scholarly journals Health reform and Indigenous health policy in Brazil: contexts, actors and discourses

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i107-i114
Author(s):  
Ana Lucia de M Pontes ◽  
Ricardo Ventura Santos
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Health Reform ◽  
Indigenous Health ◽  
Holistic Health ◽  
Political Agenda ◽  
Final Report ◽  
The Right ◽  
Specific Health

Abstract Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.

scholarly journals Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts

Elem Sci Anth ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Josée G. Lavoie ◽  
Jon Petter Stoor ◽  
Elizabeth Rink ◽  
Katie Cueva ◽  
Elena Gladun ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Access To Health Care ◽  
Indigenous Health ◽  
The United States ◽  
Native People ◽  
Culturally Appropriate ◽  
Access To Health ◽  
The Impact

Although numerous comparative Indigenous health policy analyses exist in the literature, to date, little attention has been paid to comparative analyses of Circumpolar health policy and the impact these policies may have on Indigenous peoples’ rights to health. In this article, we ground our discussion of Indigenous peoples’ right to access culturally appropriate and responsive health care within the context of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). Under UNDRIP, signatory states are obligated to guarantee that Indigenous peoples have access to the same services accessible to all citizens without discrimination. Signatory states must also guarantee access to services that are grounded in Indigenous cultures, medicines, and practices and must address Indigenous peoples’ determinants of health at least to the same extent as their national counterparts. Our analysis finds that the implementation of this declaration varies across the Circumpolar north. The United States recognizes an obligation to provide health care for American Indian and Alaska Native people in exchange for the land that was taken from them. Other countries provide Indigenous citizens access to care in the same health care systems as other citizens. Intercultural models of care exist in Alaska and to some extent across the Canadian territories. However, aside from Sámi Norwegian National Advisory Unit on Mental Health and Substance Use in northern Norway, intercultural models are absent in Nordic countries and in Greenland. While Russia has not ratified UNDRIP, Russian policy guarantees access to health care to all citizens, although access is particularly limited in rural and remote environments, including the Russian Arctic. We conclude that Circumpolar nations should begin and/or expand commitments to culturally appropriate, self-determined, access to health care in Circumpolar contexts to reduce health inequities and adhere to obligations outlined in UNDRIP.

scholarly journals The role of technology in Australian youth mental health reform

2016 ◽  
Vol 40 (5) ◽  
pp. 584 ◽  
Author(s):  
Jane M. Burns ◽  
Emma Birrell ◽  
Marie Bismark ◽  
Jane Pirkis ◽  
Tracey A. Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Health Reform ◽  
Help Seeking ◽  
The Internet ◽  
Health And Wellbeing ◽  
Mental Health Reform ◽  
The Right

This paper describes the extent and nature of Internet use by young people, with specific reference to psychological distress and help-seeking behaviour. It draws on data from an Australian cross-sectional study of 1400 young people aged 16 to 25 years. Nearly all of these young people used the Internet, both as a source of trusted information and as a means of connecting with their peers and discussing problems. A new model of e-mental health care is introduced that is directly informed by these findings. The model creates a system of mental health service delivery spanning the spectrum from general health and wellbeing (including mental health) promotion and prevention to recovery. It is designed to promote health and wellbeing and to complement face-to-face services to enhance clinical care. The model has the potential to improve reach and access to quality mental health care for young people, so that they can receive the right care, at the right time, in the right way. What is known about the topic? One in four young Australians experience mental health disorders, and these often emerge in adolescence and young adulthood. Young people are also prominent users of technology and the Internet. Effective mental health reform must recognise the opportunities that technology affords and leverage this medium to provide services to improve outcomes for young people. What does this paper add? Information regarding the nature of young people’s Internet use is deficient. This paper presents the findings of a national survey of 1400 young Australians to support the case for the role of technology in Australian mental health reform. What are the implications for practitioners? The Internet provides a way to engage young people and provide access to mental health services and resources to reduce traditional barriers to help-seeking and care. eMental health reform can be improved by greater attention toward the role of technology and its benefits for mental health outcomes.

scholarly journals The Practice of Power by Regional Managers in the Implementation of an Indigenous Peoples Health Policy in the Philippines

2020 ◽  
Author(s):  
Ryan C. Guinaran ◽  
Erlinda B. Alupias ◽  
Lucy Gilson
Keyword(s):  
Health Policy ◽  
Policy Implementation ◽  
Health System ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Organizational Factors ◽  
The Philippines ◽  
Discretionary Power ◽  
Program Managers ◽  
Health Managers

Background: Indigenous peoples are among the most marginalized groups in society. In the Philippines, a new policy aimed at ensuring equity and culture-sensitivity of health services for this population was introduced. The study aimed to determine how subnational health managers exercised power and with what consequences for how implementation unfolded. Power is manifested in the perception, decision and action of health system actors. The study also delved into the sources of power that health managers drew on and their reasons for exercising power. Methods: The study was a qualitative case study employing in-depth semi-structured interviews with 26 health managers from the case region and analysis of 15 relevant documents. Data from both sources were thematically analyzed following the framework method. In the analysis and interpretation of data on power, VeneKlasen and Miller’s categorization of the sources and expressions of power and Gilson, Schneider and Orgill’s categorization of the sources and reasons for exercising power were utilized. Results: Key managers in the case region perceived the implementation of the new Indigenous health policy as limited and weakly integrated into health operations. The forms of power exercised by actors in key administrative interfaces were greatly influenced by organizational context and perceived weak leadership and their practices of power hindered policy implementation. However, some positive experiences showed that personal commitment and motivation rooted in one’s indigeneity enabled program managers to mobilize their discretionary power to support policy implementation. Conclusion: The way power is exercised by policy actors at key interfaces influences the implementation and uptake of the Indigenous policy by the health system. Middle managers are strategic actors in translating central directions to operational action down to frontlines. Indigenous program managers are most likely to support an Indigenous health policy but personal and organizational factors can also override this inclination.

scholarly journals Toward a New Era of Policy: Health Care Service Delivery to First Nations

2011 ◽  
Vol 2 (1) ◽  
Author(s):  
Miranda D Kelly
Keyword(s):  
Health Care ◽  
Health Policy ◽  
First Nations ◽  
Policy Development ◽  
Indigenous Health ◽  
Care Service ◽  
Health Care Service ◽  
New Era ◽  
Recent Developments ◽  
Health Care Service Delivery

The disproportionate burdens of ill health experienced by First Nations have been attributed to an uncoordinated, fragmented health care system. This system is rooted in public policies that have created jurisdictional gaps and a long-standing debate between federal, provincial and First Nations governments as to who is responsible for First Nations health care. This article examines: (1) the policies that shape First Nations health care in Canada and in the province of British Columbia (BC) specifically; (2) the interests of the actors involved in First Nations health policy; and (3) recent developments in BC that present an opportunity for change to First Nations health policy development and have broader implications for Indigenous health policy across Canada and worldwide.

Culturally safe health care practice for Indigenous Peoples in Australia: A systematic meta-ethnographic review

2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Cultural Knowledge ◽  
Cultural Safety ◽  
Care Practice ◽  
Health Care Practice ◽  
Torres Strait

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.

Understanding Health Inequalities and Justice

2016 ◽  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Inequalities ◽  
Health Care Environment ◽  
Ongoing Debate ◽  
Care Environment ◽  
Original Essays ◽  
Patient Agency ◽  
Public Debates ◽  
Specific Health

Amidst ongoing debate about health care reform, the need for informed analyses of U.S. health policy is greater than ever. The twelve original essays in this volume show that common public debates bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, the contributors illuminate the relationships between justice and health inequalities to complicate and enrich debates often dominated by simplistic narratives. Understanding Health Inequalities and Justice: New Conversations Across the Disciplines grounds key conceptual discussions in timely case studies and policy analyses that explore three overarching questions: (1) how do scholars approach relations between health inequalities and ideals of justice; (2) when do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice; and (3) how can diverse scholarly approaches contribute to better health policy. From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume combines the skills and sensibilities of diverse scholars to promote a richer understanding of health and justice and the successful paths to their realization.

Evaluation of the Socialist Health Policy in Greece

1988 ◽  
Vol 18 (4) ◽  
pp. 543-561 ◽  
Author(s):  
George Tsalikis
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health System ◽  
Social Services ◽  
National Health System ◽  
Military Rule ◽  
Production And Consumption ◽  
Socialist Movement ◽  
Traditional Patterns ◽  
The Right

Following seven years of military rule and seven years of “democratic restoration” under the Right, Greece is now sailing under the flag of the Panhellenic Socialist Movement (PASOK). The Movement was inspired by the ideals of participatory democracy and socialization of the economy and of social services. A central part of socialist planning brought about the National Health System Act (1983) and related legislation intended to universalize health care, remove disparities, and restrict the private sector. It is argued here that the implementation of PASOK's statutory reforms in this field, as in others, will be subject to its ability to transform traditional patterns of production and consumption. As is now increasingly understood, it is hard to plan for socialism on the basis of wants provisions and patterns of consumption established under capitalism.

scholarly journals The RIPPLES of Meaningful Involvement: A Framework for Meaningfully Involving Indigenous Peoples in Health Policy Decision-Making

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Alycia J. Fridkin ◽  
Annette J. Browne ◽  
Madeleine Kétéskwēw Dion Stout
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Policy Decision ◽  
Power Dynamics ◽  
Policy System ◽  
Meaningful Involvement ◽  
Health Policy Decision ◽  
Policy Decision Making

Indigenous Peoples experience the greatest health inequities in Canada and other colonized countries, yet are routinely excluded from health-related policy decisions. Those advocating for Indigenous health equity are often left wrestling with the question: What constitutes, and what can foster, meaningful involvement of Indigenous Peoples in the contemporary health policy climate? Twenty (n = 20) in-depth, open-ended interviews with Indigenous and non-Indigenous leaders in health and health policy were conducted with a view to understanding what constitutes meaningful involvement of Indigenous Peoples in health policy decision-making. The analysis suggests meaningful involvement requires attuning to underlying power dynamics inherent in policy making and taking action to decolonize and transform the policy system itself. Based on these findings, the authors offer a framework for meaningful involvement.

scholarly journals Barriers to Including Indigenous Content in Canadian Health Professions Curricula

2021 ◽  
Vol 44 (3) ◽  
pp. 648-675
Author(s):  
Nicole Doria ◽  
Maya Biderman ◽  
Jad Sinno ◽  
Jordan Boudreau ◽  
Michael P. Mackley ◽  
...  
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Health Professions ◽  
Faculty Training ◽  
Structured Interviews ◽  
Increased Risk ◽  
Canadian Health ◽  
Competing Priorities ◽  
Negative Health Outcomes

Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provide equitable health care for Indigenous peoples. Keywords: Indigenous health, health professions, curricula, faculty perspectives, barriers, Canada

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