Are we on the same page? Multiple stakeholders and service users priorities for dementia care and policy: A Delphi study.

BACKGROUND: It's crucial to develop a national policy for dementia due to the growing number of persons living with the condition and the attendant impact on individuals, families, and society at large. However, there has been limited exploration of the views on long-term goals for dementia of different stakeholders involved in different aspects of service use, planning or delivery. OBJECTIVE: This study aims to examine and compare the perceived priorities of service users (i.e., people living with dementia and their family caregivers) and other multiple stakeholders for dementia care and policy. DESIGN: Two independent Delphi studies were conducted in Hong Kong. SETTING(S) AND PARTICIPANTS: In Delphi study 1, 75 stakeholders were recruited from public and private nursing, medical and social care providers, philanthropic organizations, policy-makers and government sectors. In Delphi study 2, 45 people living with dementia and 55 family caregivers were recruited from community care settings. METHODS: The Delphi study 1 was conducted using online surveys, while the Delphi study 2 was conducted using phone interviews. Each Delphi study comprised a qualitative study for exploring the range of views of the two panels and a quantitative validation for generating consensus. We systematically compared the two panels' identified priorities in terms of contents and consensus levels. RESULTS: Multiple stakeholders identified 32 consensus-based statements and service users identified 25 statements, most of which achieved moderate to high level of consensus. Through content analysis, statements from the two panels were converged into six common themes: (1) early prevention, detection and referral systems for dementia, (2) care and intervention services, (3) health and social care workforce capacity building within and across service sectors, (4) supportive services for family caregivers, (5) development of longer-term dementia service planning and a policy framework, and (6) promotion of a dementia-friendly community. Despite the similarity of the themes expressed by the two panels, critical comparison of their priorities identified the dementia service and policy gaps in providing integrated and informed healthcare, a mechanism for sensitive care allocation, enabling seamless social inclusion, and proactive health orientation of dementia caregivers. CONCLUSIONS: Discrepancies between two panels reflect the distinctive value of service user engagement in the policy-making process. Our findings have implications for developing a multi-disciplinary integrated action plan for the local health response across the primary and secondary care settings to dementia and expanding the practice scope of person-centered dementia care in a collaborative way. TWEETABLE ABSTRACT: The voices of user, caregivers and service stakeholders excel the person-centered care and policy context for integrated dementia care.

Priorities and Instruments of Local Elderly Care Policies in China: Text Mining and Comparative Analysis.

Health care for the elderly is one of the key issues in the field of public health. In the context of global aging, the government's policy framework for elderly care affects the development of local elderly care. The priorities and instruments of the elderly care policy are important windows for understanding the local development planning system. This paper uses a quantitative text analysis method based on text mining to analyze 3,618 provincial policies in China. Considering the pilot demonstration projects for elderly care selected by the Chinese government in recent years, this paper finds that local elderly care policies have a three-phase evolution, and the priorities in each phase are solving the legacy of transition, expanding private sector participation, and realizing the well-being of the elderly. Moreover, mature regions use more environmental policy instruments, and the most effective are financial services, regulatory systems, and strategic guidance. For immature regions, it is necessary to use more core instruments on the premise of using basic instruments so that public policies can serve local development and realize the well-being of the elderly.

Evaluating the Representation and Responsiveness of the United Nations Commission on the Status of Women (CSW) to Diverse Women Populations Worldwide.

The United Nations Commission on the Status of Women (CSW) is "the principal global intergovernmental body exclusively dedicated to the promotion of gender equality and the empowerment of women." The continued success of the CSW's mission is critical. Under the guise of needing competent male leaders to protect them, women and girls in many countries nonetheless suffer dire consequences from international conflict and war. While females may send mostly male loved ones into armed conflict, women and girls themselves face economic sanctions, poverty, displacement, and heightened risk of sexual violence, in an environment that already fails to respect their equal human rights with men. It is no accident that in most countries, females are de facto excluded from positions of power where they could try to prevent such conflict (Enloe, 2014), and the CSW is actively working to overcome this reality. In this article, we use a mixed-method approach to evaluate the level of United Nations Commission on the Status of Women (CSW) representation and responsiveness to diverse women populations as reflected in (a) state delegations' participation in formal session, (b) NGO participation, and (c) NGO priorities. We find that the CSW displays a high level of representation and responsiveness to diverse state delegations across UN regions in terms of their speaking time in formal session. The CSW is at best moderately representative of women's NGOs through regional advance consultations, and the level of responsiveness to women's NGOs is low. This is due to: costly barriers to entry to gain ECOSOC status, large underrepresentation of some UN Regions, and the fact that during formal session, women's NGOs participate primarily at parallel off-site events. Although the CSW passed important resolutions, its representation and responsiveness to women's NGO priorities is lower than it should be. We base our evaluation by comparing our surveys of attending and non-attending women's NGOs that showed top priorities that the 2010 CSW did not discuss or pass resolutions on such as: land rights, sex trafficking, internet access for women, and the effects of climate change on women. We contend that during 1970-1994, when World Conferences on Women occurred, parallel transnational advance consultations among women's NGOs in tandem with CSW regional consultations created a broadening of the CSW's agenda. The CSW rationally anticipated different kinds of feminism beyond liberal feminism and a broader set of priority issues for diverse women populations. We therefore argue for a Fifth World Conference on Women to increase the representativeness and responsiveness of the CSW.

Ministry of Health Jamaica Annual Report 2011-2012

The document details the strategic objectives of the Ministry and includes financial statements, estimates of expenditure for the period under review. It features a special report on the National Health Information System.

Ministry of Health Jamaica Annual Report 2012/2013

The document details the strategic objectives of the Ministry and includes financial statements , estimates of expenditure for the period 2012 - 2013. It features a special report on the National HIV Programme (NHP) Integrated into National Family Planning Board (NFPB) - Sexual Reproductive Health Authority. It also includes achievements of selected programme areas of the Ministry for the period.

Ministry of Health Jamaica Annual Report 2013-2014

The document details the strategic objectives of the Ministry and includes financial statements , estimates of expenditure for the period 2013 - 2014. It features a special report on the Public Health (Tobacco Control) Regulations. It also includes achievements in various programme areas for the period.

Are there particular social determinants of health for the world's poorest countries?

BACKGROUND: The task of improving Social and Economic Determinants of Health (SEDH) imposes a significant challenge to health policy makers in both rich and poor countries. In recent years, while there has been increasing research interest and evidence on the workings of SEDHs, the vast majority of studies on this issue are from developed countries and emphasizes specific concerns of the developed nations of the world. Importantly, they may not fully explain the underlying causal factors and pathways of health inequality in the world's poorest countries. OBJECTIVE: To explore whether there are specific social determinants of health in the world's poorest countries, and if so, how they could be better identified and researched in Africa in order to promote and support the effort that is currently being made for realizing a better health for all. METHODS: Extensive literature review of existing papers on the social and economic determinants of health. CONCLUSION: Most of the existing studies on the social and economic determinants of health studies may not well provide adequate explanation on the historical and contemporary realties of SEDHs in the world's poorest countries. As these factors vary from one country to another, it becomes necessary to understand country-specific conditions and design appropriate policies that take due cognisance of these country-specific circumstances. Therefore, to support the global effort to close gaps in health disparities, further research is needed in the world's poorest countries, especially on African social determinants of health.