scholarly journals Roma health mediators in Serbia – good example of multisectoral cooperation in health promotion

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
B Kilibarda ◽  
M Vasic ◽  
V Knjeginjic
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Service Providers ◽  
Health Indicators ◽  
Target Population ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Roma Population ◽  
The Republic ◽  
Roma Health

Abstract Issue Within the framework of the JA CHRODIS plus participants of the WP5 worked on identification of factors that contribute to collaboration within healthcare and between the broader health system and other sectors, as well as their enablers and barriers. In Serbia, practice that was identified and elaborated was aimed at improvement of health of Roma population. Description of the problem Based on available data, health indicators among Roma population in Serbia were two to three times worse than national averages. In order to tackle this issue, government of the Republic of Serbia, started with implementation of the project of education and inclusion of Roma health mediators in the health system. This project has been implemented in Serbia since 2009. Roma Health mediators (Roma ethical minority females) were trained for fast and efficient provision of support to Roma families. Results As a result of the project there was increased number of visits to health institutions and preventive check-ups of target population. Established cooperation between Roma health mediators and other health professionals in centers for primary health care, social care, and local self-government helped them in fulfilling their tasks, but also built capacity of other service providers to work in Roma communities. Through trainings they increase knowledge on various health, social and child care topics. Lessons Capacity building and inclusion of memebrs of vulnerable population into health promotion of the own to this population in terms of better acceptance of specific population population is useful to access groups as they can better understand and adapt to the needs of groups they want to reach. They should have opportunity to share their experience and lessons learned with experts involved in planning interventions for other vulberable groups. Key messages Building capacity of Roma mediators empowers them for integration into society beyond the scope of the Project. Lessons learned should be used for planning further actions for vulnerable groups.

scholarly journals Violations of the Right to Health due to Limited Access to Protection of Health during the COVID-19 Pandemic in the Republic of Croatia and Possible Legal ImplicationsL

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Nina Mišić Radanović
Keyword(s):  
Health Care ◽  
Health System ◽  
Medical Research ◽  
Cancer Detection ◽  
Right To Health ◽  
Vulnerable Groups ◽  
The Republic ◽  
The Right ◽  
Harmful Effects ◽  
Legal Consequences

The battle against the COVID-19 pandemic is still the most important problem and a great challenge for the overburdened health system in the Republic of Croatia. This paper examines the research into how violations of humans’ right to health occurred due to the inaccessibility to health protection for uninfected persons during the COVID-19 pandemic. The research implemented showed that a system of anti-epidemic measures which completely suspended or significantly reduced the possibility to access primary and hospital health care, stopped preventive programs of cancer detection. Much medical research has already revealed the possible harmful effects to people's health in the increase in cases of the contraction of and death from cancer and other serious illnesses, particularly in relation to certain vulnerable groups for example, women and oncology patients. The author concludes that the right to access protection of health during the COVID-19 pandemic in the Republic of Croatia was significantly limited and analyzes possible legal consequences which could occur due to the suspension or limitation to the right to access health care as a violation of the right to health.

scholarly journals COVID-19 and health promotion in Brazil: community health workers between vulnerability and resistance

2021 ◽  
pp. 175797592110123
Author(s):  
Gabriela Lotta ◽  
João Nunes
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Working Conditions ◽  
Health Workers ◽  
Online Discussions ◽  
Vulnerable Groups ◽  
Middle Income ◽  
Middle Income Countries

Health promotion in Brazil relies on community health workers (CHWs), frontline providers linking the health system with vulnerable groups. Brazilian CHWs are overwhelmingly women from poor backgrounds, with precarious and sometimes hazardous working conditions, as well as fragmented and unsystematic training. This paper evaluates how the COVID-19 pandemic exacerbated pre-existing vulnerabilities of CHWs (pertaining to low salary, precarious and hazardous working conditions and inadequate training) and created new ones, with a profound impact on their ability to carry out health promotion activities. Drawing on testimonials of dozens of CHWs and online discussions promoted by their unions, the paper reveals that during the pandemic CHWs were asked to continue their work without adequate training and protective equipment, thus exposing themselves to the risk of infection. It further shows how the pandemic rendered dangerous the close interaction with patients that is at the heart of their health promotion role. Nonetheless, CHWs sought to adapt their work. In the absence of leadership and coordination on the part of the federal government, CHWs mobilized different forms of resistance at the national and individual levels. Despite this, COVID-19 contributed to a trajectory of erosion of health promotion in Brazil. Findings from this case signal the difficulties for health promotion in low- and middle-income countries relying on CHWs to bridge the health system and vulnerable users.

scholarly journals STATE MANAGEMENT OF HEALTHCARE SYSTEM AS THE BASIS FOR THE QUALITY OF LIFE IN KAZAKHSTAN

2020 ◽  
Author(s):  
А.М. Рахметова ◽  
Е.Г. Будешов ◽  
A. Rakhmetova ◽  
Ye. Budeshov
Keyword(s):  
Quality Of Life ◽  
Health System ◽  
Healthcare System ◽  
Health Indicators ◽  
Institutional Development ◽  
Living Standards ◽  
Public Healthcare ◽  
State Management ◽  
The Republic

В статье обоснована объективная необходимость совершенствования государственного управления качеством жизни населения в Республике Казахстан, путем анализа системы показателей здравоохранения, которые оказывают влияние на его развитие. Авторами выявлен ряд нерешенных проблем на основе проведенного сравнительно-сопоставительного анализа основных показателей системы здравоохранения и предложены соответствующие рекомендации в части совершенствования механизма управления сферой здравоохранения, с учетом возможной адаптации передовой практики развитых европейских государств. Особое внимание авторами уделяется анализу системы здравоохранения Республики Казахстан, как важнейшему аспекту в государственном управлении качеством жизни населения страны, в частности таким показателям, как: естественное движение населения, коэффициенты смертности населения, уровень обеспеченности населения медицинским персоналом и инфраструктура, основным показателям финансирования системы здравоохранения – которые в комплексе позволяют обеспечить высокое качество жизни населения и устойчивое социально-экономическое развитие страны. При проведении исследования авторами были использованы статистические приемы и методы (сбор, анализ и сравнение данных). В частности, на основе анализа ряда показателей, используемых для измерения прогресса и достижения цели авторами предусмотрены ключевые национальные индикаторы, характеризующие качество жизни населения и результаты процесса государственного управления системой здравоохранения. Учитывая, что система государственного управления в Республике Казахстан ориентирована на повышение социально-экономического и уровень такого институционального развития, который не уступает уровню развития стран – членов Организации экономического сотрудничества и развития (далее – ОЭСР), авторами предложены рекомендации для достижения этой цели. This paper substantiates the objective need to improve the state management of the quality of life in the Republic of Kazakhstan by analyzing the system of health indicators affecting its development. Based on a comparative analysis of the main health system indicators, the authors identify a number of unresolved issues and propose appropriate recommendations for improving the management mechanism of the health sector, also considering possible adaptation of best practices of developed European countries. Special attention is paid to the analysis of the healthcare system of the Republic of Kazakhstan as the most important aspect in public management of the living standards, in particular such indicators as: natural population movement, mortality rates, the level of availability of health personnel and infrastructure, core indicators of financing of the health system – which together ensure a high quality of life and sustainable socio-economic development of the country. During the study, the authors used statistical techniques and methods (data collection, analysis and comparison). In particular, based on the analysis of a number of indicators used to measure progress and achieve the goal, the authors provide key national indicators that characterize the living standards and the results of the public healthcare system administration process. Taking into account that the system of public administration in the Republic of Kazakhstan focuses on increasing socio-economic and the level of such institutional development that is well up to the level of development of the member countries of the Organization for Economic Cooperation and Development (hereinafter referred to as the OECD), the authors propose recommendations for achieving this goal.

scholarly journals 191 A Multi-Country Survey to Explore What Key Stakeholders Consider to be Important in a Model of Dementia Palliative Care

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Siobhan Fox ◽  
Niamh O'Connor ◽  
Jonathan Drennan ◽  
Suzanne Guerin ◽  
George Kernohan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Target Population ◽  
Community Health Services ◽  
Care Services ◽  
People With Dementia ◽  
Key Stakeholders ◽  
Essential Components ◽  
Palliative Care Services ◽  
The Republic

Abstract Background The Model for Dementia Palliative Care Project will develop a service delivery model for community-based dementia palliative care in Ireland. This responds to palliative care now being recognised as a priority in care for people with dementia. Various dementia palliative care services exist internationally, however little is known about what the service providers would deem to be the most important aspects of service provision. The aim of this study was to identify what key stakeholders consider to be essential components of a model of dementia palliative care. Methods A web-based survey was developed, piloted (n=5), and revised. It was distributed electronically within five healthcare jurisdictions, in the Republic of Ireland, Northern Ireland, England, Scotland, and Wales. The target population was healthcare professionals, policy-makers, and academics, with an interest in dementia and palliative care. Content analysis of open ended questions was used to identify common themes within the data. Results Complete surveys were received from 112 stakeholders. The majority of respondents were female (86%). Identified key principles of care incorporated the philosophies of palliative care and good dementia care, with many describing ‘holistic’ and ‘person-centred care’ as core. Important individual components were identified, including support for carers, advanced care planning, information, education and training, activities for ‘meaningful living’, comprehensive disease management, coordinated case management, and linking in with community health services and social activities. Barriers to the model were identified at three levels: ‘(mis)understanding of dementia palliative care’, ‘application of dementia palliative care’ and ‘wider service organisation’. Conclusion Numerous components of a ‘good’ model were identified, along with possible barriers to implementation of the model. This study, as part of the larger project, will inform a model of dementia palliative care for the Irish Healthcare system with the potential to improve the experiences of people with dementia and their families.

Health system response to large scale migration: the case of Emilia-Romagna region

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Quargnolo ◽  
L Mammana ◽  
G Gherardi ◽  
C Bodini ◽  
D Damosto ◽  
...  
Keyword(s):  
Health Promotion ◽  
Health System ◽  
Asylum Seekers ◽  
Health Needs ◽  
Vulnerable Groups ◽  
System Response ◽  
National Guidelines ◽  
Regional Health ◽  
Health Response ◽  
Emilia Romagna Region

Abstract Background In Italy, recent changes in migration flows posed complex public health challenges. The Emilia-Romagna region (ERR) was one of the first regions to adopt specific policies addressing the health of newly arrived asylum seekers. In our study, we analysed the regional health system response comparing it to the regional and national guidelines, in order to assess its strengths and its critical areas. Methods In 2019, we conducted a survey among the referents of the regional clinics that provide healthcare to asylum seekers, in order to learn about local policies, challenges and best practices. A questionnaire with 35 closed and 11 open questions was administered and analysed through descriptive statistical analysis and text analysis. Results Regional policies showed good responsiveness and Local Health Authorities (LHAs) adhered to the guidelines. A special permit was introduced to grant asylum seekers access to healthcare, which also allowed integration of health data into the regional health information system. However, data integration was done in only 2 clinics out of 14. Instances of discretion in issuing the special permit were reported, due to ambiguity in the rules and inadequate training of office workers. Policies and LHAs protocols focused greatly on the arrival phase and on Communicable Diseases (CDs) surveillance. Other areas - such as protection of vulnerable groups, health promotion, NCDs - were prioritized in the national guidelines, but unevenly considered throughout the region, also due to lack of resources. Some clinics responded autonomously to these gaps with local resources. Conclusions The ERR health response to the influx of asylum seekers was rapid but incomplete. Interventions focused more on CDs surveillance than on responding to asylum seekers' health needs in terms of quality, access and equity. Areas to be strengthened include protection of vulnerable groups, health promotion and NCDs, together with coordination and long-term planning. Key messages The Emilia-Romagna region health response to the influx of asylum seekers reflects an emergency approach focused on communicable diseases, while NCDs and health promotion are relatively neglected. The health system in Emilia-Romagna needs to be strengthened in its capacity to respond to asylum seekers’ health needs. Health policies and practices should be planned to ensure equity and quality.

scholarly journals Organizational Change in the Sphere of Health Protection of the Roma Community in Poland Seen From Different Perspective

2020 ◽  
Vol 2/2020 (88) ◽  
pp. 101-122
Author(s):  
Marleen Blom ◽  
◽  
Izabella Łęcka ◽  
Keyword(s):  
Well Being ◽  
Target Population ◽  
Integration Policy ◽  
Polish Literature ◽  
Roma Population ◽  
Organizational Behaviour ◽  
Polish Society ◽  
Conducting Research ◽  
Roma Health ◽  
Newspaper Articles

Purpose: The intent of this study is to get insight into the different views on Roma health in Poland to improve health, access to healthcare and broaden the understanding of the limitations for the Roma inclusion in the mainstream of organizational behaviour of health and well-being institutions. Design/methodology/approach: The lack of institutional success up to date in the conduct of policies supporting the Roma on the path to an even standard of living, including health, suggests seeking new organizational approaches. To find the answers to these questions “What views do the Roma/Roma experts/Polish society have on Roma health?” qualitative research was done: six semi-structured openended interviews were conducted in the Roma community in Ochotnica Górna village in the Carpathian Mountains (across three generations), one structured and two semi-structured open-ended interviews with experts, observations of the living environments of the Roma interviewees and collection of newspaper articles as well as an analysis of different statistical data. Findings: The main insights that were provided by the views of Roma experts are the differences of approaches to health issues between Roma groups in Poland. The main insights that the newspaper articles give into the views of the society on Roma health are that the denigrating view on the Roma is still present in society, as some statements created a narrative of ‘othering’. This study also shows the change of views in time, as conformation to Romanipen principles is being relaxed among younger generations so their view on health and health care is changing. The policy in Poland that addresses the health issue of Roma is the National Roma Integration Policy 2014–2020, targeted to the whole Polish Roma population, homogeneously, although the target population is rather heterogeneous. This should be changed in the coming years. Research limitations/implications: A serious limitation in the research was the lack of willingness of both of the Roma people and Roma experts to participate in the study, and especially to share their insights on health, the protection of which follows the restrictive tradition of Romanipen. Generally, conducting research only in Ochotnica Gorna narrows the scope of this study to one particular village, even if the organizational solution is similar all over Poland. Originality/value: The value of the obtained results is increased by their uniqueness, as the separate issues of Roma health are not raised in Polish literature.

scholarly journals The main directions of the state social policy of child protection in Uzbekistan

2021 ◽  
Vol 13 (4) ◽  
pp. 87-112
Author(s):  
Nodira M. Latipova ◽  
◽  
Charos A. Abdugafurova ◽  
Keyword(s):  
Child Protection ◽  
Social Protection ◽  
The State ◽  
Lessons Learned ◽  
Protection System ◽  
Vulnerable Groups ◽  
Difficult Situation ◽  
The Social ◽  
The Republic ◽  
The Impact

The article discusses the improvement of social protection of families and children in the Republic of Uzbekistan. Based on the analysis, the National System of Child Protection in the Republic of Uzbekistan was obtained, which is made up of certain components. Methods. The content of the article is based on various research methods, primarily on the assessment of the social protection system through interviews with stakeholders. The assessment critically assessed the strategies applied, identified lessons learned and best practices, accelerating the achievement of sustainable results for children in Uzbekistan, especially from the most vulnerable groups. The assessment was aimed at assessing the relevance, effectiveness, efficiency, sustainability, consistency and, if possible, the impact of the strategies adopted to achieve the results of the start program. It was concluded that the effectiveness of the social protection system for children and families is based on the presence of the listed structural components in it. , and in the subsequent parts of this book we will try to analyze the main of these components in relation to the system of social protection of children in Uzbekistan. Results. The article is based on the support for the development of recommendations for the strategic planning of the next program cycle. The level of humanity of the state policy towards its citizens in a difficult situation, a socially vulnerable situation is measured by the system of social support provided, which is aimed at creating opportunities for them to participate in life, equal with other citizens, for socio-political, economic, cultural and intellectual development.

scholarly journals Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hamidreza Khankeh ◽  
Mehrdad Farrokhi ◽  
Juliet Roudini ◽  
Negar Pourvakhshoori ◽  
Shokoufeh Ahmadi ◽  
...  
Keyword(s):  
Health System ◽  
Social Protection ◽  
Social Inequalities ◽  
Mental Health Problems ◽  
Patient Flow ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Cultural Issues ◽  
Structured Interviews

Abstract Background With the unprecedented expansion of COVID-19 in the world since December 2019, Iran’s health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. Methods The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. Results Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. Conclusions According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.

scholarly journals Challenges to Manage Pandemic of Coronavirus Disease (COVID-19) in Iranian Special Situation: A Qualitative Multi-Method Study

2021 ◽  
Author(s):  
Hamidreza Khankeh ◽  
Mehrdad Farrokhi ◽  
Juliet Roudini ◽  
Negar Pourvakhshoori ◽  
Shokoufeh Ahmadi ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Workers ◽  
Social Inequalities ◽  
Patient Flow ◽  
Lessons Learned ◽  
Vulnerable Groups ◽  
Contact Tracing ◽  
Cultural Issues ◽  
Care Workers

Abstract BackgroundWith the unprecedented expansion of COVID-19 in the world since December 2019, the Iranian health system like other countries faced various challenges in managing the disease, which led to obtaining numerous experiences and lessons learned. The aim of this study is to identify these challenges, in regard with unique political, economic, and cultural issues which could help to other countries with similar situation.MethodsThe present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and Focused Group Discussions with 60 key persons, policy makers, health care workers and affected people by the disease, and the review of all available national reports between February 21, 2020, and December 22, 2020. The data collection and analysis process took place simultaneously.ResultsIn this study, critical challenges related to the management of COVID-19 in the health system were, including; The limited evidence and scientific controversies, Poor social prevention and social inequalities, Burnout and sustained workload among health care workers, Improper management of resources and equipment, Lack of guideline for case contact tracing and patient-flow, Community mental health problem. ConclusionsAccording to the study, measurements should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on exact case contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease and also transparency of social inequalities in the face of risk factors of the COVID-19. And finally, supporting vulnerable groups using community capacity and cooperating international community to provide vaccine which is difficult to procure due to the sanction.

Managing the effectiveness of the regional health system

2020 ◽  
Vol 26 (3) ◽  
pp. 698-720
Author(s):  
E.V. Lobkova ◽  
A.S. Petrichenko
Keyword(s):  
Public Health ◽  
Health System ◽  
System Analysis ◽  
Health Indicators ◽  
Krasnoyarsk Krai ◽  
Regional Health ◽  
Luenberger Observer ◽  
Efficiency Assessment ◽  
Public Health Indicators

Subject. This article studies the mechanism of State health regulation and methods of management of efficiency of regional healthcare institutions. Objectives. The article aims to analyze the territorial health system in the context of the urgent need to optimize budget expenditures and address public health problems, as well as develop directions to improve the effectiveness of the regional health system of the Krasnoyarsk Krai. Methods. For the study, we used the method of index numbers and calculation of dynamics indicators using official statistics data. Results. We have developed and now present a system of indicators of regional health efficiency assessment, focused mainly on public health indicators and quality of medical services. We also offer our own version of the Luenberger observer modification adapted to the objectives of the regional health system analysis. Conclusions and Relevance. The article concludes that it is necessary to optimize the regional health system using the parameters of medical and social efficiency of the system. The proposed approach to assessing the effectiveness of regional health system can be used as a mechanism to develop recommendations for the management of the network of medical and prophylactic institutions of the region.

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