Seminar on Health Transition and New Challenges for Health Systems


Within the scope of knowledge on Health and Development Policies, this curricular unit has as general objective the concept of transition in health in its epidemiological, demographic and nutritional aspects, enabling the students to apply these notions in the analysis of the health situation of countries and respective reforms of health systems.

General characterization





Responsible teacher

Luís Sambo


Weekly - 10

Total - 40

Teaching language



Available soon


• Omran A. R. The Epidemiological Transition: A theory of the epidemiology of population change, Bulletin of the World Health Organization, 79 (2), Geneva, 2001.
• Frenk J., Bobadilla J. L., Stern C., Frejka T. and Lozano R. Elementos para una Teoria de la Transicion em Salud, Salud Pública de Mexico, Vol. 33, No.5, Septiembre de 1991.
• Defo B. K. Demographic, epidemiological and health transitions: are they relevant to population health patterns in Africa? Global Health Action 2014, 7:22443, 2014.
• R.S. Downie, C. Tannahill and A. Tannahill, Health Promotion: Models and Values. Oxford University Press, 1996.
• Institute of Medicine, USA, Understanding Population’s Health and its Determinants, Chap2, book: The Future of the Public’s Health in the 21st Century, Washington DC, 2003.
• WHO, Comission on Social Determinants of Health, final report Closing the Gap in a Generation: Health Equity Through action on the Social Determinants of Health, 2008.
• WHO, Closing the Gap: Policy into Practice on Social Determinants of Health: discussion paper, 2011.
• Jacobsen K.H., Introduction to Global Health, Jones and Bartlett Learning, , 2014.
• Guest G. and Namey E., Public Health Research Methods, SAGE, London/Washington DC, 2015.
• Ransom, E. R., Joshi, M. S., and al. The Health Care Quality Book: Vision, Strategy and Tools. Editor AUPHA, Chicago, 2012.
• WHO, Strengthening Health Systems to Improve Health Outcomes: WHO’s Framework of Action, World Health Organization, Geneva, 2007.
• Sambo L G, Epidemiology and Health Policy in Africa, book chapter 6 of African Health Leaders: Making a Change and Claiming the Future, edited by Omaswa Francis and Crisp Nigel, Oxford University Press, 2014.
• Murray C and Frenk J. WHO Framework for Health Systems Performance Assessment . WHO. Geneva. 1999.
• Leiyu Shi and Douglas A. Singh, Delivering Health Care in America: A Systems Approach. NA ASPEN Publication.
• Jackson M and Sambo L, Health Systems Research and Critical Systems Thinking: the case for partnership, Systems Research and Behavioural Science, Wiley, 2019.
• OMS - Relatórios Mundiais de Saúde: 2000 (Sistemas de Saúde), 2005 (SMI), 2006 (Recursos Humanos), 2008 (Cuidados Primários de Saúde), 2010 (Cobertura Universal de Saúde).
• WHO (2007). Everybody business: strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva.
• WHO (2016). Global strategy on human resources for health: workforce 2030. Geneva.
• Global Burden of Disease Health Financing Collaborator Network (2019). Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050. Vol 393 June 1, 2019.
• Badara Samb, et al (2010). Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Vol 376 November 20, 2010.
• Economist Intelligence Unit (2012). The future of healthcare in Africa.
• E. Lambo, L.G. Sambo (2003). Health sector reform in Sub-Saharan Africa: a synthesis of country experiences. East African Medical Journal, Supplement, June, 2003.
• Chongsuvivatwong, V., et al (2011). Health and health-care systems in southeast Asia: diversity and transitions. Vol 377 January 29, 2011.
• Pablo Gottret, George J. Schieber, and Hugh R. Waters, coeditors (2008). Good practice in health financing: lessons from reforms in low and middle-income countries. The International Bank for Reconstruction and Development / The World Bank. Washington.
• UNDP – Human Development Index.
• The World Bank – World Development Reports.
• The World Bank WHO Global Health Observatory.
• UNICEF – Inquéritos de Indicadores Múltiplos (MICS).
• The European Observatory – Health Systems in Transition.

Teaching method

After a theoretical presentation of each topic the themes will be discussed by the students.

Evaluation method

A final written work (case-study) will be produced, applying to specific country - of student’s choice, the different concepts of health transition and related challenges to national health systems.

Subject matter

I. Brief review of health determinants;
II. Theoretical foundations of health transitions;
III. Architecture of international cooperation for health development;
IV. Response of National Health Services (Guinea, Sierra Leone and Liberia) and global response to 2014-2016 Ebola Virus Disease epidemic in West Africa;
V. WHO initiatives to strengthen health Systems.