Partners in Practice establishing an

International Development Programme of theDanish College of General Practitioners

Partners in Practice

Torsdag d. 25. august 2005 kl. 14.00

Rigshospitalet, Auditorium 2

Opponenter:

Aase Bengaard Andersen

Birgitte Jyding Vennervald

Thor Theander

Vejledere:

Henrik Ullum,

Anthony Butterworth

Bente Klarlund Pedersen

A model for sustainable delivery of home based care incorporating anti-retroviral treatment to people living with HIV/AIDS – the HBC+.

A sustainable, cost-effective and poverty-oriented model that, despite the complexity of the operation, strive to maintain a focused, simplified approach

Ugeskr Læger 2005;8:862-5

Medicus 2004;5:19-23

Partners in Practice

The Primary Health care approach:a paradigmatic shift – a BIG idea

Medicine HealthCurative care Holistic careSpecialised hospital care for the few Local health care for manyBiological determinantsof disease Socio-economic explanations

Partners in Practice

Alma-Ata declarationPrimary Health Care as a strategy

The concept of PHC had strong sociopolitical implications. It explicitly outlined a strategy which would respond more equitably, appropiately and effectively to basic health care needs and ALSO adress the underlying social, economical and political causes (determinants) of poor health

Partners in Practice

”Health for All 2000” was never met; contrarily: health status is stagnant or declining and public health systems are weakened mainly due to:

• increasing poverty and failure to address health determinants resulting in poorer health status• declining per capita health spending reducing a) health personnel and morale, b) drugs availability, c) transport for outreach and supervision, d) donor funding have reinforced selective & vertical approaches, fragmenting health services• HIV/AIDS affecting and infecting health personnel

-> -> reversing previous gains in PHC implementation

Partners in Practice

WHO: World Health Report 2008Focus: Primary Health Care

Vertical -> Horizontal -> Diagonal

“Globalization is putting the social cohesion of many countries under stress, and health systems are clearly not performing as well as they could and should. People are increasingly impatient with the inability of health services to deliver. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world. PHC can do that.”

Partners in Practice

Partners in Practice

Partners in Practice

Partners in Practice

Scandinavian Primary Health Care:

• Free and accessible• Cost-effective and efficient• Comprehensive and sustained by a mutually supportive referral system to secondary care• ”Second to none” – (Propably the best in the world)

• Secretive about it !!

Partners in Practice

Allegations about the Scandinavian GP as a development worker:

• Implicit knowledge of the wonders of a well-functioning Primary Health Care system• Experienced community facilitator and collaborator• Ready and able for global responsibility• By doing so maintaining local integrity and enthusiasm

Partners in Practice

Partners in PracticeInternational Development Programme

• Foster development of PHC worldwide through established partnerships• Offer wide variety of consultancy, expertice and skills transfer services• Create, initiate, fund and facilitate PHC projects benefitting less priviliged• ”Engaging locally to provide globally”

Partners in Practice

Now, isn’t that a great idea?or

Naive, hypothetical mind games!

How to do?

Partners in Practice

Inspiration:

RCGP Int. Development Programme:• Undergraduate and postgraduate training and curriculum development• Courses and seminars for partners – Teaching the teachers• Accreditation and assessment programmes

Global Health Primary Care Initiative, BU:• Development and implementation of locally sustainable models of PC• Health management education programmes• International Faculty Development Programs

DANIDA – Health Sector Support Programmes

Partners in Practice

Partners in Practiceas an organisational structure

a framework for diverse activities

• A formal body for partnerships, project development and fund-raising purposes• Promoting and facilitating local initiatives• Providing professional and administrative assistance

Partners in Practice

Partners in Practicea founding workshop !

Group discussions:

Interest and capacity? RecruitmentIdentifying potential projects – how?How to move on? Structure and fundingFollow up – concrete steps

Partners in Practice

Partners in Practice