A comparison of social prescribing approaches across twelve high-income countries.

BACKGROUND: Social prescribing connects patients with community resources to improve their health and well-being. It is gaining momentum globally due to its potential for addressing non-medical causes of illness while building on existing resources and enhancing overall health at a relatively low cost. The COVID-19 pandemic further underscored the need for policy interventions to address health-related social issues such as loneliness and isolation. AIM: This paper presents evidence of the conceptualisation and implementation of social prescribing schemes in twelve countries: Australia, Austria, Canada, England, Finland, Germany, Portugal, the Slovak Republic, Slovenia, the Netherlands, the United States and Wales. METHODS: Twelve countries were identified through the Health Systems and Policy Monitor (HSPM) network and the EuroHealthNet Partnership. Information was collected through a twelve open-ended question survey based on a conceptual model inspired by the WHO's Health System Framework. RESULTS: We found that social prescribing can take different forms, and the scale of implementation also varies significantly. Robust evidence on impact is scarce and highly context-specific, with some indications of cost-effectiveness and positive impact on well-being. CONCLUSIONS: This paper provides insights into social prescribing in various contexts and may guide countries interested in holistically tackling health-related social factors and strengthening community-based care. Policies can support a more seamless integration of social prescribing into existing care, improve collaboration among sectors and training programs for health and social care professionals.

Regulation of non-conventional therapies in Portugal: lessons learnt for strengthening human resources in health.

BACKGROUND: The integration of non-conventional therapies (NCT) into health policies and health services delivery is a worldwide trend and might have a role in achieving Universal Health Coverage. WHO has encouraged countries to integrate NCT into health service delivery and to increase the interest and utilization by consumers. Following two resolutions by the European Parliament and by the Council of Europe, in the late 1990s, recommending the recognition of NCT and calling for EU legislation on non-conventional forms of medicine, Portugal initiated, in 2003, its path towards regulation of NCT. We analyze this process and discuss its implications and impacts in terms of health policies, health services delivery and overall health workforce. CASE PRESENTATION: The need to regulate NCT in Portugal stemmed from a growing demand for NCT (and acceptability) among lay citizens and a positive attitude among conventional health professionals which also advocated for a regulatory framework. Political efforts undertaken since 2003 allowed for important advances in the regulation of NCT, beneficiating safe professional practices, and ensuring future academic training at the highest standards, with the defining moment of the social and legal model transition occurring in 2013, when acupuncture, chiropractic, homeopathy, naturopathy, osteopathy, phytotherapy and traditional Chinese Medicine were recognized and regulated. Nevertheless, and because the process knew important time gaps, significant deficiencies arose, mainly between regulation of the training and of the professional activities and the capacity to ensure the continuous production of NCT professionals at an acceptable rate and with minimum quality standards guaranteed. CONCLUSIONS: The regulation of NCT in Portugal was lengthy but steady and was able to bring consumers a safer practice environment and NCT professionals a legal and deontological umbrella for their training, practice, and professional development. Nevertheless, and despite the growing acceptability and normative quality assurance of NCT and its workforce, the regulation process has highlighted some fragilities in terms of accessibility and availability that need attention and urgent action to achieve universal coverage.

Ten years since the 2008 introduction of dental vouchers in the Portuguese NHS.

Since the creation of the National Health Service (NHS) in Portugal, in 1979, dental care is neither provided nor funded by the NHS. Thus, most dental care is paid through out-of-pocket payments, either by patients themselves or through voluntary health insurance or health subsystems. In 2008 the government created the dental voucher targeting children, pregnant women, elderly who receive social benefits, and certain patient groups (HIV/AIDS patients and those who need early intervention due to oral cancer), to be used in private dentists who contracted with the programme. The reform was well received by the different stakeholders, especially dentists and beneficiaries, and the impact of the dental voucher in access and coverage of dental care in Portugal is positive: from May 2008 until December 2017, dental voucher reached 3.3 million NHS users in Portugal and dental care indicators have dramatically improved over the last ten years. Aiming to implement dental care provision within the NHS, the Ministry of Health has announced the foreseen integration of dentists in primary healthcare units, although the current budget constraints might hamper this possibility.

Integrated health service delivery networks and tuberculosis avoidable hospitalizations: is there a relation between them in Brazil?

BACKGROUND: The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is also one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. The purpose of this study is to consider which attributes and which territories have shown the most significant progress in Primary Health Care, in terms of coordination of Health Care Networks, and also check if those areas of Primary Health Care that are most critical regarding coordination, there were more or less cases of avoidable hospitalizations for tuberculosis. METHODS: This is an ecological study that uses primary and secondary data. For analysis, coropletic maps were developed through the ArcGIS software, version 10.2. There was also the calculation of gross annual and Bayesian rates for hospitalizations for tuberculosis, for each Primary Health Care territory. RESULTS: There were satisfactory results for attributes such as Population (n = 37; 80.4 %), Primary Health Care (n = 43; 93.5 %), Support System (n = 45; 97.8 %); the exceptions were Logistics System (n = 32; 76.0 %) and Governance System, with fewer units in good condition (n = 31; 67.3 %). There is no evidence of any connection between networks' coordination by Primary Health Care and tuberculosis avoidable admissions. CONCLUSION: The results show that progress has been made regarding the coordination of the Health Care Networks, and a positive trend has been shown, even though the levels are not excellent. It was found no relationship between the critical areas of Primary Health Care and tuberculosis avoidable hospitalizations, possibly because other variables necessary to comprehend the phenomena.