwick Hepatitis A disease is generally short-lived. The virus is commonly transmitted by contaminated food or water. 3. Hepatitis B Is One of the Most Common Chronic Infectious Diseases 31 David A. Cramer and Teresa G. Odle Despite the availability of an effective vaccine, many people around the world suffer from the debilitating effects of hepatitis B. 4. Hepatitis C Can Go Undetected for Years 39 Larry I. Lutwick and Tish Davidson Millions of people are unaware that they are infected with the hepatitis C virus. Meanwhile the virus silently wreaks havoc on the liver. CONTE NTSCONTE NTS 9780737745535_PDD.indd 3 11/3/09 8:31 AM 5. Hepatitis D Has Little Public Awareness 46 Hepatitis B Foundation Hepatitis D is not as common as the other hepatitis viruses. However, it may be the most devastating. 6. A New Hepatitis B Vaccine May Help Those in the Developing World 51 ScienceDaily Researchers are devising ways to increase the availability of the hepatitis B vaccine in developing countries. 7. Hepatitis C Is the Number One Reason for Liver Transplants 57 Peter Jaret Liver transplantation is often the last resort for people suffering from advanced hepatitis C disease. CHAPTER 2 ... in demand Combining Supply and Demand in Macroeconomics Two insights emerge from this overview of Say’s law with its emphasis on macroeconomic supply and Keynes’ law with its emphasis on macroeconomic. .. on macroeconomic demand The first conclusion, which is not exactly a hot news flash, is that an economic approach focused only on the supply side or only on the demand side can be only a partial... in the government spending component or by legislating large tax 2/4 Macroeconomic Perspectives on Demand and Supply cuts to push up the consumption component Economies do, however, face genuine