Health Services Academy - Cabinet Division, Govt. of Pakistan

Master of Science in Health Economics & Management (MSc-HEM) Programme

Goal of the M.Sc-HEM Programme

The M.Sc-HEM Programme supports the Academy's mission by equipping students with a comprehensive set of skills and techniques as used in economics for the design and management of an efficient and effective health care system.

Objectives of the M.Sc-HEM Programme

To strengthen local capacity to learn to apply economic principles and techniques for the analyses of issues in the health sector policy and management.
To understand nature and implications of health economics and management.
To improve the decision making process in the health sector.
To prepare a pool of health economists and health managers in the country for an improved health and health care system.

The graduates of the M.Sc-HEM programme will be prepared to:

Take on leadership roles in health economic planning, management and decision making
Solve health system problems through the application of economic techniques
Manage and economize resources for health for attaining efficiency, equity and sustainability
Make health economic policy decisions based on evidence
Analyze health economic policy alternatives, balancing economic, financial and socio-economic imperatives
Demonstrate the ideas and thinking of economics, justify the use of economic analysis in health care, and incorporate health economic analysis in their work
Evaluate different economic approaches to priority setting in health care
Appraise the role of effective health care finance and delivery
Communicate and advocate the role of health economic policies effectively

M.SC-HEM Programme aims to equip students with:

A systemic knowledge of what is considered leading thinking and good policy practice in areas of specialization and critical awareness of health economics, management and policy issues;

A comprehensive understanding of the theory, practice, and research techniques that shape health economics and management.
An ability to apply knowledge and research methods creatively to interpret and create new knowledge.

A systemic knowledge of what is considered leading thinking and good policy practice in areas of specialization and critical awareness of health economics, management and policy issues;

A comprehensive understanding of the theory, practice, and research techniques that shape health economics and management.
An ability to apply knowledge and research methods creatively to interpret and create new knowledge.
An ability to evaluate current research and advanced scholarship in the area of health economics and management.
An ability to deal with complex issues and problems systemically and creatively.
An ability to communicate the results of research to specialist and non-specialist audiences using the resources of an academic/professional discourse.
An understanding of the role of initiative and entrepreneurship.
The capacity to work in a management position within the health system.

Further, the M.SC-HEM Programme values and objectives are defined as to equip students with:

A capacity to operate in complex and unfamiliar contexts.
A capacity to learn independently and professionally, exercising full personal responsibility.

Job Prospects

After completion of this specialized programme students can expect to find placement in the public sector organizations, Ministry of Health, Ministry of Finance, Planning Commission of Pakistan, other for-profit, not-for-profit sectors, research institutions, hospitals and other academic institutions, pharmaceutical companies and development agencies.

Rationale

The M.SC-HEM Programme is designed in line with the Academy's mission and its institutional plan. By directly addressing skills shortages in the region, HSA intends to meet the needs of stakeholders and the needs of students. M.SC-HEM complements the programme portfolio of the Academy. It will equip students with the necessary knowledge and skills to analyze public health care needs design and manage systems to for these needs, including the needs of the poor, and health system
shortfalls with the objective to achieve efficiency, equity and sustainability in health systems. The Master's degree will provide students with a range of career options within the health system. M.SC-HEM is designed to equip students with the conceptual skills from both the macro and the micro economic perspectives. Students will learn to understand current health systems designs and challenges, while learning methodological approaches to address to future challenges. The programme incorporates the practical skills and theoretical foundations as well as most recent state-of-the-art innovations in the realm of economic methodology. As a key principle, all contents will be informed by current research. The Health Services Academy, as one of the key institution for public health research in Pakistan with research linkages across the globe, is therefore ideally suited to run the programme and to promote academic excellence. Critical inquiry will be encouraged in
study and research. As health systems impinge on the economic, social and cultural environment, the skills acquired will enable students to actively and creatively engage in the developmental agenda.
In the first semester, the curriculum emphasizes basic public health sciences, essential and applied quantitative skills while second and third semesters focus on courses in health economics and management. Student's specialization will be based on their dissertation in either health economics or health management. M.SC-HEM adopts a discipline-based approach to address the core competencies (see Annex 2). The courses will be taught through a semester system in which a minimum of four courses will be taught in an integrated manner. The first semester curriculum provides exposure to the core discipline of public health. The second and third semester's curriculum provides advanced training in health economics and management focusing on areas common to disciplines and training in economics and management. In the fourth semester, all students have to undertake dissertation. The dissertation integrates knowledge, skills and methods in a professionally relevant practical
context. Students are also encouraged to become involved in the institutional research. HSA's Field Demonstration Area and collaboration with other related Organizations will provide an excellent opportunity for supervised, mentored practical experiences while addressing the health needs of Pakistan and the region.

Duration, Credits and Medium of Instruction

The M.SC-HEM degree programme extends up to twenty-four (24) months comprising of four semesters. The first three semesters are dedicated to course work and the fourth semester culminates in MSc dissertation. All semesters are followed by semester break. In the fourth semester every student has to carry out research and submit written report for the appraisal from the internal and external supervisors. The total programme consists of 60 credits. English is the medium of instruction and examination for the M.SC-HEM.

Semester-wise Distribution

The distribution of the core and elective courses in the three semesters is given in the following

The distribution of the core and elective courses in the three semesters is given in the following tables. English is the medium of instruction and examination for the MSc-HEM programme.

Semester II: Health Economics (Core and Optional) - Credits 16

Semester III: Health Management (Core and Optional) - Credits 16

Semester IV: Dissertation - Credits 12

Each semester is of 16 weeks duration. The credits per semester differ as the division of time for lectures and practical work for different courses varies. However, the maximum number of lectures/contact hours and practical work is constant per semester.

Method of Assessment/Examination

The students are evaluated during each course on the basis of:

Formative assessment which is a mix of the tests, end of course examination, class and home assignments, class participation, interactive discussions, practical exercises and/or group works depending on the course outline (ongoing assessment)
Summative assessment based on the end of semester examination papers. Summative assessments are held at the end of semester and comprise of two semester examinations (sessional and terminal) papers each.

The Dissertation work is assessed through a viva voce examination on the basis of a structured format covering the quality of the project, work performed in the field, data generation and analysis and presentation of results, discussion and conclusions presented as a written report. Fifty percent marks shall be reserved for the ongoing (formative) assessment and fifty percent for the semester examination paper and dissertation (summative assessment). Candidates obtaining less than 50% in any of the examinations will be deemed to have failed in that paper/semester of the MSc-HEM. A student failing in a paper (when scores of semester examination and ongoing assessment are less than fifty percent), will be allowed to clear that paper in the supplementary examination to be held within 3 months of the declaration of the result of the semester. However, a student accumulating more than two failures at any stage shall cease to be a student of the University. Each credit corresponds to 50 marks in the examination. Twenty-five (25) marks per credit are for the formative (ongoing) assessment and 25 marks for summative (end semester exam) assessment. The distribution of marks for each examination is as shown.

Semester I:Public Health (Core Courses) - Credits 16

Semester II: Health Economics (Core and Optional) - Credits 16

Semester III: Health Management (Core and Optional) - Credits 16

Final Evaluation

Candidates passing all the semester examinations shall be declared to have passed the MSPH programme and shall be awarded the degree. The final evaluation of the students will be as per the existing university regulations. The minimum passing marks in each of the subjects will be 50%; however the overall cumulative minimum marks required for passing the MSPH programme will be 60%.
Grading of course work is as under:

Grade “A” 80% or higher
Grade “B” 60% to 79%
Grade “C” 50% to 59%
Fail Less than 50%

Course Catalog for MSc-HEM Programme

Semester I Public Health (Core Courses)

HEM-401 Foundations of Public Health (4 credits)

This is an extensive course designed to introduce students to various aspects of public health, including, concepts, practices, theories and research. The students will be exposed to in-depth knowledge of the historical, current and future contexts of public health issues and the need to adopt multi-disciplinary approaches to problem solving in public health. Broad topics will include, defining public health, historical and contemporary developments, public health delivery system, ethics in public health management and law, GIS systems for public health, public health tracking, demographic dynamics of public health, common, preventable diseases and conditions, public health welfare, public health work force, public health administration.

HEM-401Foundations of Public Health (4 credits)

HEM-402 Comparative Health Care Systems (4 credits)
A course on comparative health care system is designed to study health care systems of other countries (both developing and developed) in providing health care to the masses. These health systems vary significantly across countries and some countries even adopt models of others. However, there is still variation in programmes across countries. The course will broadly cover contemporary health systems, national health programmes, public evaluation, and differences in health care countries across countries, national health insurance, and provision of health care low costs.

HEM-403 Quantitative Methods for Health Economics (4 credits)
This course introduces the statistical tools necessary for analyzing health care systems using

Semester II Health Economics (Core Courses)

HEM-310 Microeconomics for Health (3 credits)

This course is designed to prepare a non-economist to apply microeconomic theories and tools to health systems, to health care consumer behavior and to health care providers. The basic attempt is to find out how economic theory applies to health and health care and in what ways health care is different from other sectors of the economy. The course will focus on patterns of demand and supply and determination of price and output under asymmetric information. The course will also address challenges to health economists, managed care and health care costs, production and health insurance.

HEM 311Macroeconomics for Health (3 credits)

This course is designed for a non-economist to understand national and global economic systems of which health is a major part. It covers the major macroeconomic tools and indices which have impact on health or are affected by health. A course on macroeconomic concepts for health will address performance, and structure of national or regional economy and its effect on health. The relevance of concepts like GDP, unemployment, consumption, output, inflation, international finance and resource mobilization for the health sector will be explored. Macroeconomics for health will explore processes through which health can be addressed in the broader context of development. The focus areas will be within that broader perspective of poverty reduction strategies, increasing health investments and removing barriers in way of achieving better health.

HEM-312Economic Evaluation of Health Care Programmes (3 credits)

This course explores the nature, purpose and limitations of economic analysis and evaluation, public and private perspectives, measurement and valuation, analysis of costs, performance and effectiveness, cost-effectiveness, cost benefit analysis and cost utility analysis. The course will also address risk adjustment, concepts of QALYs and DALYs and valuation of human life.

HEM-313Health Care Finance (3 credits)

A course on health care financing will cover patterns and effectiveness of current health spending, alternative sources of revenue, collecting revenue for health, resource allocation and purchasing, fiscal space, pooling mechanisms, types of insurance (community, private and social), development assistance for health and financing challenges in low income countries. The course will also cover topics in the financial management of health care institutions. Special emphasis will be given to social health insurance for its role in health care markets. Principles of economic efficiency provide a standard against which to judge the costs and benefits of health care polices. Topics will cover social health insurance, policies and programmes, historical roots of social insurance, public insurance and health, models of social insurance such as Medicare and Medicaid and their criticism. The programme features will be studied in detail in terms of financing, beneficiary payment liabilities, provider payments, and eligibility. The course will also cover equity, efficiency and need and government intervention in health care markets.

Semester III - Health Care Management (Core courses)

Hospital Management and Long Term Care (3 credits)
In the health sector, hospital care dominates total health care expenditures. Since hospitals remain the center of health economy, issues in management and dministration remain crucial. The composition of population of children, adults and the elderly needs adequate provision of health care facilities. For the elderly, issues of long term care are even more important. The course will cover topics in background and overview of hospitals, hospital utilization and costs, nursing homes, traditional health care and management.

In the health sector, hospital care dominates total health care expenditures. Since hospitals remain the center of health economy, issues in management and administration remain crucial. The composition of population of children, adults and the elderly needs adequate provision of health care facilities. For the elderly, issues of long term care are even more important. The course will cover topics in background and overview of hospitals, hospital utilization and costs, nursing homes,
traditional health care and management.

HEM-315 Human Health Resource Management (3 credits)
A course on human health resource management will prepare students to address issues in health resource management and its various aspects. The course will impart knowledge for economic and regional pressures for health services, the effect of these pressures on personnel management, distinction between employee retention and professionalism. This course covers the cycles of human resources for health, recruitment, selection, training, education, skills, employee retention, brain drain, emigration of skilled work force, appraisal and reward system, welfare management, redundancy, skill shortages, efficiency and types.

HEM-316 Health Policy Management and Evaluation (3 credits)
A course in health policy management covers areas of health care decisions, plans and actions intended to achieve health care goals, with special reference to developing country and comparisons with developed country policies. The broad topics that will be covered are quality of health care, regulations, safety and effectiveness of drugs, evaluation of medical services and procedures, medical records, players in the organization, delivery and services, policy process,

Optional Courses (4 credits each)

In semesters II and III, one optional course of 4 credits will be offered. Following is the list of optional courses.

HEM-405Health and Sustainable Development (4 credits)

A course in health and sustainable development is important from because it intends to preserve resources to meet the needs of the present and future generations. The broad topics that will be covered in this course include TRIPS and public health, environmental health issues and their management, special and differential treatment, prevention, elimination of safety hazards, technical barriers to trade (TBT), environmental health and safety standards (EH&SS), development indices and issues in sustainability.

HEM-406Management of Population Health Issues (4 credits)

A course on population health deals with the health outcomes of groups of individuals and distribution of those outcomes within that group. The course aims at analyzing techniques for improving health of the entire population and socio-economic determinants of health. The major components of the course will be economics of inequality, the importance of family planning programmes, population health management, determinants of fertility, mortality and aging.

HEM-407Health Economics of Bads (4 credits)

This course covers topics in models of addiction and rationale for governmental interventions, advertising restrictions on cigarettes and alcohol, brand switching, excise taxes and consumption of cigarettes. The associated mental health issues of addiction and its related costs will also be covered. The economics of bads also includes topics in accidents, fear, anxiety, stress, nicotine, or secret ingredients.

HEM-408Pharmaco-Economics (4 credits)

This course will focus on economic methods for comparing the value of one pharmaceutical drug/ therapy to another. The course will cover topics such as cost evaluation, monetary effects, drug efficacy, enhanced quality of life, burden of disease, issues in patient care and drug utilization, drug benefits and outcomes. The course will also discuss regulatory framework designed to access safe and affordable drugs and health policy developments that affect the pharmaceutical industry. The
supply pf and demand for drugs will also be evaluated.

HEM-409Quality Management in Health Care (4 credits)

In this course, participants will learn the general principles and frameworks for defining and promoting the quality in health care. Different quality management approaches and models will be compared and their suitability for the health sector will be assessed. In this regard, case studies derived from experiences in Pakistan and different countries will be discussed. Additionally, the students will learn different tools for assuring and evaluating quality with a focus on improving quality of healthcare in organizations. At the end of the course, the participants will be able to define quality management and enumerate the different principles of improving and assuring quality in health care, explain the strengths and weaknesses of different quality management models and approaches and determine their applicability in health care, in general, and in Pakistan, in particular, describe accreditation, certification, supervision and licensing principles and processes of evaluating health care services providers, gain knowledge and develop skills in using specific tools in identifying and analyzing problems and in making evidence-based decision- making. The course contents will be health care, health care organizations and health sector reform, definitions: Quality and Quality Management, Approaches and Models in Ensuring Quality in Health Care, The Role of Management in Quality Assurance, Teamwork in Promoting Quality, In this course, participants will learn the general principles and frameworks for defining and promoting the quality in health care. Different quality management approaches and models will be

HEM-410Gender and Health (4 Credits)

This optional course aims at addressing gender specific health issues with special reference to a developing country like Pakistan. Major course components include differences between gender and sex, gender specific determinants of health, roles and norms, gender influences on health, gender and mental health issues, awareness, respect and behavior, gender inequality for specific health problems, gender responsive budgeting, gender policies and proposed policies and interventions, gender violence.

Semester IV: MSc HEM 499 Dissertation/Thesis- 12 Credits

Twelve credit hours of M.Sc thesis will be earned through engaging in evidence based research, research based on primary and secondary data sources, addressing issues of practical relevance to the national health care issues in particular and global health issues in general, under the supervision of specified faculty member(s) from within or outside Health Services Academy. A list of approved MSc thesis supervisors will be developed in accordance with the HEC guidelines for research supervisors. The completion time for research and defense will be one semester. The thesis will be evaluated by a team of internal and external examiners and viva voce examination will be held for defense.

Admission Criteria and Procedures

The Health Services Academy abides by its strict merit-based criteria with absolute transparency to select its students for the MSc-HEM programme. Every year, the number of Pakistani and foreign students is fixed by the Board of Governors.

Eligibility Criteria

Basic Qualifications

The candidate should possess one of the following qualifications or an equivalent degree from a recognized university or accrediting body.
(A) BA/ BBA/ BSc Degree with one of the following subjects: Economics Statistics, Mathematics, Psychology, and Sociology.
(b) MBBS (Bachelor of Medicine & Bachelor of Surgery)
(c) B.Pharmacy (Bachelor's in Pharmacy)
(d) BSc Nursing (Bachelor of Sciences in Nursing)
(e) B. Veterinary (Bachelor of Veterinary Medicine)

Fee Structure

This section explains the fee structure for the MSc-HEM programme. Since HSA is affiliated with the Quaid-i-Azam University, the dues are for both the University and HSA itself.

Quaid-i-Azam University Dues

Note: All fees are subject to revision of Quaid-i-Azam University plicy

Health Services Academy Dues

Fee Structure for Pakistani Students

The following is the fee structure for the MSc-HEM programme dues to be paid in favor of the Health Services Academy. Please note that this fee structure applies only to Pakistani students.

NOTE: All fees are subject to revision as per Health Services Academy Policy.

The total amount to be paid for the entire MSc-HEM programme during the two-year duration of the programme, both to the Quaid-i-Azam University and to the Health Services Academy, is Rs.346,000/, with an additional Rs. 1000/ for the application.

Fee Structure for International Students

The following is the fee structure for the MSPH/EMSPH programmes dues to be paid in favour of the Health Services Academy. Please note that this fee structure applies only to international students.