DESK REVIEWS | 04.08.04. Are the expected policy changes, likely to result in any of the following:

DESK REVIEW | 04.08.04. Are the expected policy changes, likely to result in any of the following:

Yes. The first National Dementia Plan is likely to be totally approved as it has been already approved by the Senate House, but it still needs approval from the Chamber of Deputies and sanction from the president of the Republic. The STRiDE Brazil team is in direct contact with government and STRiDE-Brasil may be key in these policy changes. Professor Cleusa Ferri has contact with the Ministry of Health through her work in the Health Technology Assessment and has been invited to some events to raise awareness and push dementia to the NCD agenda. Professor Nitrini from the STRiDE-Brazil Steering Committee was also invited to go to a meeting at the Chamber of Deputies with several politicians. From that meeting it was agreed that a commission would be created including civil society and politicians to take the further steps to prioritize dementia on the public health and social agenda. It seems that this, together with STRiDE Brazil activities, may accelerate the development of a national strategy in the next few years. Besides, professor Cleusa Ferri has been awarded with a grant from the Ministry of Health to develop the First Dementia National Report which will inform about various topics in dementia such as epidemiology, situation of care, costs etc.

Yes, the STRiDE project will contribute to development of a National Dementia Plan.

A revision of the National Dementia Plan could be likely developed in the next couple of years.

There is no evidence about this question.

Yes, it is possible that dementia may come under future ageing, NCD or other state level plans.

The Ministry of National Development Planning is currently drafting a National Plan on Older People’s Welfare (Kementrian Koordinator Bidang Pembangunan Manusia dan Kebudayaan RI, 2020) and dementia might be included in this plan.

References:

Kementrian Koordinator Bidang Pembangunan Manusia dan Kebudayaan RI. (2020). Tanggapan Terkait White Paper “Pemenuhan hak-hak lansia untuk hidup setara, sejahtera dan bermartabat.” Presentasi.

The development of the training manual for community health volunteers on healthy ageing for older persons is likely to lead to a healthy ageing strategy which will cover dementia.

It might be included as an end-goal of NCD prevention and management.

We are living a complex political time. It is hard to say what is going to happen in the near future. The 2019 pension reform is estimated to save R$800 billion over the next ten years. However, the socioeconomic consequences and the impact on welfare through this reform are yet to be understood. Besides, the Covid-19 pandemic has raised different priorities in terms of healthcare systems in Brazil and the consequences on the population are still difficult to estimate, as the pandemic is still in place.

The following strategies described in earlier sections are likely to contribute to increase in access to care for persons dementia and/or increase in treatment guidelines on dementia care:

  1. Increase in the number of households receiving older persons and persons with severe disability cash transfers
  2. 66% (31 out of 47 counties) coverage of hospital based palliative care services
  3. The Constitution of Kenya 2010, Article 57, mandates the state to take steps to make sure that the rights of the elderly are protected government and private partnerships
  4. Involvement of NGOs with the Ministry of Health in task-sharing approaches and development of training manuals for community health volunteers
  5. Involvement of different partners with the Ministry of Health in policy and plans development e.g., national dementia plan by AMHRTF and ADOK; and healthy ageing strategy by HelpAge International
  6. Commitment of the government in supporting community health initiatives

As previously mentioned, there are two groups working together towards the generation of a National Care System, one led by the National Institute for Women (INMUJERES) and a second one at health system level lead by the General Health Council, CSG (Consejo de Salubridad General) at the Ministry of Health and the National Institute of Geriatrics (INGER). As people with care dependency will be included as a target group, this could be a viable way to include people with dementia who have care needs as a specific target group. In addition, the inclusion of care-specific priorities in the six-year plans of three federal government institutions, opens the door to the establishment of the National Care System and long-term care policies.