DESK REVIEWS | 04.03.12. (How) does the policy incorporate equity? (e.g., in access to care (availability, provision, costs), workforce rights, carer rights & protection)

DESK REVIEW | 04.03.12. (How) does the policy incorporate equity? (e.g., in access to care (availability, provision, costs), workforce rights, carer rights & protection)

In Brazil, there is the Unified Health System (SUS), and the concept of equity is already incorporated in the government healthcare policies, being one of the three main principles of SUS. The National Healthcare Policy for Older People incorporates equity and universality in the sense that healthcare is offered to all persons aged 60 years and over regardless of whether they have dementia (Brazilian Ministry of Health, 2006b). However, although all people in Brazil are offered the same right of accessing care through the SUS (funded by public sector), people who are better off tend to use healthcare services provided by the private sector through out-of-pocket payments or healthcare insurances. So, there is a selection bias among people who use SUS. But even those using the public services, face different realities depending on where they live because the quality of and access to health services may vary according to neighbourhoods and cities. The SUS principles include universality and equity, but this is different in the different parts of the country.

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

Equity is incorporated in the policy by upholding the national law on health, which ensures that all people have equal access to healthcare, as the national dementia plan operates within the universal healthcare system. The strategic plan emphasises the availability of standardized care for all older people across healthcare facilities. This includes public access to screening, diagnosis, and treatment. In addition, rights of the workforce alongside with patients’ rights are mentioned (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.

Although it is not directly mentioned, the plan not only refers to equity through awareness raising, but it also aims to emphasise that dementia is a public health problem that can affect anyone, and that generates profound changes in the lives of those who live with it. This includes promoting the fight against discrimination, informing people about their rights and services available to them, should they become victims of abuse or discrimination, recognising the role of caregivers as partners, and incorporating civil organisations to broaden the dissemination.

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