There are no monitoring targets specified in the policy documents. In terms of monitoring, there are health and social indicators available in the Brazilian Information Systems that may be used to support the monitoring of policies (such as mortality rate, number of live births, number of hospitalizations, many data stratified by sex, age etc.). For instance, some academic publications make use of these indicators to show advances or setbacks in the healthcare system. Another example is an article that shows positive impact of the Family Health Strategy program on mortality from heart and cerebrovascular diseases (Rasella et al., 2014).

References:

Rasella, D., Harhay, M. O., Pamponet, M. L., Aquino, R., & Barreto, M. L. (2014). Impact of primary health care on mortality from heart and cerebrovascular diseases in Brazil: A nationwide analysis of longitudinal data. BMJ, 349. https://doi.org/10.1136/bmj.g4014

There is no clear monitoring mechanism for the targets or recommendations suggested in the Mental Health Review Report (MHRR) and the Elderly Services Programme Plan (ESPP).

In the Mental Health Review Report (MHRR), there are some major service gaps identified in the current delivery model of dementia care which require further actions for improvement. These services gaps and actions to bridging the gaps in the seven-stage model for dementia service planning are (Food and Health Bureau, 2017a, p. 186):

1. Pre-diagnosis

• Service gaps: awareness; knowledge; early detection
• Actions: territory-wide epidemiological studies; public education; care worker training

2. Diagnosis

• Service gaps: tests & scans for dementia; long waiting time; younger onset dementia
• Actions: coordinate primary, secondary & specialist care; share electronic health record

3. Post-diagnostic support

• Service gaps: difficult to access service & handle crisis
• Actions: clear pathways of referral; advice on treatment options; hotline service

4. Coordination & care management

• Service gaps: unclear coordination among service providers in the neighbourhood
• Actions: case management; identify special needs; database to review outcomes

5. Community services

• Service gaps: no dementia-specific services
• Actions: more day care, respite, outreach & home-based services; carer training

6. Continuing care

• Service gaps: inadequate support to promote longer living in the community
• Actions: strengthen medical & long-term care; discharge planning; care worker training

7. End-of-life palliative care

• Service gaps: not widely understood among the public
• Actions: promote greater acceptance; legal issues in making informed decisions.

Regarding evidence of achievement, for 5. Community services, a dementia-specific community service, namely Dementia Community Support Scheme, was piloted for 2 years starting from 2017 and became regularised in 2019.

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.

Not applicable.

The document does not mention specific timeline/milestones. There are no instruments mentioned to monitor (Ministry of Health Republic of Indonesia, 2015b) and yet, no national evidence of evaluations linked to the national policy have been published.

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.

Although progress has been made, no monitoring mechanisms have been established.

NZ Dementia framework:

The dementia framework was released in 2013 and “highlights some goals that may take time to achieve. It is anticipated that steady progress can be made towards these goals with the ultimate aim of significantly improving dementia health and support services within five years”.

The framework also outlined that “in the 2012/13 annual planning process, the Ministry asked DHBs to develop their own dementia care pathways by June 2013. In the 2013/14 year, DHBs are expected to implement their dementia care pathways and develop regional governance groups. The Ministry’s annual planning process will monitor the progress of the development and implementation of these pathways”.

Dementia Action Plan:

The Dementia plan was released in early 2020, just prior to COVID-19, and outlines recommendations for 2020-2023. The four priority action areas have associated targets for the four-year period and some that are for development with the aim of implementation in 2023 and beyond. There is no specific mention of monitoring targets and milestones.

The plan also describes “enablers” required for successful implementation of the plan which include:

• Allocation of sufficient financial resource by government,
• A knowledgeable, skilled, and supported workforce,
• Stronger links across the dementia sector,
• A partnership focussed commissioning model,
• Systematic and routine population monitoring of a core set of dementia indicators.

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