![Page 1: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/1.jpg)
Role of primary care Role of primary care and health and health
professionals in professionals in community community resilience resilience
Reflections from WHOReflections from WHO
Elke JakubowskiProgramme Manager, Public Health
WHO Regional Office for Europe
9 June 2015SUMMER SCHOOL SLOVENIA
![Page 2: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/2.jpg)
“The health of the unity is the health of the community.(…)Combination is the antidote, combined interests, recreation, combination to secure the best air, the best food and all that makes life useful, healthy and happy.(…)
May we hope that the day will come when every mother will become a health care nurse, when every poor sick person will have the opportunity of a share in a district sick nurse at home!(…)”
Florence’s wisdom on community health
![Page 3: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/3.jpg)
And a more recent personal experience related to resilience
![Page 4: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/4.jpg)
Presentation covering
• Challenges to community health • Case examples of strategies
• A 5 point change agenda towards community resilience
![Page 5: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/5.jpg)
By 2050 …
• Life expectancy is close to 90 years;
• One third of Europeans are over 65 years;
• 4 out of 5 people live in cities;
• Net migration differs dramatically between countries;
• Cardiovascular mortality continues to fall;
• Cancer incidence has increased by 30 per cent;
• Premature digestive and liver disease mortality remains high
• Global warming and extreme weather events increase further
![Page 6: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/6.jpg)
Harder times ahead for communities
• Rapidly ageing populations
• Migration favouring the cities
• De-population in rural communities
• Over-populations in metropolitan regions
• Decreasing number of jobs in local communities
• Decreasing qualified employees
• Diminishing capital
• Infrastructure deterioration in rural communities
• On-going health challenges (risk behaviour, climate change)
![Page 7: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/7.jpg)
“a slow-burning crisis is emerging”…
Julio Frenk Lincoln Chen
and 17 Commissioners Lancet 2010; 376: 1923-58
Health professionals in the 21st century
![Page 8: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/8.jpg)
• "the current medical training model, which annually consumes about 100 billion USD per year worldwide, no longer works".
• "fragmented, static and outdated"
• "under-financed institutions".
– The Lancet 376(9756): 1923-1958. 2010
The stake of professional education
![Page 9: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/9.jpg)
• Mismatch of competencies to needs
• Professional silos and weak teamwork
• Gender stratification
• Hospital dominance over primary care
• Primary care not well integrated with public health
• Labour market imbalances
• Weak leadership for population health and health system performance Abraham Flexner
Health professionals fit for purpose?
![Page 10: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/10.jpg)
Presentation covering
• Challenges to community health • Three case examples of strategies
• A 5 point change agenda towards community resilience
![Page 11: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/11.jpg)
Example 1: Teaming up for a good start in life
http://www.fruehehilfen.de/
![Page 12: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/12.jpg)
Example 2: PC networking to combat drought
www.health.vic.gov.au
![Page 13: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/13.jpg)
Example 3: A mega community in Auerberg
• Unification of 14 communes into one alliance community with 30,000 people
• Mayor: “Everybody can polish her church tower but has to widen the outlook beyond it”
• Development of a joint tourism concept
• Attracting new citizens through selling attractive and subsidised land for new homes to young families
• Establishment of three inter-generation houses operated through volunteers
![Page 14: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/14.jpg)
Presentation covering
• Challenges to community health • Three case examples of strategies
• An 5 point change agenda towards community resilience
![Page 15: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/15.jpg)
A 5 point agenda for change
1. Transforming professional education
2. Transforming training and practice
3. Transforming health services
4. Transforming funding
5. Strengthening community interventions
Knowing where to go, what to do
![Page 16: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/16.jpg)
Transforming health professional education
Instructional• Competency-driven• Local-Global• Inter + trans-professional• IT empowered• Educational resources• New professionalismInstitutional• Joint planning• Academic systems• Networking• Culture critical inquiry
EnablingActions
10 Reforms
• Align accreditation
• Strengthen global learning
• Enhance investments
• Mobilize leadershipGoal
Professional education for
equity in health
Goal
Professional education for
equity in health
Source: Education of Health Professionals for the 21st century: A Global Independent Commission, 2010
![Page 17: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/17.jpg)
Transforming training and practice
Working differently with different disciplines
At workplaces: everybody is important, rethink hierarchies
When facing shortages: Can we substitute? Use telemedicine solutions?
The importance of postgraduate inter-disciplinary education, training and practice
![Page 18: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/18.jpg)
Transforming practice
Understanding, engaging and empowering patients and people
► 11:11 www.youtube.com/watch?v=LnDWt10Maf812. Apr. 2011 - 11 Min. - Hochgeladen von TEDx TalksProfessor Bas Bloem ( @basbloem ) is a consultant neurologist at the Department of ...
From god to guide
![Page 19: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/19.jpg)
Source: Adapted from National Voices (2013); WHO (2015)
Malcolm
& Barbara
Live-in carers
Dementia specialist
Out-of-hours
doctor
Alzheimer’s social outreach worker
Social worker
Oxygen service
Wheelchair service
Physiotherapist
Equipment service
Occupational therapist
Community dentist
Dietician
Speech & language advisor
Continence adviser
GPDistrict nurse
Consultant
Transforming services: from provider driven …
![Page 20: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/20.jpg)
Source: Adapted from National Voices (2013); WHO (2015)
Malcolm
& Barbara Live-in carers
Dementia specialist
Out-of-hours
doctor
Alzheimer’s social outreach worker
Social worker
Oxygen service
Wheelchair service
Physiotherapist
Equipment service
Occupational therapist
Community dentist
Dietician
Consultant
Speech & language advisor
Continence adviser
GPDistrict nurse
People-centred health services
delivery
Coordinated
Continuous
Endowed with rights and
responsibilities
Led by whole systems thinking
Evidence-informed
Shared accountability
Empowering
Goal-oriented Holistic Ethical
Respectful
Collaborative
Co-produced
Comprehensive
Equitable
Sustainable
Preventive
… to people centred
![Page 21: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/21.jpg)
Transforming funding
![Page 22: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/22.jpg)
Strengthening community interventions
Intervention Focus
Quick Wins0-5 years
Longer Term Gains- Over five years
Resilience • Violence prevention
• Prevention of Post natal depression• • Family support projects
• Bullying prevention
• Mental health in the workplace
• Psychosocial groups for older people
• Parenting programmes
• Depression prevention
• Pre-school programmes
• Prevention of conduct disorder
• Multi-systemic therapy for juvenille offenders
• Detection and care for intimate partner violence
![Page 23: Role of primary care and health professionals in community resilience Reflections from WHO Elke Jakubowski Programme Manager, Public Health WHO Regional](https://reader036.vdocuments.site/reader036/viewer/2022062518/56649eda5503460f94be98a6/html5/thumbnails/23.jpg)
Your experience?