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Health in All Policies: A Guide for State and Local Governments was created by the Public Health Institute, the California Department of Public Health, and the American Public Health Association in response to growing interest in using collaborative approaches to improve population health by embedd
...
ing health considerations into decision-making processes across a broad array of sectors. The Guide draws heavily on the experiences of the California Health in All Policies Task Force and incorporates information from the published and gray literature and interviews with people across the country.
The guide was developed through funding from the American Public Health Association and The California Endowment.
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Guide to national implementation of the Shanghai Declaration describes policy orientations and approaches that can unlock the transformative potential of health promotion for sustainable development. This guide was developed to support country level implementation of the commitments and recommendati
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ons in the Shanghai Declaration.
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
...
y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new
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Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
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Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a
...
pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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This document describes the ethical values that are most important to the nursing profession in Ontario. It also provides scenarios of ethical situations in which there is a conflict of values. Nurses are encouraged to use these scenarios for reflection and discussion. No solutions are offered becau
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se there is no one solution that is best in all situations. The behavioural directives are intended to help nurses work through ethical situations and provide information about the College of Nurses of Ontario’s (CNO’s) expectations for ethical conduct. These are taken into account when CNO Committees assess nurses’ practices. Nurses need to consider behavioural directives carefully when making decisions about ethical care as this process will strengthen their practice.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
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These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focu
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s on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs.
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This document outlines why and how nurses and midwives are important, not only for individual health optimization but also to achieve the thematic priorities of For the Future. More specifically, it provides case studies to showcase the amazing work that nurses and midwives across the Region are doi
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ng to improve health. The document also provides future policy directions to strengthen the scope and leadership of the nursing and midwifery workforce, alongside actions to accelerate investment in their education, skills and employment.
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The humanitarian situation in the Central African Republic (CAR) has further worsened over the past six months. Election-related violence that broke out in mid-December 2020 has had a devastating effect on civilians. Thousands of people have been forced to flee, human rights violations have surged,
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hundreds of schools and dozens of hospitals have been forcibly closed and food prices have skyrocketed. This deterioration occurred in an already alarming context, with more than half of the population (2.8 million people) in need of humanitarian assistance and protection and 1.9 million people in acute need. In the past five years, there have never been as many people in humanitarian distress in CAR as today.
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Since the emergence of COVID 19 in December 2019, various public health responses measures have been implemented to control the pandemic. Among measures taken by the Africa CDC was the launch of PACT initiative to accelerate COVID 19 testing. Key to the initiative is the engagement of Community Heal
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th Workers (CHWs) in risk communication and community engagement (RCCE), surveillance activities for early case identification, contacts tracing and in facilitating referrals for testing and continuum of care.
As of 31 May 2021, Through PACT support, over 17154 CHWs have been trained and locally deployed in 24 AU Member states. The PACT supported CHWs visited more than 2,568,654 households for community engagement activities, active case search and contact tracing, identified 1,618,601 Contacts, 710,167 COVID 19 suspect cases based on the standard case definition and facilitated referrals for 553053 (78%) suspect cases for testing. These efforts were crucial for early identification and isolation of cases in limiting further transmission.
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Este documento de referência foi preparado pelo Grupo de Trabalho sobre Vacinas contra COVID-19 do Grupo Consultivo Estratégico de Especialistas em Imunização (SAGE) para orientar as discussões do SAGE em sua reunião extraordinária de 8 de fevereiro de 2021, que resultou na publicação do do
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cumento da OMS de 10 de fevereiro de 2021 Recomendações provisórias para o uso da vacina AZD1222 [ChAdOx1-S (recombinante)] contra COVID-19 desenvolvida pela Universidade de Oxford e pela AstraZeneca. Os dois documentos estão disponíveis na página sobre COVID-19 do SAGE: https://www.who.int/groups/strategic-advisory-group-of-experts-on-immunization/covid-19-materials. Têm sido usados vetores de adenovírus deficientes na replicação contendo um transgene específico do patógeno como novas vacinas devido à sua capacidade de induzir respostas humorais e celulares fortes.
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The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce.
This toolkit was developed by the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention (DHDSP) to provide healthcare organizations, including those in resource-constrained settings, with the information and resources to implement the HMP and improve hyper
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tension control among their patients. CDC DHDSP developed an online toolkit that consists of interactive e-learning modules that are designed to guide learners through the key features of the ten HMP components and prepare them for implementation at their health system. The online e-learning modules are accompanied by a PDF toolkit document that can be used as an additional resource for users.
The purposes of this toolkit and the associated online e-learning modules are to provide healthcare organizations:
An overview of the HMP, its ten core components, and suggestions for implementing the HMP in clinical settings.
Guidance to staff, administrators, and other healthcare professionals on how to implement and adapt the HMP for their unique clinical setting.
The online e-learning modules you can find here:
https://www.cdc.gov/dhdsp/pubs/toolkits/hmp-toolkit/index.htm
accessed 29.07.2021
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Operating Department Practice - Clinical Pocket Reference - for nurses, students and other healthcare professionals - third edition,
supplemantary material Available from
www.clinicalpocketreference.com
ISBN: 978 1 908725 10 3
Вакцинация и доверие: Как возникает озабоченность и роль коммуникации в смягчении кризисных ситуаций
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Когда возникают ситуации, при которых нежелательные явления справедливо или ошибочно связывают с вакцинацией, они могут подорвать доверие к вакцинам и официальны
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м органам, осуществляющим их введение. Этот документ предоставляет научные данные, помимо рекомендаций ВОЗ, относительно создания и восстановления доверия к вакцинам и вакцинации как в процессе осуществления работы, так и в период кризисных ситуаций. Данные привлекают внимание к широкому набору научных лабораторных фактов и фактам, полученным при полевых работах в области психологии и коммуникаций. Он рассматривает, как люди принимают решения по поводу вакцинации; почему некоторые лица не доверяют вакцинации; и факторы, которые вызывают критические ситуации, уделяя внимание тому, как создавать доверие, слушать и понимать людей, создавать взаимоотношения, сообщать о рисках и формировать сообщения для аудитории, что может смягчать кризисные ситуации. Этот документ предоставляет базисные знания заинтересованным сторонам, которые разрабатывают коммуникационные стратегии или содействуют проведению семинаров по коммуникациям и деятельности по созданию доверия в связи с вакцинами и иммунизацией, таким как подразделения программы иммунизации, министры здравоохранения, подразделения по связи с общественностью и укреплению здоровья, преподаватели по коммуникации относительно безопасности вакцин и консультативные органы по иммунизации
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In order to meet changing global population needs and consumer expectations, healthcare systems worldwide are under transformation and face restructuring. As systems adapt and shift their emphasis in response to the disparate requests for healthcare services, oppor-tunities emerge for nurses, especi
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ally the APN, to meet these demands and unmet needs (Bryant-Lukosius et al. 2017; Carryer et al. 2018; Cassiani & Zug 2014; Cooper & Docherty 2018; Hill et al. 2017; Maier et al.2017). In 2002, the International Council of Nurses (ICN) pro-vided an official position on Advanced Practice Nursing (ICN 2008a). Since that time, worldwide development has increased significantly and simultaneously this field of nursing has matured. ICN felt that a review of its position was needed to assess the relevance of the definition and characteristics offered in 2002. This guid-ance paper defines diverse elements such as assump-tions and core components of the APN. The attributes and descriptors presented in this paper are intended to promote a common vision to continue to enable a greater understanding by the international nursing and healthcare communities for the development of roles commonly identified as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP).
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