It attempts to recognise common barriers to access. The National Policy for Primary Care document recognises that in some geographical areas of Brazil services are difficult to access. Therefore, some healthcare teams provide care for people living in regions with difficult access to services, such as rural, riverside, and Amazon rainforest (Brazilian Ministry of Health, 2012). Despite its challenges, in theory, such teams should have access to transportation (by car or by boat) so that such communities could be visited by healthcare providers. Older people’s policies mention the integration and coordination with other areas (intersectoral approach) to overcome some of these challenges. As healthcare is a right of every person in Brazil, it is implied that the government must actively identify strategies to overcome eventual barriers of access.

References:

Brazilian Ministry of Health. (2012). Política Nacional de Atenção Básica. http://189.28.128.100/dab/docs/publicacoes/geral/pnab.pdf

The Mental Health Review Report (MHRR) recognises some potential barriers to access the existing dementia care services. First, the post-diagnostic medical and community support services for dementia need a long waiting time. Firstly, lack of coordination among service providers in delivering stepped-down care for persons with dementia, is a key issue. Secondly, the current assessment mechanism is not dementia-specific for determining suitable dementia-oriented care services. Lastly, the diagnosis and post-diagnostic secondary or tertiary medical support for younger onset of dementia is often delayed due to inadequate recognition of symptoms by clinicians (Food and Health Bureau, 2017a, p. 162). To overcome these barriers, the implementation of a refined intervention model is recommended to facilitate timely intervention for persons with dementia. Primary care setting can be used as a proper gate-keeping and dementia cases can be transferred to community setting for ongoing management. Enhancing capacity in secondary care, shorten the waiting times, and more effective use of specialist services would be helpful interventions (Food and Health Bureau, 2017a, p. 186).

The Elderly Services Programme Plan (ESPP) recommends the set-up of a real-time vacancy information system and district-based pre-registration system to reduce the barriers of service utilisation and facilitate timely access to service, especially for respite and emergency placement services (Working Group on Elderly Services Programme Plan, 2017, pp. 24-25). It also recommends the need to improve the current assessment mechanism for better service matching and develop a case management model for better coordination among different services (Working Group on Elderly Services Programme Plan, 2017, p. 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.

We could not identify any information on barriers to access and how these could be overcome.

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

No potential barriers to access are described.

NZ Dementia Framework:

The framework acknowledges potential barriers to access due to difficulties with language or communication, a lack of understanding of dementia, or other cultural reasons that delay or prevent access to, or uptake of, services. The principles of the framework note the need for age and culturally appropriate services, as well as an explicit identification of the need to reduce funding barriers to access as much as possible.

Dementia plan:

The dementia plan acknowledges that access to services is “inequitable across specific groups such as Māori, Pasifika, ethnic minorities particularly refugees, people living alone, and people living with young-onset dementia, deafness, intellectual disability, or neurological or psychiatric illness; and across urban-rural and District Health Board (DHB) boundaries” and that their needs must be recognised and responded to so that equitable access to appropriate services and care can be provided. The plan also highlights a priority research area of “culturally appropriate ways of describing and approaching dementia with NZ’s non-pakeha cultures”.

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