Cambridge A Level Global Perspectives and Research 9239 — 2023 May/June Paper 1 · Variant 2

This document has 4 pages. Any blank pages are indicated. [Turn over Cambridge International AS & A Level * 7 9 2 1 6 2 2 7 6 8 * DC (CJ) 313377/1 © UCLES 2023 GLOBAL PERSPECTIVES & RESEARCH 9239/12 Paper 1 Written Exam May/June 2023 1 hour 30 minutes You must answer on the enclosed answer booklet. You will need: Answer booklet (enclosed) Insert (enclosed) INSTRUCTIONS ● Answer all questions. ● Follow the instructions on the front cover of the answer booklet. If you need additional answer paper, ask the invigilator for a continuation booklet. INFORMATION ● The total mark for this paper is 45. ● The number of marks for each question or part question is shown in brackets [ ]. ● The insert contains all the resources referred to in the questions.

2 9239/12/M/J/23 © UCLES 2023 Read both documents in the accompanying insert and answer all the questions. You should spend approximately 15 minutes reading both documents in the insert before attempting to answer the questions. This is allowed for in the time set for the exam. Write brief answers to Question 1, using short sentences or bullet points. Write your answers to Question 2 and Question 3 in continuous prose. 1 Study Documents A and B. (a) The authors of Document A describe Rwanda’s response to COVID-19. Rwanda ensured that people who did not have COVID-19 felt safe seeking health care during the pandemic. Identify three ways Rwanda did this as given by the authors of Document A. [3] (b) The author of Document B discusses the impact of universal healthcare on doctors. Identify two financial impacts of introducing universal healthcare as given by the author of Document B. [2] 2 Study Document A. Assess the strengths and weaknesses of the evidence used by the authors of Document A to support their argument that universal health coverage is the key to pandemic management. In your answer include the impact of the evidence on the authors’ argument. [15] 3 Study Documents A and B. The authors of the two documents present different arguments and perspectives on the impacts of universal healthcare. Evaluate the arguments of the authors of both documents. In your answer, consider their perspectives and include a reasoned judgement about whether one argument is stronger than the other. [25]

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4 9239/12/M/J/23 © UCLES 2023 Permission to reproduce items where third-party owned material protected by copyright is included has been sought and cleared where possible. Every reasonable effort has been made by the publisher (UCLES) to trace copyright holders, but if any items requiring clearance have unwittingly been included, the publisher will be pleased to make amends at the earliest possible opportunity. To avoid the issue of disclosure of answer-related information to candidates, all copyright acknowledgements are reproduced online in the Cambridge Assessment International Education Copyright Acknowledgements Booklet. This is produced for each series of examinations and is freely available to download at www.cambridgeinternational.org after the live examination series. Cambridge Assessment International Education is part of Cambridge Assessment. Cambridge Assessment is the brand name of the University of Cambridge Local Examinations Syndicate (UCLES), which is a department of the University of Cambridge. BLANK PAGE

This document consists of 25 printed pages. © UCLES 2023 [Turn over Cambridge International AS & A Level GLOBAL PERSPECTIVES AND RESEARCH 9239/12 Paper 1 Written Exam May/June 2023 MARK SCHEME Maximum Mark: 45 Published This mark scheme is published as an aid to teachers and candidates, to indicate the requirements of the examination. It shows the basis on which Examiners were instructed to award marks. It does not indicate the details of the discussions that took place at an Examiners’ meeting before marking began, which would have considered the acceptability of alternative answers. Mark schemes should be read in conjunction with the question paper and the Principal Examiner Report for Teachers. Cambridge International will not enter into discussions about these mark schemes. Cambridge International is publishing the mark schemes for the May/June 2023 series for most Cambridge IGCSE, Cambridge International A and AS Level and Cambridge Pre-U components, and some Cambridge O Level components.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 2 of 25 Generic Marking Principles These general marking principles must be applied by all examiners when marking candidate answers. They should be applied alongside the specific content of the mark scheme or generic level descriptors for a question. Each question paper and mark scheme will also comply with these marking principles. GENERIC MARKING PRINCIPLE 1: Marks must be awarded in line with:  the specific content of the mark scheme or the generic level descriptors for the question  the specific skills defined in the mark scheme or in the generic level descriptors for the question  the standard of response required by a candidate as exemplified by the standardisation scripts. GENERIC MARKING PRINCIPLE 2: Marks awarded are always whole marks (not half marks, or other fractions). GENERIC MARKING PRINCIPLE 3: Marks must be awarded positively:  marks are awarded for correct/valid answers, as defined in the mark scheme. However, credit is given for valid answers which go beyond the scope of the syllabus and mark scheme, referring to your Team Leader as appropriate  marks are awarded when candidates clearly demonstrate what they know and can do  marks are not deducted for errors  marks are not deducted for omissions  answers should only be judged on the quality of spelling, punctuation and grammar when these features are specifically assessed by the question as indicated by the mark scheme. The meaning, however, should be unambiguous. GENERIC MARKING PRINCIPLE 4: Rules must be applied consistently, e.g. in situations where candidates have not followed instructions or in the application of generic level descriptors.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 3 of 25 GENERIC MARKING PRINCIPLE 5: Marks should be awarded using the full range of marks defined in the mark scheme for the question (however; the use of the full mark range may be limited according to the quality of the candidate responses seen). GENERIC MARKING PRINCIPLE 6: Marks awarded are based solely on the requirements as defined in the mark scheme. Marks should not be awarded with grade thresholds or grade descriptors in mind.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 4 of 25 Social Science-Specific Marking Principles (for point-based marking) 1 Components using point-based marking:  Point marking is often used to reward knowledge, understanding and application of skills. We give credit where the candidate’s answer shows relevant knowledge, understanding and application of skills in answering the question. We do not give credit where the answer shows confusion. From this it follows that we: a DO credit answers which are worded differently from the mark scheme if they clearly convey the same meaning (unless the mark scheme requires a specific term) b DO credit alternative answers/examples which are not written in the mark scheme if they are correct c DO credit answers where candidates give more than one correct answer in one prompt/numbered/scaffolded space where extended writing is required rather than list-type answers. For example, questions that require n reasons (e.g. State two reasons …). d DO NOT credit answers simply for using a ‘key term’ unless that is all that is required. (Check for evidence it is understood and not used wrongly.) e DO NOT credit answers which are obviously self-contradicting or trying to cover all possibilities f DO NOT give further credit for what is effectively repetition of a correct point already credited unless the language itself is being tested. This applies equally to ‘mirror statements’ (i.e. polluted/not polluted). g DO NOT require spellings to be correct, unless this is part of the test. However spellings of syllabus terms must allow for clear and unambiguous separation from other syllabus terms with which they may be confused (e.g. Corrasion/Corrosion) 2 Presentation of mark scheme:  Slashes (/) or the word ‘or’ separate alternative ways of making the same point.  Semi colons (;) bullet points (•) or figures in brackets (1) separate different points.  Content in the answer column in brackets is for examiner information/context to clarify the marking but is not required to earn the mark (except Accounting syllabuses where they indicate negative numbers).

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 5 of 25 3 Calculation questions:  The mark scheme will show the steps in the most likely correct method(s), the mark for each step, the correct answer(s) and the mark for each answer  If working/explanation is considered essential for full credit, this will be indicated in the question paper and in the mark scheme. In all other instances, the correct answer to a calculation should be given full credit, even if no supporting working is shown.  Where the candidate uses a valid method which is not covered by the mark scheme, award equivalent marks for reaching equivalent stages.  Where an answer makes use of a candidate’s own incorrect figure from previous working, the ‘own figure rule’ applies: full marks will be given if a correct and complete method is used. Further guidance will be included in the mark scheme where necessary and any exceptions to this general principle will be noted. 4 Annotation:  For point marking, ticks can be used to indicate correct answers and crosses can be used to indicate wrong answers. There is no direct relationship between ticks and marks. Ticks have no defined meaning for levels of response marking.  For levels of response marking, the level awarded should be annotated on the script.  Other annotations will be used by examiners as agreed during standardisation, and the meaning will be understood by all examiners who marked that paper.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 6 of 25 The total mark for this paper is 45. Question 1 assesses AO1 skills. Question 2 assesses AO1 skills. Question 3 assesses AO1 and AO3 skills. Question 1 is points marked using or . Answers to Question 1 can be brief, using short sentences or bullet points. Answers to Question 2 and Question 3 should be written in continuous prose. For Question 2 and Question 3 annotate clearly in the left-hand margin according to the specific instructions provided. Refer to the marking grid at the end of each question to award a mark based on the annotations for each aspect (e.g. AO1a). Record the mark for each aspect (e.g. AO1a) in the right-hand marking panel on RM Assessor. Indicative content or exemplar responses are provided as a guide. Inevitably, the mark scheme cannot cover all responses that candidates may make for all the questions. In some cases, candidates may make responses which the mark scheme has not predicted. These answers should nevertheless be credited according to their relevance and quality. The definition of perspective used in this syllabus is: a perspective is a coherent world view which is a response to an issue. It is made up of argument, evidence, assumptions and may be influenced by a particular context.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 7 of 25 Question Answer Marks 1(a) The authors of Document A describe Rwanda’s response to COVID-19. Rwanda ensured that people who did not have COVID-19 felt safe seeking health care during the pandemic. Identify three ways Rwanda did this as given by the authors of Document A. The question assesses AO1. Answers to Question 1 can be brief, using short sentences or bullet points. Show a correct answer with  in the text, up to a maximum of three marks.  (Ministry of Health requested that members of the public call) a toll-free phone number (if possibly infected)  (It set up) specialised COVID-19 treatment centres  (It designated) specific ambulances / specific personnel  (to transport potentially infected people from their homes to a facility). Do not accept:  CHWs played a role in contact tracing and identifying COVID-19 cases.  Testing, isolation and quarantine were provided free of charge. 3

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 8 of 25 Question Answer Marks 1(b) The author of Document B discusses the impact of universal healthcare on doctors. Identify two financial impacts of introducing universal healthcare as given by the author of Document B. The question assesses AO1. Answers to Question 1 can be brief, using short sentences or bullet points. Show a correct answer with  in the text, up to a maximum of two marks. Any 2 of the following:  Large pay cut for current physicians  Deter potential medical students, who would be unable to pay off debt / cause debt repayment problems for existing doctors  University funding would need to be overhauled / state would have to fund undergraduate (and graduate) studies (to avoid student debt) Do not accept:  Longer waiting times  Technicians not working at weekends 2

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 9 of 25 Question Answer Marks Instructions for Question 2 The question assesses AO1. (Research, analysis and evaluation) Answers should be written in continuous prose. There is no requirement for candidates to use technical terms to access any level and candidates will NOT be rewarded for their use unless they link them directly to the assessment made. Annotate clearly in the left-hand margin according to the instructions provided below. There are three aspects to consider when marking the answer. Annotations for each aspect are listed in increasing order of significance. For example, in AO1a EG reflects a higher skill than T. This is reflected in the mark tables.  Identify evidence (AO1a). Candidates should identify a range of types of evidence and give examples. Annotate with T if no example given or EG if type is given and exemplified. T Identify type of evidence. (Without an example) EG Example of type of evidence.  Analyse strengths and weaknesses of evidence (AO1b). Candidates should analyse both strengths and weaknesses of a range of evidence used by the author including an explanation. For limited explanation use + for strength and – for weakness. For clear explanation use EXP + Strength of evidence recognised but with limited explanation. - Weakness of evidence recognised but with limited explanation. EXP Strength or weakness of evidence clearly explained.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 10 of 25 Question Answer Marks  Evaluate evidence (AO1c). Impact of evidence may be asserted and not explained (I) Evaluation may be attempted but not explained (EVAL ^) [EVAL and ^ are two separate annotations on RM]. Candidates explain the impact of evidence on the author’s argument/perspective (EVAL) and include a judgement of its effectiveness. (EVAL J) I Impact of evidence is asserted and not explained. EVAL ^ Shows undeveloped point of evaluation. Evaluation attempted but not explained. EVAL Evaluation of impact of evidence on argument/perspective. EVAL J Evaluation of impact of evidence on argument/perspective and includes judgement.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 11 of 25 Marking grid for Question 2 Examiners should allocate a mark for each aspect (AO1a, AO1b, AO1c), using the mark descriptors and required annotations. AO1 Research, analysis and evaluation AO1a Identify evidence Mark Annotations Identifies a wide range of different types of evidence with examples 5 4 EG or more Identifies a range of different types of evidence with examples 4 3 EG Identifies a limited range of different types of evidence with examples 3 2 EG Identifies a limited range of evidence, using different types or examples 2 2T or 1EG Identifies one piece of evidence 1 1T Identification of evidence is not present. No creditable material. 0 No T or No EG AO1b Analyse strengths and weaknesses of evidence Mark Annotations Analyses strengths and weaknesses of a wide range of evidence with clear explanation 5 2 + (or more) and 2 – (or more) with 3 or more EXP Analyses strengths and weaknesses of a range of evidence with clear explanation 4 2 + (or more) and 1 – (or more) (or opposite) with 2 EXP Analyses strengths and weaknesses of a range of evidence with limited explanation 3 2 + (or more) and 1 – (or more) (or opposite) with 0 or 1 EXP Analyses strengths or weaknesses of a range of evidence with limited explanation 2 [2+] or [2-] or [1+ and 1-] Explanation of strengths or weaknesses of evidence is limited 1 [1+] or [1-] No analysis is present. No creditable material 0 No + or – or EXP

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 12 of 25 AO1c Evaluate evidence Mark Annotations Evaluation includes explanation of the impact of evidence on the argument/ perspective and makes a wide range of reasoned judgements 5 2 EVAL J or more Evaluation includes explanation of the impact of evidence on the argument/ perspective and makes reasoned judgements 4 1 EVAL J Evaluation includes an explanation of the impact of evidence on the argument/ perspective 3 1 EVAL (or more) Evaluation is attempted but lacks clarity, and the impact of evidence on the argument/perspective is not explained 2 1 EVAL ˄ (or more) The impact of evidence on the argument/perspective is asserted and not explained 1 1 I (or more) No evaluation is present. No creditable material 0 No I, EVAL^, EVAL or EVAL J Examiners allocate a mark for each aspect (AO1a, AO1b, AO1c), using the mark descriptors and required annotations.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 13 of 25 Question Answer Marks 2 Assess the strengths and weaknesses of the evidence used by the authors of Document A to support their argument that universal health coverage is the key to pandemic management. In your answer include the impact of the evidence on the authors’ argument. 15 Indicative content No set answer is expected, and examiners should be flexible in their approach. Candidates may include some of the following indicative content. Strengths  [Example only] The authors’ clear evidence (+) that CHWs are elected in each of the 15 000 villages (EG) shows us the extent (EXP) of decentralisation in Rwanda’s health system. This clear evidence helps the reader understand the details of how Rwanda has tackled the pandemic. (EVAL)  All evidence provided is relevant and supports the authors’ conclusion.  The authors provide a statistic (1 million deaths over nine months) that sets the scene and supports the point made about lack of resilience.  provenance – Agnes Binagwaho is vice chancellor of the University of Global Health Equity with expertise – Rwandan pediatrician  ability to see (e.g. Agnes Binagwaho as Minister of Health and relevant details from preamble)  Authors provide a clear example of the contrast between numbers of cases in Rwanda and Pennsylvania – the statistics provided support this.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 14 of 25 Question Answer Marks 2 Weaknesses  No sources are used – we have to depend on the credibility of the authors / unsourced evidence – e.g. ‘204 000 cases recorded by the similarly populated U.S. state of Pennsylvania’  Evidence is not balanced, there are no statistics or examples to support an opposing view (indicating possible bias).  The authors may have a vested interest in selecting evidence that makes the Rwandan system seem better than it is.  Gaps in evidence: No evidence that universal access is the only way to ensure universal compliance. This is an unsupported statement.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 15 of 25 Question Answer Marks Instructions for Question 3 The question assesses AO1 (Research, analysis and evaluation) and AO3 (Communication). Answers should be written in continuous prose. There is no requirement for candidates to use technical terms to access any level and candidates will NOT be rewarded for their use unless they link them directly to the assessment made. A perspective is made up of argument, evidence and assumptions and may be influenced by a particular context. Annotate clearly in the left-hand margin according to the instructions provided below. There are five aspects to consider when marking the answer. Annotations for each aspect are listed in increasing order of significance. For example, in AO1a C reflects a higher skill than K. This is reflected in the mark tables.  Identify and compare key components of arguments (AO1a). Candidates should identify a range of key components of arguments from both documents. Annotate with K if key component is identified for one document and C if key component is compared for both documents. K Identification of key component of argument for one document C Comparison of key components from both documents.  Analyse and compare perspectives (AO1b). Candidates should analyse by identifying, describing and explaining the perspectives given in both documents. Identification only (P ^), identification with limited description (P), comparing and describing in both documents (PD) and comparing and explaining in both documents (PE). P ^ Identification of perspective(s) with no description. P Identification of perspective(s) with limited description. PD Analyses by comparing and describing perspectives in both documents. PE Analyses by comparing and explaining perspectives in both documents.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 16 of 25 Question Answer Marks  Evaluate arguments (AO1c). Candidates should aim to evaluate key components of arguments with clearly illustrated and balanced reference to both documents. Evaluation may be unsupported (asserted) (ND). Evaluation includes illustration with reference to both documents. (EVAL) ND Unsupported evaluation of argument. EVAL Evaluation of argument in both documents.  Judgement about argument and perspective (AO1d). Candidates should aim to give a reasoned and supported answer which includes intermediate conclusions and a main conclusion. The judgement may be unsupported (U ^ or U), partly supported (J ^) or clearly reasoned and supported (J) U ^ Unsupported judgement – stated only U Unsupported judgement – with reasoning J ^ Partly supported judgement – with reasoning J Supported judgement – with reasoning  Communication (AO3) A candidate should aim to produce a clearly expressed, well-structured and logical argument that is focused throughout on the question. Structure should include introduction, clear paragraphs and conclusion, should flow and answer the question. Each paragraph should follow on logically and contain a separate point. Each new idea should be clearly indicated – preferably in a new paragraph. “Logical” means that it is easy to follow the argument as there are no sudden changes of direction leading to confusion in the reader. No annotation is required except NAQ to show not linking to the question. The mark should be selected by using the guidance that follows the mark tables. Choose the most appropriate descriptor in the marking grid. NAQ Not answering the question

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 17 of 25 Marking grid for Question 3 – AO1 Research, analysis and evaluation AO1a Identify and compare key components of arguments Mark Annotations Compares a wide range of key components of arguments from both documents 5 4 C or more Compares a range of key components of arguments from both documents 4 3 C Compares a limited range of key components of arguments from both documents 3 2 C or (1 C and 2 K or more) Identifies key components of arguments with no comparison 2 2 K or 1 C or 1 C and 1 K Limited identification of key components of arguments with no comparison 1 1 K No identification of arguments. No creditable material 0 No K AO1b Analyse and compare perspectives Mark Annotations Analyses by comparing and explaining the perspectives given in both documents 5 1 PE or more Analyses by comparing and describing the perspectives given in both documents 4 1 PD or more Identifies and compares both perspectives but with limited description 3 2 P (one for each doc) Identifies one perspective but with limited description 2 P Identifies one perspective with no description 1 P ^ No identification of perspectives. No creditable material 0 No P^, P, PD or PE

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 18 of 25 AO1c Evaluate arguments Mark Annotations Evaluation of key components of arguments is illustrated by clear, balanced reference to both documents 5 4 or more EVAL (2 or more for each Doc) Evaluation of key components of arguments is illustrated by clear reference to both documents but lacks balance 4 3 or more EVAL (2 or more for one Doc and one for the other Doc) Evaluation of key components of arguments with limited reference to both documents 3 2 EVAL / 1 EVAL and 1 ND (both Docs) Evaluation of arguments is unsupported (asserted) but refers to both documents 2 ND but refers to Doc A and Doc B Evaluation of arguments is unsupported (asserted) and only refers to one document 1 ND and only refers to Doc A or Doc B No evaluation is present. No creditable material 0 No ND or EVAL AO1d Judgement about argument and perspective Mark Annotations Judgement is clearly reasoned and supported. Includes intermediate conclusions and a main conclusion 5 J or J ^ intermediate and J in the final conclusion Judgement is clearly reasoned and supported. Includes either intermediate conclusion(s) or a main conclusion 4 J intermediate or in the final conclusion Judgement is reasoned but is only partly supported. Includes either intermediate conclusion(s) or a main conclusion 3 J ^ intermediate or in the final conclusion Judgement is reasoned but not supported 2 U Judgement is stated without reasons or support 1 U ^ No judgement is made. No creditable material 0 No U^, U, J^ or J

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 19 of 25 AO3 Communication Communication Mark Guidance Produces a clearly written, well-structured and logical argument that is focused throughout on the question 5 Meets the descriptor – and contains no NAQ Produces a clearly written, well-structured argument that links to the question 4 Meets the descriptor Produces a clearly written argument with uneven structure that links to the question 3 Meets the descriptor Produces an argument that lacks clarity and structure and does not always link to the question 2 Meets the descriptor Communication is cursory or descriptive and lacks structure 1 Meets the descriptor No creditable material 0 Meets the descriptor – NAQ throughout Examiners should allocate a mark for each aspect (AO1a, AO1b, AO1c, AO1d and AO3), using the mark descriptors and required annotations. Further guidance for AO3 is given below on page 20.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 20 of 25 Guidance for awarding marks for AO3 in Question 3. Note: ‘clearly written’ refers to the content and the ease of being able to follow the candidates’ argument. It should be thought of as: ‘clearly expressed’. The quality of handwriting should not be considered as a factor when awarding marks. This is not what clearly written means in the descriptors. If a candidate made little attempt to answer the question and had lots of NAQ (e.g. was very descriptive or wrote an essay on their own opinion of the subject matter) the maximum score is 2 marks. If a candidate wrote very little/ wrote in bullet points/has limited content that addresses the question the maximum score is 2 marks If a candidate makes no attempt to develop an argument at all, the maximum score is 1 mark. If a candidate wrote in continuous prose, expressed themselves clearly and addressed the question, start at 3 marks – then consider if it better fits the descriptions above or below 3 marks. If the answer was not clearly expressed or focused mainly on one document, it lacks clarity and has uneven structure and may only be worth 2 marks. If the answer has an introduction, clear paragraphs, considers both documents in a balanced way, reaches a judgement and generally links to the question it could be worth 4 marks. If the answer contains the criteria for 4 marks above, is logical and has no irrelevant content (No NAQ) it could be worth 5 marks.

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 21 of 25 Question Answer Marks 3 The authors of the two documents present different arguments and perspectives on the impacts of universal healthcare. Evaluate the arguments of the authors of both documents. In your answer, consider their perspectives and include a reasoned judgement about whether one argument is stronger than the other. 25 Indicative content – perspectives No set answer is expected, and examiners should be flexible in their approach. Candidates may include some parts of the following indicative content. A perspective is made up of argument, evidence and assumptions and may be influenced by a particular [global] context.The perspective is the overall point the author is making / what the author is writing about / what the overall argument the author is making. It gives an overview. The other AO1 aspects consider the key components of argument, evaluation and judgement. These consider the individual components of the candidate’s argument. Doc A states it is essential for management of COVID-19 (P^). Doc B states it is disadvantageous to doctors. (P^) In Doc A the authors have talked about Rwanda and the number of Covid cases recorded. (P) In Doc B writes that introducing universal healthcare from a private system would cause issues. (P) PD requires analysis by comparing and describing perspectives for both documents. It requires active comparison, not just placing two separate points for each document next to each other. McNulty (Doc B) gives a clear realistic perspective of the difficulties faced by potential doctors if UHC were to be introduced in the US. She is focussed on the US and her main concern is the financial situation of doctors. (PD) Her perspective comes from her stated position as someone who hopes to become a doctor, so she sees the possible introduction of UHC in the US as a bad option. (PE) Whereas, Binagwaho/Mathewos (Doc A) give a clear supported perspective of the positive impacts of Rwanda’s (UHC) health care system, suggesting that this system should be adopted by other countries as the best approach to pandemic management. (PD) Binagwaho/Mathewos are concerned with the benefits to the health of the whole population, but they focus on that with no details of the challenges faced by health workers. Binagwaho’s perspective is that of a pediatrician who has worked in the health sector and as minister of health, with an overview of how the whole system works, making her enthusiastic about UHC. (PE)

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 22 of 25 Question Answer Marks 3 Indicative content – Arguments No set answer is expected, and examiners should be flexible in their approach. At each point of comparison, candidates may argue that either Document is stronger, or they are equally strong. Candidates may include some of the following indicative content. [Example only]:  Balance/ opposing view /counter argument: Doc B (McNulty) has some balance, mentioning the opposing point of view (Bernie Sanders), shows some understanding (a pretty sweet deal), plus concedes that privatised healthcare has room for improvement. Though these are not developed and are rebutted, this may persuade the reader that McNulty has considered both sides which strengthens the argument in Doc B. (EVAL) On the other hand, Binagwaho (Doc A) only presents one perspective: that UHC is the way to go. (C) This weakens the argument in Doc A compared to Doc B. (J)  Sources: McNulty (Doc B) uses sourced statistics effectively in places (comparing pay in US with that in European countries) to support argument (though Doc B does not look at cost of living). However, Binagwaho (Doc A) provides no sources.  Clear supporting evidence for the argument Doc A includes clear examples with detail of how Rwanda’s health system operates and how it is managed, whereas Doc B is much vaguer about the details of private health care and provides little actual evidence apart from information about salaries and costs.  The conclusion of Doc A follows on from the argument and is well-supported by the evidence and examples provided, whereas the conclusion of Doc B is not well supported, we have not been told what improvements could be made to privatised health care.  Both appear one sided may be biased (despite some consideration of the opposition in Doc B)  Both well-structured easy to read and clearly expressed

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 23 of 25 Question Answer Marks 3 Judgement Candidate’s may introduce their answer with an unsupported judgement as to which, if any argument is stronger. (U^) Judgement will normally occur at the end of a point, especially as an intermediate judgement at the end of a paragraph. Use U^ or U, for unsupported judgements and where the candidate refers to one document only. J^ and J are used when an answer directly refers to both documents and answers the question by including a reasoned judgement about whether one argument is stronger than the other. [More details to illustrate the difference between J^ and J will be added here] The candidate may conclude that Doc A is stronger as it is more detailed and presented by an author with relevant experience and expertise. (J) The candidate may conclude that Doc B is stronger, as it considers an opposing view (Bernie Sanders) and gives the perspective of how trainee doctors feel. (J) The candidate may conclude that overall neither document is stronger than the other. They have different perspectives, and both are well structured, easy to read and clearly expressed, but both are somewhat one-sided. (J)

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 24 of 25 Annotation Meaning Correct, creditworthy point. Used in Question 1 only. Incorrect point. Used in Question 1 or for clear error elsewhere. T Identify type of evidence. (Without an example) Used in Q2 (AO1a) EG Example of type of Evidence. Used in Q2 (AO1a) + or – Strength or weakness of evidence recognised but with limited explanation. Used in Q2 (AO1b) EXP Strength or weakness of evidence clearly explained. Used in Q2 (AO1b) I Impact of evidence is asserted and not explained. Used in Q2 (AO1c) ^ Shows undeveloped point. Added to other annotations (EVAL, P, J and U in Q2 and Q3) EVAL Evaluation of impact of evidence on argument/perspective and includes a judgement. Used in Q2 (AO1c) J Added to EVAL to show the inclusion of a judgement. Used in Q2 (AO1c) K Identification of key component of argument. Used in Q3 (AO1a) C Comparison of key components from both documents. Used in Q3 (AO1a) P Identification of perspectives with limited description. Used in Q3 (AO1b) PD Analyses by comparing and describing perspectives in both documents. Used in Q3 (AO1b) PE Analyses by comparing and explaining perspectives in both documents. Used in Q3 (AO1b) ND Unsupported evaluation of argument. Used in Q3 (AO1c)

9239/12 Cambridge International AS & A Level – Mark Scheme PUBLISHED May/June 2023 © UCLES 2023 Page 25 of 25 Annotation Meaning EVAL Evaluation of argument in both documents. Used in Q3 (AO1c) U Unsupported judgement. Used in Q3 (AO1d) J Supported judgement. Used in Q3 (AO1d) Not answering the question. Repetition. When repeating a point as a summary or simply stating another example that does not develop the evaluation. SEEN To show that answers/pages have been assessed. On Page Comment. Used where necessary to clarify a decision.