The National Policy for Older People’s Health (Brazilian Ministry of Health, 2006b) recognises the need for a high quality workforce with sufficient knowledge to take care of older people. The government, through its Federal, State, and Municipal levels provide training to professionals working at primary care level so that they can recognise people with cognitive impairment and refer them to adequate, more specialised, and integrated care units (Informal Source, 2019). Indicators of quality assurance include e.g., how many older adults have had a routine geriatric assessment completed and how many people living with dementia have been diagnosed, etc. However, this information is not available, or is not open for consultation.

References:

Brazilian Ministry of Health. (2006b). Política Nacional de Saúde da Pessoa Idosa. Brazilian Ministry of Health. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt2528_19_10_2006.html

As mentioned in the Mental Health Review Report (MHRR), an effective medical-social collaboration is essential to achieve a person-centred and holistic care model to ensure the quality of nursing and personal care in health and social care services (Food and Health Bureau, 2017a, p. 171).

The Elderly Services Programme Plan (ESPP) recommends the development of a comprehensive quality assurance system to monitor the quality and make continuous improvement for elderly services (Working Group on Elderly Services Programme Plan, 2017, p. 25). This plan also suggests measures to strengthen the quality of community and residential care services, reviews Residential Care Homes (Elderly Persons) Ordinance (Cap 459), and encourges public-private partnership in service provision (Working Group on Elderly Services Programme Plan, 2017, pp. 28-29).

References:

Food and Health Bureau. (2017a). Mental Health Review Report.  Retrieved from https://www.fhb.gov.hk/download/press_and_publications/otherinfo/180500_mhr/e_mhr_full_report.pdf.

Working Group on Elderly Services Programme Plan, Elderly Commission of Government of Hong Kong SAR,. (2017). Elderly Services Programme Plan. Hong Kong: Elderly Commission of Government HKSAR Retrieved from https://www.elderlycommission.gov.hk/en/download/library/ESPP_Final_Report_Eng.pdf.

Not applicable.

The policy document sets national targets as indicators of standardised, good quality of care. Examples of such targets are the initiation of a national training centre in cognitive health and dementia treatment, the development of standard operational procedure of older people’s care (to be implemented in all healthcare facilities), the implementation of an instrument for the screening of cognitive impairment and diagnosis of dementia among people at risk of developing it, the initiation of a referral system for people with dementia embedded in all primary healthcare facilities (alongside with screening, diagnosing and counselling), neurorestoration care in all referred healthcare facilities and ultimately supporting the development of long term care insurance (Ministry of Health Republic of Indonesia, 2015b).

References:

Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.

No data was sourced due to a lack of dementia policy in Jamaica.

There is a specific strategy focusing on ensuring access to quality services, and it is centred on the following lines of action:

1. The availability of human, material, and financial resources in accordance with the number of dementia patients at the three levels of health care.
2. To improve the quality of geriatric, neurological and psychiatric care to achieve comprehensive medical management in advanced stages of the disease.
3. To strengthen care at the community and family level with a comprehensive ambulatory, non-hospital vision for long-term care of dementia patients through specific rehabilitation programs.
4. To establish, grow, maintain, and regulate day centres as an alternative for the comprehensive management of patients with dementia in the early stages of the disease.
5. To destine the third level of attention to the study and management of difficult cases for an adequate differential and final diagnosis.

NZ Dementia Framework:

One of the overarching factors identified by the dementia framework is the need for regional and local governance groups that:

• help to implement their dementia care pathways in line with the framework,
• ensure that a wide range of expertise (e.g., secondary care, primary health care, allied health, community services, volunteer services, family and whānau) is involved in developing dementia care pathways and services at the local and regional level,
• ensure that new models of care, good practice examples and research are shared locally, regionally, and nationally,
• develop measureable outcomes of the pathways’ effectiveness,
• identify and facilitate national and regional collaboration opportunities,
• develop regional approaches for complex cases (e.g., alcohol or drug addiction related dementia, people with Down syndrome, young onset dementia and tertiary services).

Another overarching factor is the need for monitoring and evaluation which should

• include measureable outcomes,
• identify gaps and ensure improvements in dementia care and support,
• include national and international benchmarking,
• evaluate outcomes from the perspective of people with dementia and their families and whānau.

Dementia Action Plan: 

The dementia plan identifies four priority action areas to focus on over the next three years:

• Dementia incidence reduction,
• Supporting people living with dementia and their family/whānau care partners to live well,
• Build accepting and understanding communities,
• Strengthen capability across the sector.

Each of these objectives have actions associated with them and suggest the organisations best placed to lead. The action area of strengthening capabilities includes the recommendations for quality assurance and governance including the establishment of a national cross-sector leadership group with clear lines of accountability at DHB, regional, and national levels and the development of national indicators, measures, and standards in the dementia sector.

Not applicable as there is no dementia-specific policy or plan for South Africa.