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Public Health Panorama, Primary Health Care: Time to Accelerate (No 4, 2018)
The themed issue on primary health care of the Public Health Panorama is out. It sets out to capture the progress made in advancing primary health care principles in practice in the various models of family medicine, general practice, ambulatory and first contact care across the Region. It focuses on tackling the main areas that appear to have set back the implementation of the Declaration of Alma-Ata, as recognized by the first meeting of the Region’s Primary Health Care Advisory Group members in 2017.
This themed issue aims to give voice to the patients, health practitioners and managers at work in health facilities and their communities as well as local, regional and national health authorities and civil society working to transform services based on a primary health care approach. Articles address the following themes:
Public Health Panorama is the journal of the WHO Regional Office for Europe. It provides a platform to scientists and public health practitioners for the publication of lessons learned from the field, as well as original research work, to facilitate the use of evidence and good practice for public health action.
Download the Public Health Panorama, Primary Health Care: Time to Accelerate (No 4, 2018)
People live longer and recover quicker when they live in societies where health and social sectors work in alignment. Countries learned from each other at the latest intercountry meeting on long-term care in Almaty.
From 11 to 13 December 2018 experts, government officials and representatives of professional associations representing over 35 countries united in Almaty for a workshop on integrated delivery of health and social services for older people: Leapfrogging the integration of long-term care for older people in the WHO European Region: getting it right, fast.
The aim of the meeting was to review trends in long-term care reforms in Europe and to discuss the preliminary results of the assessment of integrated delivery of health and social sectors for long-term care systems. Policy innovations and best practices from the Member States were presented at the workshop.
The context in Europe
The average age in the European Region is the highest in the world and the proportion of people aged 65 and older is expected to double between 2010 and 2050. Health indicators for older adults varies within Europe. WHO supports people at all ages by promoting good health, strengthening health systems and social sector to address vulnerability and risks of the old age. Support to active and healthy life in later age can be provided by a group of professionals from both health and social sectors. Expanding coverage applies to all people over their life course, including services that are of quality, from promotion of healthy life styles to rehabilitation and palliation, and ensuring no one becomes poor because of money spent to health services or long-term care.
This principle lies in the foundation of the most health policies and, in reality, countries have done a lot of work to achieve these goals. However, there remain gaps in evidence – only 41% of European countries collect data on healthy ageing. This is crucial to apply evidence-based policies.
The workshop tackled the number of ageing concerns and trends that are shared by many countries, to name a few:
The need for integrated health care and social care
Countries showed and discussed how clinical accomplishments add no value if not sustained by social care. What older people really need is not a bio-medical approach to solve their often chronic conditions rather living actively and contributing productively to the community. The social sector has a key role in supporting to maximize and optimize a new approach to health ageing.
Isabel Yordi Aguirre, Programme Manager on Gender and Human Rights at WHO Regional Office for Europe, highlighted that “we must challenge the inequality between women and men in care work. Unpaid care keeps women out of the labour market and reinforces poverty in older age. At service level, long-term care providers are predominantly women, a profession of low prestige and salary. Unpaid and informal care work is mainly performed by women and reinforces gender stereotypes that have negative direct and indirect health effect.”
Borja Arrue Astrain from the think tank – AGE Platform Europe presented the human rights approach to long-term care, giving the older man perspective: “I am afraid my daughters will decide suddenly to send me to a residential care home without talking about it to me beforehand. I like living alone and I would prefer to stay at home if possible.” Elder abuse is experienced by 3% of older people, 25% of those with high care needs. Expert calls for rights-based care and support adding that “ageism” was the most frequently mentioned type of discrimination in Europe according to Eurobarometer survey in 2015.
Giovanni Lamura, National Institute of Health and Science on Ageing, Centre for Socio-Economic, Research and Ageing shared the results of his research on the informal care and migrant workforce “migration cannot be considered the main tool to tackle labour force shortages, as it might jeopardize development in source countries or lead to migrants’ exploitation. We need a balance between integration policies in recipient countries and development programmes in source countries. It is urgent to adopt a coherent, coordinated and integrated approach to recognize and mainstream the role of informal care across all policies, especially those in the LTC sector.”
Thiyagarajan A Jotheeswaran from the Ageing and life course programme at the WHO headquarters shared: “There are many ways for stronger investment in frailty prevention – a better integration of care and specific care pathways including for people with dementia, access to assistive devices, age-friendly, supportive cities and communities, health promotion and disease prevention: physical activity, nutrition, vaccination…”
The workshop provided a shortcut, leapfrog opportunity, for many countries that are planning reforms on long-term care delivery systems.
The workshop was organised jointly by WHO European Centre for Primary Health Care, Health Services Delivery Programme of the Division of Health Systems and Public Health, the Healthy Ageing, Disability and Long-term Care Programme of the Division of Noncommunicable Diseases and Promoting Health through the Life-course and the Gender and Human Rights Programme of the Division of Policies for Health and Wellbeing.
The WHO European Centre for Primary Health Care welcomes a workshop on long-term care: Leapfrogging the integration of long-term care for older people in the WHO European Region: getting it right, fast.
By integrating health and social services in the community, long-term care can help older people continue to be able to do the things they value for as long as possible. A workshop on the future of long-term care opens today in Almaty. From 11–13 December experts and policy makers will discuss best practices and learn about 35+ country policy innovations in integrated long-term care across the European Region.
WHO European Healthy Cities Network Almaty Summit of Mayors took place on 23 – 24 October 2018 and welcomed over 250 participants from all regions of the world. After a comprehensive consultation process leading up to the event, the Almaty Acclamation of Mayors: Cities at the Frontline of Health and Well-Being for All was adopted and was a key achievement of the Summit. The Almaty Acclamation of Mayors reaffirms the commitment of the WHO European Healthy Cities Network to the definition of health in the WHO Constitution and the values and principles of a primary health care approach as enshrined in the Declaration of Alma-Ata (1978). It recognizes that cities, urban places, and local governments have an essential role in achieving health and well-being for all through universal health coverage. The final text of the Almaty Acclamation of Mayors is available online in English, French, German and Russian languages.
The Summit was an important event to discuss opportunities and roles for healthy cities to support universal health coverage and the primary health care approach. The Summit was also a pre-conference event to the Global Conference on Primary Health Care, which took place in Astana, Kazakhstan on 25-26 October 2018 and a key event of the WHO European Healthy Cities Network who this year is celebrating 30 years of its movement.
The Almaty Acclamation of Mayors was presented at the Global Conference on Primary Health Care during the closing plenary by Ms Charlotte Marchandise, Deputy Mayor for Health, Rennes, France and member of the WHO European Healthy Cities Network Political Vision Group.