DESK REVIEWS | 04.03.08. (Who) are the key actors described in the policy document? Are their roles defined?

DESK REVIEW | 04.03.08. (Who) are the key actors described in the policy document? Are their roles defined?

The documents do not specify key actors. Based on the policies outlined above, we assume that the Ministry of Health is a key actor.

The Mental Health Review Report (MHRR) proposes a seven-stages model for dementia service planning promulgated by the WHO and the Alzheimer’s Disease International. The service needs and major service providers (i.e., key actors) in each stage of dementia care (Food and Health Bureau, 2017a, p. 151):

  1. Pre-diagnosis
  • Service needs: public education & prevention
  • Major service providers: Department of Health (DH), Hospital Authority (HA), Social Welfare Department (SWD), NGOs, carers, private doctors
  1. Diagnosis
  • Service needs: primary & specialist care
  • Major service providers: HA, private doctors
  1. Post-diagnostic support
  • Service needs: primary & specialist care; community & information support
  • Major service providers: HA, SWD, NGOs, carers, private doctors
  1. Coordination & care management
  • Service needs: primary & specialist care; community support; needs assessment
  • Major service providers: HA, SWD, NGOs, carers, private doctors
  1. Community services
  • Service needs: specialist care; community support; outreach services; carer training
  • Major service providers: HA, SWD, NGOs, DH, carers
  1. Continuing care
  • Service needs: acute & sub-acute medical services; hospital care; community support
  • Major service providers: HA, SWD, NGOs, carers
  1. End-of-life palliative care
  • Service needs: acute & sub-acute medical services; continuing & palliative care
  • Major service providers: HA, SWD, NGOs, carers.
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.

The plan describes the main stakeholders/key actors as:

  • the National Commission on Older People,
  • the government (through the Coordinating Ministry for Human Development and Cultural Affairs),
  • community involvement (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 no description of key actors or the definition of their roles.

NZ Dementia framework:

When outlining the guiding principles of the framework and overarching factors, the framework talks in general terms about the roles/responsibilities of the MoH, DHBs, and then “health and social services” more generally. The document gets more specific when going into detail about each of the key elements of the framework, identifying specific agencies, and providing “good practice examples” of how some agencies/organisations have addressed some of the issues raised. For example, the key element of “early intervention and ongoing support” (p21) outlines issues to consider for the person with dementia, their family/whānau, and what specific services the health navigator can consider liaising with to successfully address the issues.

Dementia Action Plan:

The priority objectives outlined by the dementia plan also suggest who the lead organisations should be for the associated action areas. For example, the plan suggests health promotion agencies/sector NGO’s lead risk factor reduction drives, DHBs/primary care sectors lead the development of cognitive impairment pathways, or that the MoH leads the establishment of national cross sector leadership groups.

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