lecture 9: primary health care, health promotion, structural violence

Mostly Individual

At point of care- Interaction with the health care system

Informed by values of Primary Health Care

1. Accessibility

Public participation

Health promotion

Appropriate technology

Intersectoral collaboration

• Promotive• Preventive• Curative• Rehabilitative• Supportive/palliative

People are invited to participate in making decisions about the health needs of their own community. This requires to be flexible, responsive, and have a respect for diversity including alternative approaches to address those needs.

”Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.” (WHO, 2023)

a movement toward a "new public health"

1. Build healthy public policy

2. Create supportive environments for health

3. Strengthen Community Action

4. Develop personal skills

5. Reorient health services to prevention of disease and promote health

enable, mediate, advocate

Health prevention and promotion

Policy

Nurse Advocacy

Social Determinants of Health

Understand and address racism and oppression

income

upstream: advocate for living wage policies, wage capping

midstream: link clients with welfare, social assistance

downstream: ensure that chronic disease prevention programs are accessible

education

upstream: create opportunities for educators to reduce barriers to education for youth

midstream: support adult high school completion programs

downstream: expand mental health promotion + early intervention program

• Effective health care uses appropriate technology based on the needs of communities

Examples: telehealth, electronic charts

Health and well-being are linked to economic and social policies

Education, transportation, agriculture, finance, housing, policing

Providers from accross health sectors, local, national

Education on health problems and prevention

Promotion of food supply and nutrition

Adequate supply of safe water and basic sanitation

Maternal and child health care

Immunization against major infectious diseases

Prevention and control of locally endemic diseases

Appropriate treatment of common disease and injuries using the PHC principle of appropriate technology

provision of essential drugs

foundations: research, values experiences

determinants: income, education, gender, race, environments

action strategies: develop skills, create supportive environments, build public policy

levels of action: society, community, fam, individual

• « Social structure; econmic, political, legal, religious, cultural; that stop individuals, groups, and societies from reaching thier full potential »

• Education system, healthcare system

The active effort to eliminate all forms of racism including individual,

institutional, structural, and systemic racism.

Actions that challenge social, historical, and existing intersectional

inequities and injustices within systems and institutions that privilege groups to dominate over others.

Indigenous strengths, beauty, and resistance

Explain the implications of federal and provincial influences on Indigenous health and well being.

how Indigenous people view the world, all things connected

north, cedar, mental health, air

east, tobacco, spiritual health, fire

south, sweetgrass, emotional health, water

west, sage, physical health, earth

“The great aim of our legislation has been to do away with the tribal system and assimilate the Indian people in all respects with the other inhabitants of the Dominion as speedily as they are fit to change.”

We have sovereignty

We have rights to the land and air

We have spiritual beliefs, customs, and traditions

We have our own languages

We have our own justice systems

Self-determination

• Dominion Lands Act

• Attempt at assimilation and eradication

• Land or monetary certificates for Red River Métis

Define Cultural Humility and Cultural Safety.

Describe how to apply Cultural Humility and Cultural Safety in nursing practice.

Define distinction-based approaches of health and well- being.

Define the Indigenous Determinants of Health.

Reflect and acknowledge personal bias, power, and privilege.

• Verbal and Non-verbal

• Holisitc• Land based• Stars and Sky

• Dreams• Storytelling• Song + Dance

• Ceremony

“When nurses consider the historical and social contexts as well as structural and interpersonal power imbalances that shape health and health care services”

“Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity”

“Cultural humility is a stance of being open to the cultures of other individuals and communities"

used to examine our interpretations of events that happened, our role, and the role of others. This reflection process is a valuable tool to examine our nursing practice for strengths and areas of improvements

a reflective practice described as the ability to understand and question your own contexts, attitudes, values, beliefs, assumptions, and experiences of advantage and disadvantage that have shaped the way you understand the world and in relation to others

Reclaiming and define land, language, cultural traditions, laws, political and economic rights, ways of being/knowing, and healing practices

The United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) states that Indigenous peoples have the right to self-determination.

This guarantees the right to freely determine political condition and the right to freely pursue their form of economic, social, and cultural development

balance

life control

education

material resources

social resources

environmental and cultural connections