Class 6 Ethics And Community Health Nursing

Question 1

What are the differences of downstream, midtream, and upstream approaches to advocacy

Question 2

It is a critical population health strategy that emphasizes collective action to effect systemic change.

Answer 2

Advocaty

Question 3

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.

Answer 3

Advocacy

Question 4

Examples of public health as ROI

Answer 4

1. Vaccination
2. Road and vehicle safety - booster seats
3. Safe, healthy workplace - injuries, illness
4. Healthy environemnt - clean water, air pollution
5. Chronic disease prevention - tobacco
6. Mental health and illness prevention - addictions
7. Social and econimic conditions - education, social and juctive services

Question 5

WHO has identified three strategic areas of work to strengthen PHC worldwide:

Answer 5

1. Providing a ‘one-stop’ mechanism for PHC implementation support, tailored to country context and priorities
2. Producing PHC-oriented evidence and innovation, with a sharper focus on people left behind.
3. 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.

Question 6

Principles of Primary Health Care (PHC)

Answer 6

1. Accessibility
2. Public participation
3. Health promotion
4. Appropriate technology
5. Intersectoral collab

Question 7

Process in which parties with a stake in the issue actively seek a mutually determined solution or plan

Answer 7

Collaboration

Question 8

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

Answer 8

Partnership

Question 9

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)

Answer 9

Partnership

Question 10

require building trusting relationship; constant evaluation; ability to respond/adapt to change; re-negotiate purpose and revise action plan, if necessary

Answer 10

Partnerships

Question 11

Guiding principles of partnerships

Answer 11

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

Question 12

a collaborative continuum to help us understand various ways of working together between organizations

Answer 12

Himmelman’s Collaborative Continuum

Question 13

The continuum includes

Answer 13

networking (information exchange)
coordination (altering activities)
cooperation (sharing resources)
and collaboration (mutual benefit)

Question 14

It is an approach where:
Community is involved in planning, problem solving
Members have ownership of initiative
Commitment is to long-term change

Answer 14

Participatory approach

Question 15

It is an approach where:
Change process imposed by outside force (e.g., health professional)

Answer 15

Directive/prescriptive approach

Question 16

WHAT IS THE PURPOSE OF: Ottawa Charter strategy

Answer 16

Building healthy public policy

Question 17

What is the strategy that does coalition advocacy and political action?

Answer 17

EMPOWERMENT STRATEGY

Question 18

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

Answer 18

Non-linear approach:(Policy Cycle, Howlett, 2009)

Question 19

“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

Answer 19

Medium profile

Question 20

Ad campaigns, media interviews (especially radio/TV), demonstrations and rallies

Answer 20

High profile

Question 21

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

Answer 21

Low profile

Question 22

Using Figure 1 in the NCCDH document, try to link advocacy actions at all four levels hat with the Ottawa Charter strategies.

Question 23

Identify advocacy actions at all four levels to address your health issue in your briefing note

Question 24

What are four levels hat with the Ottawa Charter strategies

Answer 24

1. Strengthening individuals
2. Strengthening communities
3. Promoting healthy macro-policies
4. Improving living and working conditions

Question 25

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]

Answer 25

Advocacy

Question 26

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

Answer 26

Public Health Advocacy

Question 27

What is the NON-LINEAR APPROACH for POLICY CHANGE

Question 28

Give an example of low, medium, high profile advocacy for policy change

Answer 28

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

Question 29

How to convine decision makers

Answer 29

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)

Question 30

ethical principles, foundations, and strategies to resolve ethical concerns in the community.

Question 31

links between public health ethics and social justice

Question 32

Levels of Collaboration/Partnership

Answer 32

1. Inform
2. Input
3. Engage
4. Collaborate
5. Empower

Question 33

Process in which parties with a stake in the issue actively seek a
mutually determined solution or plan

Often short term, less formal

Answer 33

Collaboration

Question 34

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

Answer 34

Partnership

Question 35

Himmelman’s Collaborative Continuum

Answer 35

1. Networking
2. Coordination
3. Cooperation
4. Collaboration

Question 36

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

Answer 36

DIRECTIVE/PRESCRIPTIVE APPROACH