slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
The aim of Access Health is to provide primary health care that enhances the health and well being of : Marginalized/ st PowerPoint Presentation
Download Presentation
The aim of Access Health is to provide primary health care that enhances the health and well being of : Marginalized/ st

Loading in 2 Seconds...

play fullscreen
1 / 31

The aim of Access Health is to provide primary health care that enhances the health and well being of : Marginalized/ st - PowerPoint PPT Presentation


  • 428 Views
  • Uploaded on

The aim of Access Health is to provide primary health care that enhances the health and well being of : Marginalized/ street- based injecting drug users Street sex workers People experiencing homelessness Multiple sectors Funded from D&A Staffed from mainly multi-disciplinary health

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'The aim of Access Health is to provide primary health care that enhances the health and well being of : Marginalized/ st' - Leo


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide2
The aim of Access Health is to provide primary health care that enhances the health and well being of:
  • Marginalized/ street- based injecting drug users
  • Street sex workers
  • People experiencing homelessness
slide3
Multiple sectors
  • Funded from D&A
  • Staffed from mainly multi-disciplinary health
  • Auspiced/located in community/welfare service
slide4
Primary Health Care

an approach to care

and

a philosophy of care

slide5
As an approach to health care
  • first point of contact
  • close to where people congregate
  • first element of a continuum of health care
  • a balanced system of illness treatment, rehabilitation, disease prevention and health promotion
slide6
As a philosophy, PHC aims to:
  • improve health and reduce health inequalities
  • address the determinants of health

(social, political, environmental, economic)

slide7
Principles of PHC:
  • Equity
  • Participation
  • Responsiveness
  • Social acceptability
  • Local, sustainable responses
  • Affordability
  • Accessibility
slide8
Ottawa Charter for Health Promotion

“The process of enabling people to increase control over, and to improve, their health” (WHO 1986)

“Health promotion is a process it is not an outcome but a means to an end..” (Nutbeam 1998)

slide9
Ottawa Charter
  • Advocate for conditions favourable to health
  • Enable people to achieve their health potential by focusing on equity in health
  • Mediate between differing interests in society beyond the health sector
slide10
Ottawa Charter

Areas for action

  • Build healthy public policy
  • Reorientate health services
  • Create supportive environments
  • Develop personal skills
  • Strengthen community action
slide11
PHC & HP - global strategies for reducing health inequalities through equity of access to services, emphasis on prevention & action outside the health sector
  • In Western countries - have tended to become a more limited approach to responding to selected diseases eg. heart disease etc (Baum & Sanders, 1995)
slide12
“Many health promotion programs still have a strong focus on directly changing behaviour, despite the evidence that doing so meets with very limited success..”

(Baum & Simpson 2006)

This is especially relevant to disadvantaged and vulnerable groups.

slide13
Social determinants of health

“The social conditions in which people live powerfully influence their chances to be healthy. Indeed factors such as poverty, social exclusion and discrimination, poor housing, unhealthy early childhood conditions and low occupational status are important determinants of most diseases, deaths and health inequalities….”

(WHO 2004)

slide14
Levels of factors affecting health
  • Downstream (micro)- physiological/biological factors eg. intervention - pharmacotherapies
  • Midstream (intermediate) – health behaviours eg. intervention - harm reduction strategies
  • Upstream (macro) – policy, systems, government and organisations eg. intervention - reducing discrimination & stigma, poverty, improved access to health services, harm reduction policies
slide15
It is the upstream factors that are the fundamental causes of poor health & inequalities
  • Structurally determined v’s individually chosen lifestyles
  • Behaviour risk factors such as smoking and problematic drug and alcohol use are often portrayed as ‘freely chosen’

(WHO, 2004)

slide16
Health inequality and the example of smoking

(from Jarvis & Wardle 1999 in Marmot & Wilkinson)

  • Disadvantaged groups more likely to smoke & less likely to give up

Why? Possible reasons…

Higher rates of smoking initiation, less resources to tolerate withdrawal eg patches , more peer influence and smoking environments, higher levels of nicotine dependence, other life stressors/other priorities

= Social determinants – poverty, unemployment, education, unsuitable housing, stress

slide17
Health inequality and the example of smoking

(from Jarvis & Wardle 1999 in Marmot & Wilkinson)

  • There is no evidence to suggest that disadvantaged groups are less likely to want to give up
  • Public health strategies to increase cost of cigarettes can lead to:
    • switch to cheaper and higher nicotine brands (or locally ‘chop chop’).
    • Reducing spending in other areas eg food

= even greater increase in health inequalities

slide18
What are we doing at Access Health?
  • Developed a framework for health promotion- guided by PHC philosophy
  • Undertook health promotion needs assessment
slide19
What are we doing at Access Health?
  • Utilised the Ottawa charter action areas as a framework for a 2 year action plan
  • Developed an overarching priority of creating a supportive environment for health including reducing health inequalities
slide20
What are we doing at Access Health?
  • Developed priorities areas for health promotion action:
    • Food security and nutrition
    • Mental health and social inclusion
    • Blood borne viruses and sexually transmitted infections
    • Drug safety
slide21
What are we doing at Access Health?
  • Mediating and advocating for action outside the health sector – co-location within community and welfare sector
  • Increasing access to health care by utilising the principles of primary health care – equity, participation, responsiveness, social acceptability, affordability and accessibility
slide22
What are we doing at Access Health?
  • Reorientating health services to an accessible primary health environment eg specialist services such as psychiatry
  • Promoting social inclusion of marginalised groups
  • Advocating for system changes and policy development and access to mainstream
slide23
What are we doing at Access Health?
  • Developing specific programs and strategies for vulnerable groups eg indigenous access, street based injecting drug users, women
slide24
What strategies does the WHO suggest to reduce health inequalities?
  • Education – in the broad sense
  • Invest in the early years of life
  • Social & community inclusion
  • Reduce unemployment
  • Increase access to health services
  • Multi-sectoral collaboration
  • Create healthy work environments

(WHO, 2004)

slide25
Reducing health inequalities -

Integrate health equality objectives into existing programs including housing, education and health services

  • How does this policy or program affect the health of different social groups?
  • What can be done to optimise positive health impacts for vulnerable or disadvantaged groups?

(WHO, 2004 )

slide26
Disease specific strategies – tackling the determinates of a specific condition
  • Risks limiting to downstream factors but sometimes is useful to mobilise community action
  • Special attention is required to link strategies to programs/policy that focus on broader social and economic determinants of health

(WHO, 2004)

slide27
Settings approach – specific geographical area or place eg school
  • Risks relying on local community approaches when wider policy is needed.
  • Needs attention to vulnerable and marginalised groups who may not have a voice.

(WHO, 2004)

slide28
Group specific strategies eg people experiencing homelessness or elderly people
  • Specific strategies for vulnerable groups need to be used in combination with broad strategies for addressing determinants of health.

(WHO, 2004)

slide29
“Work to deal with problems of both legal & illicit drug use needs not only to support & treat people who have developed addictive patterns of use, but also to address the patterns of social deprivation in which the problems are rooted”.

(Marmot & Wilkinson, Social Determinants of Health: The Solid Facts, 2003 WHO)

slide30
Thank you and acknowledgement to

Sue White

Manager of Access Health

slide31
References:

Baum, F & Sanders, D ‘Can health promotion and primary health care achieve Health for All without a return to their more radical agenda?’ Health Promotion International, 1995, Vol.10, No.2

Baum, F & Simpson, S ‘Contact details for knowledge networks of the WHO commission on social determinants of health’, Health Promotion Journal of Australia, Dec. 2006, Vol 17, No.3

Dahlgren, G & Whitehead, Levelling up (part 2) A Discussion Paper on European Strategies for tackling social inequities, 2004, World Health Organisation,www.euro.who.int/document/e89384.pdf)

 Marmot, M & Wilkinson, R (ed) Social Determinants of Health, 1999, Oxford University Press

Nutbeam, D. ‘Evaluating health promotion – progress, problems and solutions”, Health Promotion International, 1998, Vol 13, No. 1