scholarly journals Sociocultural Aspects of Health Promotion in Palliative Care in Uganda

Author(s):  
James Mugisha

AbstractDespite its vital importance, health promotion has not occupied its due place in public health in Uganda. The country is engulfed into a rising wave of both communicable and non-communicable conditions. This rising burden of both communicable and non-communicable conditions turns health promotion and palliative care essential health care packages; though there is little to show that these two important programs are getting vital support at policy and service delivery levels. A new theoretical framework that is anchored into sociocultural issues is essential in guiding the design and delivery of both health promotion and palliative care in Uganda. The salutogenic theory puts socio-cultural issues at the centre of developing health promotion and palliative care and, seems to solve this dilemma. In this chapter, illustrations from indigenous communities in Uganda are employed to demonstrate the challenges to the health promotion and palliative care agenda in the country and how they can be addressed. Uganda Ministry of Health should develop robust structures within public health for development of health promotion and palliative care in the country. Research should be conducted on the effectiveness of the current strategies on health promotion and palliative care and their cultural sensitivity and appropriateness. Given the limited resources available for development of health care in Uganda, as an overall strategy, health promotion and palliative care should be anchored in public health and its (public health) resources.

Author(s):  
Diana Hart

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Annette Kaspar ◽  
Sione Pifeleti ◽  
Carlie Driscoll

Abstract Background Translation and cultural adaptation of health resources is an integral part of good health-policy development and health program implementation. As part of our efforts to address ear disease and hearing loss in the Pacific Islands, we promote the translation an cultural adaptation of hearing-related questionnaires into local languages and cultural contexts. The Pacific Islands have among the highest rates of ear and hearing disorders in the world and, given the scarcity of ear/hearing health professionals in the region, a public health approach that uses appropriately translated ear/hearing health resources is highly recommended to tackle this health issue. Although formal translation and culturally adaption of hearing-related questionnaires may seem a cumbersome process, the aim of this commentary is to illustrate the potential benefits of translating two audiology questionnaires for our use in Samoa. We have carefully selected questionnaires that will serve multiple purposes (i.e., clinical, epidemiology, monitoring and evaluation, evidence-based health policy formulation and implementation), thus making the process ultimately beneficial and worthwhile. Main body The leading cause of preventable hearing loss among Samoan adolescents and young people is excessive noise exposure to recreational and environmental noise. The Youth Attitude to Noise Scale is a validated tool that assess knowledge and attitudes of adolescents towards recreational and environmental noise, and a Samoan version should provide preliminary data to guide health promotion activities for adolescents on noise-induced hearing loss. The leading cause of hearing disability among older adult Samoans is age-related hearing loss. The Revised Hearing Handicap Inventory is a tool that assess the emotional and social/situational impact of hearing difficulty among older adults, and a Samoan version should provide preliminary data to guide the development of auditory rehabilitation services. Conclusion Investment in quality translations and cultural adaptations of hearing-related questionnaires is essential for the development of audiology services that are relevant to their Pacific Island context. The use of formally translated audiology questionnaires in research studies will optimise data quality, leading to improved hearing health promotion activities, as well as provision of evidence for advocacy for public health noise policy legislation.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Le Bodo ◽  
R Fonteneau ◽  
C Harpet ◽  
H Hudebine ◽  
F Jabot ◽  
...  

Abstract Background The potential contribution of local authorities to prevention and health promotion is well recognized. In France, since 2009, Local Health Contracts (LHCs) are mobilising Regional Health Agencies, local elected officials and stakeholders to intervene in 4 areas: health promotion, prevention, health care and social care. LHCs remain poorly documented policy instruments. Methods As part of the CLoterreS study, a multidimensional coding tool was developed and tested by two coders to explore the place of prevention and health promotion in LHCs. Its development was based on the WHO conceptual framework for action on the social determinants of health and the Self-assessment tool for the evaluation of essential public health operations in the WHO European Region. Preliminary results concern a random sample of 17 LHCs from as many French regions selected among the 165 LHCs signed between 2015 and March 2018. Results On average, the LHCs featured 26 action forms (AF) (min: 5; max: 56). In a LHC, the average proportion of AF addressing either the social determinants of health, living circumstances or other determinants targeted by health protection, promotion or primary prevention interventions (SDoH-HPP-P1) was 79% while 44% of the AF address secondary/tertiary prevention, social care or the organization of health care and services. Among the SDoH-HPP-P1 themes (double coding permitted): psychosocial life circumstances were addressed in the 17 LHCs and concerned, on average, 31% of their AF; material living circumstances were addressed to a lesser extent (16 LHCs, 13%); other key themes include environmental health (12, 14%), mental health (16, 12%), alcohol abuse (15, 11%), drug use (14, 11%), smoking (13, 9%), physical activity (13, 12%), healthy eating (12, 12%). Conclusions This work confirms that LHCs are instruments with prevention and health promotion at their core. Explanation of the differing investments in this area across our sample will be further explored. Key messages Local Health Contracts are promising instruments to address locally a broad range of health determinants. The CLoterreS analytical tool has proven effective in capturing multiple themes and shedding light on differences between Local Health Contracts’ action plans.


2007 ◽  
Vol 33 (5) ◽  
pp. 591-598 ◽  
Author(s):  
Emilio Herrera ◽  
Javier Rocafort ◽  
Liliana De Lima ◽  
Eduardo Bruera ◽  
Francisco García-Peña ◽  
...  

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F De Bock ◽  
Y Shajanian Zarneh ◽  
S Matusall

Abstract The public health system in Germany, similar to education and cultural affairs, is characterised by the federal structure. It is mainly regulated and decided at the state and municipal level, and not primarily at the national level. The preventive health care act (The Act to Strengthen Health Promotion and Preventive Health Care) (2015) underlines the setting-based approach of health promotion and takes a life course perspective by recommending goals of growing up healthy, living and working healthy and healthy ageing. The act formulates broad recommendations for prevention and health promotion at the national level, that in turn take on concrete forms in mandatory framework agreements at the federal state level with uniform health objectives. On the whole, the key objective of the act is to improve preventive health care and general health promotion. Also the financing of the act by the mandatory health insurance is a special feature and at the same time a novelty. At the same time a bottom-up project has been recently launched with the aim to develop a public health strategy in Germany. The project future forum public health (ZfPH) is a platform for public health professionals, researchers and students following incorporated concepts of policy analysis as well as methods that will ensure participation, transparency and transferability of the results into policy and practice. Over the next three years, ZfPH’s steering group will moderate a participatory process, including stakeholders from public health practice and research as well as policy makers. In an evidence-based approach, they will first analyse the current state of Germany’s public health system before developing concrete policy recommendations for a coherent and efficient public health system. The presentation will give a short overview over the German public health system and the preventive health care act, its structure and the achievements as well as the bottom-up project future forum public health.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Contu ◽  
E Breton

Abstract Background There is a growing recognition of the limitations of a linear cause-and-effect rationality in planning and evaluating public health interventions. Although this perspective is amenable to programme planning and evaluation, it leaves aside a whole array of mechanisms of change triggered by interactions taking place in complex social systems. Generative causality is one and recognized under a number of works referring to the complexity paradigm. Here we review the state of knowledge on what is often referred to as the complexity theory (CT), and present the results of a review of the literature on its application in public health. Methods We searched PubMed for articles, commentaries, editorials published in English, French and Italian, using the keywords 'Complexity Theory' (also plural). We categorized the fields of application of the CT according to the three core WHO's Essential Public Health Operations, i.e., Health Promotion, Prevention and Protection. All papers addressing issues related to health care services (but not prevention) were included in the category “health care services” while others were tagged as “others”. Results We found 203 papers meeting our inclusion criteria. The largest share of the research output applying the CT was in health care services (n = 167), followed by Health Promotion (5), Prevention (3) and Protection (2). 26 papers were labelled others. In health promotion/ prevention, applications of the CT have yet to integrate most of its concepts. Most authors tap into both the linear and generative rationality perspectives. Conclusions Although regularly deemed as promising in uncovering mechanisms for change triggered by public health intervention, applications of the complexity theory remain uncommon and has made little inroads in the public health domain. This is particularly the case for health promotion where one would assume that participatory community-based interventions would be an incentive to integrate this perspective. Key messages Although deemed promising the complexity theory has made little inroads in public health. Health promotion with its participatory community-based interventions can benefit from its application.


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