Decolonizing First Nations Health and Social Services Funding in Canada

Access to education and support for a learner is among the most important educational policy and management issues in the context of educational reform. In many European countries, both academics and practitioners are looking for optimal ways to ensure the child's well-being through the implementation of the principle of access to education, which, as it is known, contributes to reducing social exclusion and, at the same time, increasing academic success. One of the possible means to implement these goals is the idea of the all-day school. Several patterns of the implementation of this idea in Europe can be detected. However, there is often a lack of arguments about the meaningfulness and feasibility of creating such all-day school models. With a view to solving that problem from the perspective of stakeholders and applying a strategy of case study, a comprehensive analysis was carried out in order to find out the need for education, health, social and cultural services for children in Lithuania. In Lithuania, the length of the school year was extended from 2017–2018. It raised a number of issues related to the package of education and social services can be incarnated at school. The discussion about the need to extend working hours in school created preconditions for talking about the wider possibilities of providing additional education, health, social and cultural services at school. Thus, a representative parental survey was conducted to determine the need for additional education, health, social and cultural services at school and the need for all-day school in general. A sample of 1615 parents from all 10 Lithuanian counties was selected. The results of the research are valuable for the discussion of the researchers of educational sciences.

In 2020, an estimated 596 million people worldwide had distance vision impairment and a further 510 million had uncorrected near vision impairment.1 Most of these people live in low-income and middle-income countries (LMIC). Eye health is also affected by conditions that do not, at least initially, impair vision. Although these conditions are not currently included in global prevalence estimates, they contribute substantially to the unmet need for eye health services. Vision is important for many aspects of life, and vision impairment can profoundly affect individuals, families, and society. Eye health touches all lives, either directly or indirectly, through its impact on those close to us. The year 2020 marks the culmination of the global initiative to eliminate avoidable blindness, VISION 2020: The Right to Sight (appendix 1 p 7). This initiative provided the framework for national programmes to address eye health over the past 20 years. In 2019, WHO published the World report on vision,2 which was endorsed by the 73rd World Health Assembly in 2020. The report and resolution call for the advancing of eye health as an integral part of universal health coverage, by implementation of integrated people-centred eye care, following the approach outlined in a broader health services framework.3 The Lancet Global Health Commission on Global Eye Health contends that eye health should be part of the mainstream agenda to achieve universal health coverage and sustainable development. We define eye health as the state in which vision, ocular health, and functional ability are maximised, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Eye health can be considered both a process and an outcome. We define eye care services as those that contribute to any of vision, ocular health, or functional ability being maximised. This report broadly divides into two halves. First, we present evidence for the importance of eye health, supporting the case for urgent action. Second, looking beyond 2020, we examine approaches to enable delivery of eye health services within universal health coverage. In section 1 we summarise the visual system, vision impairment, and common conditions. In section 2, we synthesise several reviews done by the Commission on the relevance of eye health to the Sustainable Development Goals (SDGs), as well as its impact on quality of life, general health, and mortality. In section 3, we describe the magnitude and causes of vision impairment in 2020 and projected global and regional trends. We explore service needs of people with non-vision impairing eye conditions. We propose a more standardised approach to reporting population-based eye health surveys and examine the disability weights applied to vision impairment. In section 4, we summarise findings from a systematic review of eye health economics, identifying important areas for future work. We present a new estimate of global lost productivity associated with vision impairment for 2020, and an analysis of the cost-effectiveness ratios for cataract surgery and refractive error services. In section 5, we outline a bibliometric analysis of eye health research since 2000, and report a global Grand Challenges project, highlighting crucial issues for concerted research and action. Lastly, we address the question of how health systems can practically advance towards delivering high quality integrated people-centred eye care within universal health coverage.2 We argue that business as usual will be insufficient, as evidenced by new analysis of effective cataract surgical coverage data. We examine service delivery components: primary eye care and integration with general health services, workforce strengthening, financing, health information systems, indicators, advocacy, and approaches to increase quality and equity. The development of global eye health This Commission views global eye health through the global health framework articulated by Koplan and colleagues.4 Eye health started with an understanding of the anatomy, physiology, diseases of the eye, and the development of clinical ophthalmology, the medical and surgical discipline for diagnosis and treatment of eye diseases. From the mid-20th century onwards (figure 1), there have been major technological advances in microsurgical techniques for cataract and other conditions, and equipment for diagnosis and treatment of major non-communicable eye diseases, resulting in more effective interventions. There has been an enormous demographic transition, with ageing populations and epidemiological changes from infectious diseases and towards non-communicable diseases, requiring accessible and affordable eye services with long-term follow-up. The increase in demand, emphasis on better quality, and higher cost of more sophisticated diagnostic and treatment services is requiring an increase in resources, which presents enormous public health challenges. Open in a separate window Figure 1 The development of global eye health Blue circles indicate major global developments. Red circles indicate major treatments and programmatic developments. WHA=World Health Assembly. IAPB=International Agency for the Prevention of Blindness. RAAB=Rapid Assessment of Avoidable Blindness. RACSS=Rapid Assessment of Cataract Surgical Services.

This study sought to identify social service needs of HIV-infected persons at the time of release from prison/jail and to describe their case management experiences after release from prison/jail. Sixteen men and women who were infected with HIV, each with a history of incarceration, participated in one of three focus group sessions. Study participants consisted of 11 men and five women. The majority of the participants were African-American (81%), single (50%), and currently unemployed (69%). Qualitative analysis of the focus group transcripts revealed a total of 483 comments regarding a need for social or health services. These comments were further grouped into 13 categories of services or service-related issues that represented the range of the responses. Although participants described positive experiences with specific case managers, their overall evaluation of case management was negative. Identified social services needs and the descriptions of their experiences with case management provides insight as to how case management services can be improved for this population.

This article summarises recent work, commissioned by the Department of Health, which estimated the future need for health and social care services for adults with profound multiple learning disabilities (PMLD) in England. This estimation process involved four stages: identifying children with SEN associated with PMLD; adjusting for the effects of child mortality; estimating the number of adults with PMLD in England; and estimating net changes in the number of adults with PMLD in England. The overall findings suggest sustained and accelerating growth in the number of adults with PMLD in England over the time period 2009‐2026 and hence the need and demand for health and social care services for adults with PMLD.

SUMMARY Two Philadelphia-based HIV service organizations and a local university collaborated on a study of health and social service needs of transgender people. Transgender people were the primary resource for the development of the needs assessment survey. In this article, the survey development process, including two discussion groups and two focus groups, are described. Findings on barriers to care, violence, perception of public safety and comfort, suicide and health and social service needs are presented. Total sample size was 81, with 49 male-to-female and 32 female-to-male transgender individuals. Most (68%) were African American. About half of the respondents had thought about attempting suicide. High levels of violence were reported, especially among male-to-females. Health and social service needs included job training/work, dental care, health care, legal services, transportation, education and housing.

SUMMARY A needs assessment of transgender people was conducted in Chicago in 2001 to assess their HIV risks, health and social service needs, and barriers to care. One hundred and eleven transgender individuals, 78 male-to-females (MTFs) and 33 female-to-males (FTMs), participated in the study. Fourteen percent of respondents reported being HIV-positive; they were all male-to-female and the majority was of color. Risk factors for HIV included unprotected sex and willingness to have high-risk sex in the future. Respondents experienced high levels of violence. Two-thirds of respondents had thought of attempting suicide. Respondents reported a high need for health and social services, particularly MTFs and people of color.

The Health and Social Service Needs of Pregnant Women Who Consider but Do Not Have Abortions.

Unmet Mental Health and Social Service Needs of Formerly Incarcerated Women Living with HIV in the Deep South

Functioning and Health Service Use Among Elderly Nursing Home Residents With Alcohol Use Disorders: Findings From The National Nursing Home Survey

Functioning and Health Service Use Among Elderly Nursing Home Residents With Alcohol Use Disorders: Findings From The National Nursing Home Survey

The purpose of this study was to examine the need for health and social support services of the elderly who lived alone in a rural community in Korea. All 97 elderly who lived alone in 32 communities in H Eub(county), Kangwon Province participated in the study. Comprehensive assessment was conducted on their need for these services and on the status of their physical, functional, cognitive, emotional, nutritional, social, and environmental factors. Data were collected by eight public health nurses and were analyzed using descriptive statistics and stepwise multiple regression. Elderly subjects living alone had more than one disease, limited gait ability, limited functional capabilities as measured by the combination of activities of daily living and instrumental activities of daily living, and poor nutritional state. They had low level of cognitive ability, high level of depression, and high level of need for financial support. They engaged in no or little exercise. Service need for physical care was highest, and the factors contributing to the service need were gait ability, functional capabilities, nutrition state, and perceived health status. The results of this study indicate that their needs are multiple and complex. Well-coordinated health services that integrate social welfare services for elderly population who live alone are recommended.

Grants and Outcomes

SUMMARY Norway has been a leading nation when it comes to lesbian, gay, and bisexual (LGB) rights. With the majority of LGB people enjoying a high quality of life, Norway has turned its attention to a minority of the LGB population experiencing a clustering of chronic and other life cycle-related problems. A number of needs assessments have been initiated in order to determine how to meet these challenges. The needs assessments underscore the importance of social networks for health and well-being. An important action is, therefore, to provide arenas for network building. Partnerships between public, private, and voluntary sectors would facilitate these arenas. Existing health, social, and labor market public services need to be sensitized to LGB issues and particular challenges.

Background: The Ministere de la Sante et des Services Sociaux of Quebec (MSSS) pioneered an innovative patient pathway accreditation initiative with Accreditation Canada to advance integrated care by unifying standards across patient pathways, and organizational and professional boundaries to enable high-quality services that meet the needs of people and communities.Citizens, community and service organizations, and policy makers with an interest in evaluating its programs and services and promoting continuous improvement and the development of integrated, people-centred care. Approach: The Quebec MSSS is the government department responsible for overseeing public health and social services in the province of Quebec, Canada. The MSSS has a broad mandate, including the planning, coordination, funding, and evaluation of health and social services across the province.The MSSS serves 8.7 million, and growing, residents of Quebec and is structured to provide comprehensive, integrated, and high-quality services to all residents, ensuring that the system is responsive to the needs of the population. A province-wide patient pathway accreditation cycle was co-designed with Quebec MSSS and Accreditation Canada to meet its unique and integrated structure and to uphold quality and safety through assessment.Quebec's health and social services system is characterized by a high degree of integration on three levels. The The Ministere de la Sante et des Services Sociaux of Quebec (MSSS) is the government entity responsible for developing and implementing health and social services policies in the province. It establishes strategic orientations, policies and allocates resources. On the other hand, the new Sante et des Services Sociaux of Quebec agency was created to operationalize the orientations and policies of the MSSS, and to supervise health and social services establissements. The latter are organizations that provide direct health care and social services to users. Each establissement reports to Sante et des Services Sociaux of Quebec , and may include one or more hospitals, local community service centers, long-term care hospitals, rehabilitation services, mental health and addiction services, and others. Results: 30 public establishments took part in the first patient pathway accreditation cycle between 208 and 2023. The accreditation process engages with senior management, service providers, clinical teams, patients, and family caregivers in each public establishment. Over 00,000 stakeholders expressed their perceptions of quality and safety through 5 surveys in areas such as governance, staff mobilization, quality of life at work, patient safety culture and patient experience.The Quebec accreditation program is based on more than 50 co-designed quality standards from Accreditation Canada. The program covers a 0-year period organized in two five-year cycles (208-2023 and 2023-2027), including areas of focus such asleadership, governance, public health, infection prevention and control, medication management, telehealth and the evaluation of programs and services along a patient pathway, including at transitions of care and coordination of services. Qualitative and quantitative assessment methods are used to understand integrated, quality and safety practices aligned to national and international quality standards. ImplicationsThe patient pathway assessment aims to develop a culture of continuous improvement for the benefit of patients, family care givers, and communities. A co-designed accreditation program that meets specific structural and population needs enables a clear understanding of strengths and weaknesses along a patient pathway, the ability to unify practices and standards across professions and organizations. Learn how gaining a better understanding of patient pathways has helped to illustrate gaps in transitions of care, resulting in more informed decision-making at the organizational and ministry levels. Learn how to build patient safety and quality into an everyday practice by mapping your own jurisdiction patient pathway journey.The second phase of implementation occurs 2024-2027. Improvements will be applied to continue to co-design an assessment program that meets the needs of Quebec and of its residents.

Women who have experienced intimate partner violence (IPV) victimization are at risk for physical and mental health problems, as well as social and economic challenges. In this cross-sectional study, 173 adult, English-speaking women who had experienced police response to IPV completed a self-report questionnaire about their use of, interest in, and need for various social services and whether or not each type of service helped (or would help) them to feel safer. More than three quarters of the participants reported a current need for health and economic support services. There was less interest in traditional IPV resources: law enforcement and domestic violence counseling or shelter. Expanding services to meet survivors’ needs for health care and economic independence may facilitate long-term safety. Recommendations for further research in this area are provided.