Class 6 Ethics And Community Health Nursing Flashcards
What are the differences of downstream, midtream, and upstream approaches to advocacy
It is a critical population health strategy that emphasizes collective action to effect systemic change.
Advocaty
It focuses on UPSTREAM FACTORS related to social determinants of health, and explicitly recognizes the importance of engaging in political processes to effect desired policy changes at organizational and system levels.
Advocacy
Examples of public health as ROI
- Vaccination
- Road and vehicle safety - booster seats
- Safe, healthy workplace - injuries, illness
- Healthy environemnt - clean water, air pollution
- Chronic disease prevention - tobacco
- Mental health and illness prevention - addictions
- Social and econimic conditions - education, social and juctive services
WHO has identified three strategic areas of work to strengthen PHC worldwide:
- Providing a ‘one-stop’ mechanism for PHC implementation support, tailored to country context and priorities
- Producing PHC-oriented evidence and innovation, with a sharper focus on people left behind.
- Promoting PHC renewal through policy leadership, advocacy and strategic partnershipswith governments, non-governmental organizations, civil society organizations, development partners, UN sister agencies, donors, and other stakeholders at global, regional and country levels.
Principles of Primary Health Care (PHC)
- Accessibility
- Public participation
- Health promotion
- Appropriate technology
- Intersectoral collab
Process in which parties with a stake in the issue actively seek a mutually determined solution or plan
Collaboration
A type of collaboration; occurs when purpose of collaboration is to advance a shared vision of a need, and the expected outcome is to develop and implement a joint agreement to address the problem and bring the vision to reality
Partnership
is characterized by:
Shared authority, responsibility, management
Shared liability, risk-taking, accountability, rewards
Detailed communication strategies
Joint investment of resources (time, work, funding, material, expertise, information)
Partnership
require building trusting relationship; constant evaluation; ability to respond/adapt to change; re-negotiate purpose and revise action plan, if necessary
Partnerships
Guiding principles of partnerships
Same mission, goals, objectives and guiding principles
Partners are recognized for their unique, essential contributions
All partners agree to share risks, responsibilities, rewards, and power
The partnership should enhance capacity of partners while achieving a common purpose
Flexible structure to accommodate changing needs
All communication and activities undertaken embody principles of social justice and equity
a collaborative continuum to help us understand various ways of working together between organizations
Himmelman’s Collaborative Continuum
The continuum includes
networking (information exchange)
coordination (altering activities)
cooperation (sharing resources)
and collaboration (mutual benefit)
It is an approach where:
Community is involved in planning, problem solving
Members have ownership of initiative
Commitment is to long-term change
Participatory approach
It is an approach where:
Change process imposed by outside force (e.g., health professional)
Directive/prescriptive approach
WHAT IS THE PURPOSE OF: Ottawa Charter strategy
Building healthy public policy
What is the strategy that does coalition advocacy and political action?
EMPOWERMENT STRATEGY
Select policy option/s, considering the direct and indirect costs and benefits, and moral and ethical arguments
Opens if the work of the problem and policy streams align
Non-linear approach:(Policy Cycle, Howlett, 2009)
“feed” the opposition, deputations at committee meetings with elected officials/decision-makers, alliances/partnerships with other groups, letters to elected officials/newspapers, use of social media/blogs
Medium profile
Ad campaigns, media interviews (especially radio/TV), demonstrations and rallies
High profile
meeting/speaking to/writing to decision-makers on behalf of a client, sharing information (eg. research findings), preparing non-public briefing note, publishing policy recommendations from research findings
Low profile
Using Figure 1 in the NCCDH document, try to link advocacy actions at all four levels hat with the Ottawa Charter strategies.
Identify advocacy actions at all four levels to address your health issue in your briefing note
What are four levels hat with the Ottawa Charter strategies
- Strengthening individuals
- Strengthening communities
- Promoting healthy macro-policies
- Improving living and working conditions
It refers to the act of supporting or recommending a cause or course of action , undertaken on behalf of persons or issues . It relates to the need to improve systems and societal structures to create greater equity and better health for all. Nurses endeavour, individually and collectively, to advocate for and work toward eliminating social inequities” [Canadian Nurses Association Code of Ethics for Registered Nurses , 2017, p.5]
Advocacy
is a critical population health strategy that
emphasizes collective action to effect systemic change. It focuses on
changing upstream factors related to the social determinants of
health, and explicitly recognizes the importance of engaging in
political processes to effect desired policy changes at organizational
and system levels” (NCCDH, 2015, p.3)
Examples
• Fluoride in water • Supervised consumption services for PWUD
Public Health Advocacy
What is the NON-LINEAR APPROACH for POLICY CHANGE
Give an example of low, medium, high profile advocacy for policy change
Low: punlic briefing note, publishing policy recommendations from research findings, meeting/speaking/writing to decision malers
Medium: “feed the opposition, deputations, alliances, letters to officials, newspapers,
Social media/blog
High: ad campaigns, media interviews, rallies, demonstrations
How to convine decision makers
Your solutions need to be clearly linked to a compelling problem
• Build as many plausible links as you can between the health issue and the
desired solution • Clearly explain the proposed solutions/policies • Build coalitions and stimulate debate in various venues • Identify the barriers to implementation you are likely to encounter • Look for signs that indicate a need for change (e.g., dissatisfaction with the
status quo)
ethical principles, foundations, and strategies to resolve ethical concerns in the community.
links between public health ethics and social justice
Levels of Collaboration/Partnership
- Inform
- Input
- Engage
- Collaborate
- Empower
Process in which parties with a stake in the issue actively seek a
mutually determined solution or plan
Often short term, less formal
Collaboration
A type of collaboration; occurs when purpose of collaboration is to
advance a shared vision of a need, and the expected outcome is to develop and implement a joint agreement to address the problem and bring the vision to reality
Usually longer term, more formal
Partnership
Himmelman’s Collaborative Continuum
- Networking
- Coordination
- Cooperation
- Collaboration
Change process imposed by outside problem solving force
Advantage: quicker partners = more richer/deeper
Disadvantage: may not be sustained, challenging if there’s no good level of trust
DIRECTIVE/PRESCRIPTIVE APPROACH
