IPCHS. Integrated People-Centred Health Services

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Contents tagged: social determinants of health

Jan. 14, 2020 Africa Publication

Determinants of enrollment decision in the community-based health insurance, North West Ethiopia: a case-control study

Health security is increasingly being recognized as an integral part of poverty reduction effort. Many lower and middle-income countries (LMICs) have not been able to fulfill equitable healthcare needs of their citizens.
The aim of this study was to identify the determinants for enrollment decision in the community-based health insurance program among informal economic sector-engaged societies, North West Ethiopia.

May 16, 2018 Africa Publication

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review

Cash transfers (CTs) are now high on the agenda of most governments in low-and middle- income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health and health inequalities. A systematic review was conducted to synthesise the evidence on CTs´impacts on social determinants of health and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs.

Nov. 23, 2017 Americas Publication

Community Care for People with Complex Care Needs: Bridging the Gap between Health and Social Care

Introduction: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community.

Methods: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted. Patient vignettes illustrating significant health and social care needs were presented to participants. The vignettes prompted discussions on i) how best to meet complex care needs in the community and ii) the barriers to delivering care to this population.

Results: Categories to support care needs of complex patients and their families included i) relationships as the foundation for care, ii) desired processes and structures of care, and iii) barriers and workarounds for desired ...

Nov. 21, 2017 Europe Publication

Individual determinants of integrated care for indigent patients: an experimental study in Brussels: Pierre Smith

In metropolitan area, socially deprived patients with chronic disease undergo the fragmentation of health and social care services because of their complex needs. Integration of health and social care would benefit these patientes, however, it is not feasible or appropriate to integrate all the services for all vulnerable patients. This study aims at identifying the indicidual determinants of deprived patients´preferences in integration of health and social care. 

July 25, 2017 Americas Publication

Providing primary health care through integrated microfinance and health services in Latin America

The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs, so this study analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. 

Dec. 12, 2016 Americas Publication

Community health center provider ability to identify, treat and account for the social determinants of health: a card study

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20- million of America´s highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH.

The results suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations. 

Oct. 3, 2016 Global Publication

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012

The WHO Commission on the Social Determinants of Health set out an impressive collection of policy proposals on the social determinants of health. However, a serious weakness for securing implementation is the difficulty for policymakers in identifying priorities for action. The objective of this study is to determine a small set of the most influential determinants using existing data and an empirical approach.

There is no evidence that national income, public spending on healthcare and education, secondary schooling, terms of international trade, employment, debt service and relief, out-of-pocket expenditures, agricultural ex- or imports, lifestock production, foreign investment, urbanization or environmental degradation are robustly associated with population health. Results provide support for the relevance of some proposed policies. The findings can inform priorities for future research and policy action on the social determinants of health.

May 27, 2016 Americas Partner

St. Michael’s Hospital, Department of Family & Community Medicine-Family Health Team

The St. Michael’s Hospital Academic Family Health Team (SMHAFHT) is a large, primary care teaching clinic, affiliated with the University of Toronto, and nestled within the downtown core of Toronto. The Family Health Team provides services to the inner-city community of Toronto through 6 clinical sites located conveniently in these neighbourhoods. We serve the poorest communities in Toronto - people who are marginalized, underhoused and with significant health comorbidities who are significantly impacted by many social determinants of health that negatively affect the quality of one’s life, such as poverty, inadequate housing and inequitable access to health and social care services. 

In identifying the significant impact that social determinants of health have on our community, and in consideration of the research which supports the importance of interprofessional (IP) care and education, our department undertook a visioning and planning process to evolve and ‘re-purpose’ the way we deliver care, how ...

May 26, 2016 Americas Practice

Enhancing primary healthcare delivery in the inner-city community in Toronto, Canada

A very participatory evaluation process with broad involvement of all stakeholders, including patient and community members, led to consensus on priorities and gaps in services; prioritization of an innovative, patient-centred, model of health and social care led to development of an integrative Family Health team working from a social determinants of health lens; multiple partnerships support long-term sustainability and educational collaboration; supportive leadership and internal champions created momentum for change and mitigated internal and external barriers to change; active and ongoing engagement of patients, community and health team members in program design and implementation.

May 25, 2016 Americas Publication

Integrating health care and housing to promote healthy aging.

In recent decades, the influence between health status and social conditions has been broadly studied; one of the conditions that has been strongly linked to health status has been housing.

Population ageing and the increase of chronic conditions are two of the drivers that have made that housing conditions become an important factor influencing health.

Many different proposals have been made regarding home care, most of them trying to take hospital care to patient’s home; in this post, some different aspects are discussed, mainly related to what Medicare could do in order to improve housing conditions and its influence in patient’s health: (I) increasing the emphasis on vulnerable population covered by Medicare’s Publicly Assisted Housing Programme, (II) tackling elderly falls as a main health problem and striving to reach the Health People 2020 goal of a 10 percent reduction in the rate of emergency-department visits due to ...

April 20, 2016 Europe Publication

Inclusion Health: Education and Training for Health Professionals: END of STUDY REPORT

The concept of Inclusion Health is founded on the premise that not all UK citizens have access to the highest standards of healthcare. Meeting the health needs of a small group of socially excluded individuals and their communities remains a challenge. This population has poorer predicted health outcomes and a shorter life expectancy than the average population. The National Inclusion Health programme for England was launched in March 2010 as a cross-government programme led by the Department of Health. It provides a framework for driving improvements in health outcomes for socially excluded groups. The rationale for setting up this framework is to increase the understanding and visibility of the health needs and health outcomes of socially excluded groups. The framework will also ensure that the services which support this population continue to improve, including continuity of care and building capability and capacity. One key activity within the framework is to ...

Feb. 10, 2016 Africa Publication

Counting the cost of child mortality in the World Health Organization African region

Background: Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years of age". There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all ...

June 1, 2015 Publication

Policy relevant determinants of health: an international perspective

Background: International comparisons can provide clues to understanding some of the important policy-related determinants of health, including those related to the provision of health care services. An earlier study indicated that the strength of the primary care infrastructure of a health services system might be related to overall costs of health services. The purpose of the current research was to determine the robustness of the findings in the light of the passage of 5–10 years, the addition of two more countries, and the findings of other research on the possible importance of other determinants of country health levels. Methods: Thirteen industrialized countries, all with populations of at least 5 million, were characterized by the relative strength of their primary care infrastructure, the degree of national income inequality, and a major manifestation of a behavioral determinant of health that is amenable to policy intervention (smoking), using international data sets and ...