Day 1: The country we are in and its health system

Activity 2: The country’s health system

Day 1: The country we are in and its health system

Activity 2: The country’s health system

2 hours


To help us to:

  • Learn about Spain’s health system today
  • Enhance our critical comparative skills in understanding different health systems globally

Task 1
Group work: Insights into Spain’s health system

1 hour

Watch the two videos allocated to your group. As you watch, compare what you are learning about Spain, to South Africa’s health system today, using your political economy questioning tools. Make notes in your journal, so that you remember the issues that come to mind, to discuss them in your group:  

Group 1

Group 2

Group 3

Look back at your Module 1 and Pre-module updated notes from your re-reading of this article:  Coovadia et al (2009) ‘The health and health system of South Africa: historical roots of current public health challenges’, The Lancet, Vol 374, 5 Sep 2009, 817-834

Your group task is to critically compare South Africa’s key health indicators to the Spanish health system, based on what you know from these videos. Choose a maximum of 4 of the following headings that are relevant to the two videos that you watched, and offer us a factual comparison between the two countries. Each group member will need to have clear notes on your comparative exercise, that you can draw on during the plenary Teach In that will follow. 

These are your categories to draw on:  

  • Structural and social determinants of health
  • Health as a universal right
  • Health as a public good vs health as a commodity
  • Health policy – policy goals, the outlines of the health system as defined in policy, and public involvement
  • Public vs private vs cooperatives health
  • Financing and per capita expenditure
  • Integrated care
  • Primary health care
  • Human resources for health care (doctor-patient ratio, nurse-patient ratio, staff workload, staff compensation, community health workers, staff shortages)
  • Technical resources for health care
  • Quality of health service delivery
  • Organised collective action focusing on the health system
  • Key health outcomes in each country (infant and child health, maternal health, mental health, disability management, HIV/AIDS treatment, COVID-19 treatment, reproductive and sexual health, nutrition, physical activity and obesity)

Task 2
Plenary: A Teach-In on Spain and South Africa’s health system challenges in 2022

1 hour

Four Critical Friends will take seats to the side and they will watch for issues that need clarifying or correcting, as the picture emerges. We’ll divide the room in two, with one half of the room acting as learners about South Africa’s health system and the other half of the room acting as learners about Spain’s health system. 

It’s now time for our Teach-In, guided by the facilitator. Categories will be chosen by the facilitator, and the floor will be open to each group for a maximum of 5 minutes. Each side will alternate in kicking off some key learning about relevant facts on different categories from the country they are representing.  The other side will then have 5 minutes to respond and offer a comparison for their country.  There will be time for a focus on four categories in 40 minutes

The lead facilitator will allow engagement by the Critical Friends for a maximum of 10 minutes, and will then offer a 5 minute drawing through of the critical threads of learning and what picture is emerging on the defining similarities and differences between the two countries’ health systems today.

Last updated: May 2022