2. to do what noBody eLse wiLL
do, in a way that noBody eLse
can, in spite of aLL we go
through; is to Be a nurse. --
rawsi wiLLiams
3. According to ICN, 2002
Patient And Health Systems Management, Education And
Research
4. According to Campbell et al
(2014)
“The resilience of a health system is its
capacity to respond, adapt, and
strengthen when exposed to a shock,
such as a disease outbreak, natural
disaster, or conflict.”
6. A Health System……..
• consists of all of the organizations,
institutions, resources and people whose
primary purpose is to improve health.
• The health system delivers preventive,
promotive, curative and rehabilitative
interventions
• A health system need staff, funds,
information, supplies, transport,
communications and overall guidance
and direction to function. WHO (2007)
7. Resilient Health Systems
• Governance
• Organization of care
• Human resources
• Health financing
• Health information systems
• Access to technology including medicines
Health Services Delivery
10. • The need for strong and
resilient health systems able to
respond effectively to
challenges is key to realising
the United Nations’
Sustainable Development
Goals (SDGs).
11.
12. According to WHO 2014
The Ebola virus disease outbreak in western Africa
clearly showed that without a health system capable
of responding rapidly and effectively, an epidemic
can spread rapidly across borders and cause
tremendous problems.
• When hit by the outbreak, the most affected
countries had a fragile health system with
insufficient numbers of health care workers.
• 815 health care workers who had been infected by
the Ebola virus since the onset of the epidemic,
more than 50% were nurses and nurse aides. Two
thirds of the health workers who were infected had
died.
13. This outbreak raised many
questions:
• How can you rapidly respond to a lack of
health care workers due to illness or even
death?
• How can you rapidly skill up a nurse
workforce to deliver care in very different
settings?
• How do you rapidly get access to the right
equipment?
• How do you communicate to the public in
an effective way?
14. Aging and sickerAging and sicker
populationpopulation
Aging and sickerAging and sicker
populationpopulation
High costsHigh costsHigh costsHigh costs
Primary care andPrimary care and
public healthpublic health
shortagesshortages
Primary care andPrimary care and
public healthpublic health
shortagesshortages
FragmentationFragmentationFragmentationFragmentation
Health careHealth care
disparitiesdisparities
Health careHealth care
disparitiesdisparities
Health Care System Challenges
15.
16. New Goals:
From MDGs to SDGs
There is now a global recognition that
whatever the nature of the challenges,
staying focused on:
• ensuring healthy lives and promoting well-
being for all at all ages is essential to
sustainable development.
• The need for strong and resilient health
systems, able to respond to rapid change,
is at the heart of the United Nations
Sustainable Development Goals (SDGs).
17.
18.
19.
20.
21.
22.
23. Sustainable Development Goal 3, Ensuring
healthy lives and promoting the well-being for
all, at all ages, is essential to the
achievement of the other SDGs
24. Universal Health Coverage
(UHC)
The goal of UHC is to ensure that all people
can use the promotive, preventive, curative,
rehabilitative and palliative health services
that are of sufficient quality, while at the
same time ensuring that the use of these
services does not cause financial hardship to
the consumers (WHO 2013).
One of the targets (3.8) is Universal Health Coverage
(UHC), which has received much attention as a key
enablerto sustainable development.
25. • UHC means not only reaching
everyone in need, but also
delivering quality health care
services that are people-centered.
• This requires a well-performing
health system with a sufficient
number of well-trained motivated
health workers.
27. WHY
NURSES ?• As a member of the single largest
group of health professionals, with a
presence in all settings, nurses can
make an enormous impact on the
resilience of health systems.
• Every decision that you make in your
practice can make a significant
difference in the efficiency and
effectiveness of the entire system.
29. Largest segment of health
care workforce
Need to enhance nurses’ skills and capabilities
Critical role in providing
patient care and care
coordination
Nurses and Health Care
30. New Expectations of
the Workforce
• UHC means not only reaching everyone
in need, but also delivering quality health
care services that are people-centered.
This requires a well-performing health
system with a sufficient number of well-
trained motivated health workers.
• It is projected that there will be a shortfall
of 10.1 million skilled health professionals
(nurses, midwives and physicians,) by
2030 (GHWA 2015).
39. Nurses at the core of
resilience
• Nurses make a significant contribution to
developing and maintaining resilience in
health systems.
• We contribute to service development;
supervise and develop other members of
the team;
• work with and advocate for patients, their
careers and communities; and
• collect data and inform the development
of evidence.
40. How Can Nurses’ Contribute
• Shamian et al. (2015) list nine areas
where nurses can make an essential
contribution to discussions on health
systems and health workforce
strengthening
41. 1. Collaboration
Nurses and nursing can lead and support
inter-professional education (IPE)
and
inter-professional collaborative practice
(IPCP).
42.
43.
44.
45.
46.
47.
48.
49.
50.
51. The importance of
nursing at all levels of
the health system,
including governmental
and policy levels, is
recognized in health
systems strengthening.
The importance of
nursing at all levels of
the health system,
including governmental
and policy levels, is
recognized in health
systems strengthening.
Leadership
52.
53. A way of working together…
What ground rules can
we agree on?
54. Positive
Relationships
& Bonding
Set Clear,
Consistent
Boundaries
Opportunities
For Meaningful
Participation
Teach
Life-Skills
Set and
Communicate
High
Expectations
Provide
Care
And
Support
Factors
that build
personal
resilience
for Nurses
Adopted from
Resiliency in
Schools Making it
happen for Students
and Educators,
Henderson and
Milstein 1996
55. The 7 C’S
Kenneth Ginsburg
• Competence
• Confidence
• Connection
• Character
• Contribution
• Coping
• Control
Universality and Equity in health constitute major challenges for our region, given the unmet needs of vulnerable and at-risk populations. Ex: women and children.
Right to Health: 34 states in the Region have committed themselves to ensuring the right to highest attainable standard in health through international human rights treaties; and 19 countries in the Region have provisions in their constitutions that guarantee access to health care for everyone in their jurisdictions.
UHC is built on the principle of solidarity, pooling and rational/efficient use of resources.
Title
Adapted from ‘Resiliency in schools: Making it Happen for Students and Educators’ by Nan Henderson and Mike Milstein (1996)
Henderson and Milstein have looked at developing resiliency in schools. We have spent time in schools looking at developing the School Ethos. This is a different lens to look at schools ethos. If you are going to help pupils develop resilience you need these six key building blocks:-
Providing care and support
Set and communicate High expectations
Opportunities for meaningful participation
Positive relationships and bonding
Set clear and consistent boundaries
Teach Life Skills
Exercise as Individuals
Give out Word handout on ‘How Resilient is your school?’
They can mark two numbers per area, one for the whole school and one for their classroom (suggest different coloured pens, or circle and square the issues).
Discussion in Pairs
Have a short discussion in pairs about your assessment.