Education for Sustainable Developmentarchive.ias.unu.edu/resource_centre/Topic 3.pdf · Education...
Transcript of Education for Sustainable Developmentarchive.ias.unu.edu/resource_centre/Topic 3.pdf · Education...
Education for Sustainable Development
Sustainable Health Programs
Allison E. Gocotano, MDRaymond Francis R. Sarmiento, MD
Jaime Z. Galvez Tan, MD, MPH
RCE CebuU.P. Cebu Campus
RCE CebuU.P. Cebu Campus
Focal Projects: I-WARM-CEBU (Integrated Water and Resource
Management) – to catch and harvest rain water in response to the current and future water shortage problem
REPORMA (Regional Resource, Poverty, and Poverty Response Mapping) – to inventory all available resources in the region starting with Cebu
Construction of an ESD resource centre which would include a multimedia library, training and ICE (Information, Communication and Education) material production
RCE CebuU.P.Cebu Campus
Currently, promotion of ecotourism at the forest reserve of Camp 7 Minglanilla
Part of the showcase project ‘Promoting ESD through Conservation and Sustainable Use of Forest Resources and Empowerment’, implemented in partnership with the Institute for Global Environmental Strategies (IGES)-Asia Pacifi c Forum for Environment and Development (APFED)
RCE Cebu Partners - NGOs
Visayas Primary Health Care Services Inc.Community Based Health Programs in
Cebu City urban poor communitiesProvinces of Bohol and Negros Oriental rural
communitiesTraining of Community Volunteer Health WorkersPromotion and Use of Asian and Filipino Traditional
MedicineSpecial services for reproductive health and family
planning
A Conceptual Framework of Sustainable Health
Levels of Sustainable Health
PersonalFamily CommunityMunicipal/City/ProvincialNationalGlobal
Components of Sustainable Health: Personal Level
Personal:healthy lifestylepersonal hygienegood diet and nutritionemotional integritybody-mind-spirit integration
Sustainable Health: Personal Level: Barriers and Strategies Barriers
Healthy Lifestyle - regular exercise, family planning
Smoking, alcohol, dangerous drugs, physical inactivity
Personal Hygiene - safe sex, hand washing, use of toilet
High risk sex behavior, lack of safe water and sanitation
Good diet and nutrition - eating a variety of food daily and in moderation, plant based diets
Overconsumption, fast food & junk food, processed food, pesticide & organo-phosphate laden food
Emotional integrity Lack of personal security, lack of economic & educational opportunities, personal isolation
Body-mind-spirit integration -inner peace
Lack of personal security, lack of economic & educational opportunities, personal isolation
Strategies: Health Promotion; Personal Wellness & Health Scorecards; Risk-Reduction Counseling; Stress Management; Behavior Change Communication; Education Scholarships; Vocational and Technical Training for Job Creation; Tobacco Free Policies; Animal companionship
Components of Sustainable Health: Family Level
Familyfamily beliefsgeneticsgenealogyfamily interaction and harmonyhousehold economic well beingfamily food gardens, family food basketinter-generational learning;
Sustainable Health: Family Level: Barriers and Strategies Barriers
Family Beliefs Formal education at times contradictory to family belief systems
Genetics and Genealogy Lack of access to newborn screening and genetic screening; family “shame” for hereditary disabilities - tendency to hide disabled family member
Family Interaction and Harmony Absence of one parent due to overseas work or far from ancestral home;
Household Economic Well Being Lack of education and job opportunities
Family Food Gardens Massive advertisements of fast food, junk food & processed food; lack of indigenous seeds for local fruits & vegetables & nuts;
Family Food Basket Low cost prices of junk & processed foods versus naturally grown food
Inter-Generational Learning Extended households now becoming nuclear households due to rapid urbanization and population pressure
Strategies: Family Health Promotion; Family Wellness & Health Scorecards; Family Oriented Counseling; ; Family Behavior Change Communication; Education Scholarships; Vocational and Technical Training for Job Creation for Female Headed Households; Production of Family Medicine Practitioners; Family Kitchen Learning Demonstrations of Healthy Foods; Bio-Intensive Family Gardening Promotion.
Components of Sustainable Health: Community Level
Community Customs, norms, and traditions (indigenous
knowledge)Water, sanitation and environmental healthFood production and securityOccupational health and safetyAvailability, accessibility & affordability of health
careCommunity managed and community based health
programsTraditional medicine
Sustainable Health: Community Level Barriers and Strategies Barriers
Indigenous knowledge (customs, norms, traditions)
Lack of research resources for documentation of indigenous health knowledge and practices ; prejudice against indigenous peoples
Water, Sanitation & Environmental health
Lack of investments in safe drinking water systems, sanitary toilets with desludgeable septic tanks; lack of community action on solid waste management
Food Production and Food Security
Take over of production of traditional (bio diverse) foods by large scale mono crops and cash crops plantation
Occupational Safety and Health (OSH)
Failure to fully implement laws and regulations mandating companies to apply occupational safety and health (OSH)
Availability, accessibility & affordability of health care
Lack of health personnel at the village level ; lack of essential medicines at the village level; high cost of health care and essential medicines
Community Managed and Community Based Health Programs
Lack of investments in community based and community managed programs
Traditional Medicine Dominance of North American and European Medicine (allopathic); dominance of multi-national pharmaceutical companies and infant milk formula companies of the commercial health markets.
Strategies: Universities as loci for research in traditional indigenous knowledge and medicine; Community Led Water, Sanitation and Environmental Health Approaches; Public-private-community investments in water, sanitation and environmental health ; Promotion of community biodiversity; Continuing education and capability building of community volunteer health workers; Community organizing; Public policy recognition of traditional healers.
Components of Sustainable Health: Local Government Level
Municipality/City/Provincelocal policies, laws, ordinanceshealth systems developmentroad safetylocal health investmentsinter-sectoral linkagesmultidisciplinary and trans-disciplinary
partnershipshealth management information system
Sustainable Health: Local Government Level: Barriers and Strategies
Barriers
Local Policies, laws, ordinances There maybe enough laws and policies but these are not uniformly implemented and enforced
Health Systems Development Lack of Capacity of Local Governments to manage various aspects of health systems development
Road Safety Lack of enforcement of transportation and road safety laws and ordinances - seat belts, no drinking when driving, traffic rule enforcement etc
Local Health Investments Health not a major priority of local governments; health varied as an expenditure rather than an investment
Inter-sectoral linkages Turfing of government agencies and even NGOs; fear of partnerships on both sides, government and NGOs
Multidisciplinary & Trans disciplinary Partnerships
Fear of partnerships; Difficulty in integrating established curriculum
Health Management Information System
Insufficient documentation; Faulty data collection
Strategies: Political will to re-evaluate existing policies for proper implementation and perhaps improvement; Training of individuals for health systems management; Proper implementation of laws and ordinances; Prioritization of health in the local budget; Pilot partnerships with small scale projects to build up confidence in both parties (government and NGOs); Pilot curriculum for trans-disciplinary partnerships maintaining open-mindedness; Improvement of documentation and process evaluation of data collection
Components of Sustainable Health: National Level
Nationalhealth policy developmenthealth standards, regulations and licensingquality and equity in healthhealth human resource developmenthealth research and developmenthealth financing and social health insurancedemographics and population management national medicinal drug development national disease surveillance system
Barriers
Health policy development There may be sufficient policies but with improper implementation
Health standards, regulations, and licensing
Substandard health condition probably due to lack of sufficient budget
Quality and equity in health Geographical challenges in terms of service delivery
Health human resource development Substandard schools; Health profession perceived as a means of economic advancement
Health research and development There may be a lot of ongoing researches but there is lack in advocacy and support from local government
Health financing and social health insurance
Coverage is still for those who can afford; Highest share of reimbursement claims come from rich, private institutions
Demographics and population management
Population growth at a faster rate than economic progress
National medicinal drug development Lack of local capacity to produce the drugs
National disease surveillance system Improper documentation; Faulty data collection
Sustainable Health: National Level: Barriers and Strategies
Strategies: Political will to re-evaluate existing policies for proper implementation and perhaps improvement; Sufficient budget allocation for health; Commitment of LGUs in ensuring availability of health service to their locality, or sponsoring a local resident for health education with return of service; Continuing advocacy; Reproductive health education; Initiatives to attract investors for local drug manufacturing; Process evaluation for disease surveillance system and with focus on preventive care
Components of Sustainable Health: Global Level
Global health professional migrationclimate changeemerging diseases and pandemicsglobal terrorism and armed conflictsglobal health equity (MDGs)global food equitygender and developmentglobal health governance (W.H.O. and United
Nations multilateral mechanisms)
Barriers
Health professional migration Imbalanced migration leading to depletion in source countries; Lack of equitable policies
Climate change Natural as well as Manmade causes
Emerging diseases and pandemics
Unpredictability; Delay in rousing awareness and concern
Global terrorism and armed conflicts
Conflicting beliefs; Unyielding attitude
Global health equity (MDGs) Insufficient local political will
Global food equity Typhoons and natural calamities
Gender and development Oppression
Global health governance Cross cultural differences
Sustainable Health: Global Level: Barriers and Strategies
Strategies: Development of a win-win bilateral agreement/policy between source and receiving countries; Education and awareness raising with initiatives on research and development to address climate change; Level of preparation in order to handle unexpected diseases; Bilateral peace talks and a margin for open-mindedness; Advocacy to local government to strengthen political will in prioritizing health issues; Nationwide preparations for natural disasters, and prioritization in food production; Gender equality empowerment initiatives; Strengthening of WHO and UN multilateral mechanisms , research and development, and informed policy making
Six Dimensions of Sustainable Health, Wellness and Well-Being
Physical
Mental
Spiritual
Emotional
Social
Enviromental
Six Contexts of National & Global Sustainable Health, Wellness and Well-Being
Good Politics & Governance
Social & Cultural Accord
EconomicEquity
Education & Gender Equality
Biosphere Balance & Harmony
Security, Peace &Human Rights
Sustainable Healthis the state of complete
physical, spiritual, mental, emotional, social, and environmental well-being and not just the absence of infirmity and
disease at the personal, family and community levels, but within the context of local, national and global
economic equity, good politics and governance, cultural and social accords, gender and education equality, security, peace and human rights, and biosphere balance and harmony
RCE Cebu
University of the Philippines, Manila Campus: Citing an example of the Role of a
University in Sustainable Health
Organizational Structure
The University of the Philippines SystemUP Visayas
Cebu campus (Central Visayas - RCE Cebu Headquarters)
Iloilo campus (Western Visayas)Tacloban campus (Eastern Visayas)
UP Manila (Health Sciences Campus)UP Diliman (Main Campus)UP BaguioUP MindanaoUP Los Banos (Agriculture and Forestry Campus)
Organizational Structure
UP Manila (Health Sciences)UP College of Medicine
Department of Family and Community MedicineCommunity Oriented Medical Education
Rural (Batangas province) and Urban (Pasay city) poor Communities
Community-Based Health Development Program
(CBHDP)Province of Batangas
Municipality of Laurel (1993-1997)Municipality of Santo Tomas (1998-2005)Municipality of San Juan (2006-present)
5-7 year partnership agreement with local government
CBHDP
Multi-disciplinary moving to Trans-disciplinary approachUP College of Medicine UP College of Nursing UP College of Allied Medical Professions (Physical
Therapy and Occupational Therapy)UP College of DentistryUP College of PharmacyUP College of Arts and SciencesUP College of Social Work and Community
Development (UP Diliman)
CBHDP
Live with the communityParticipation in community diagnosis,
organizing, local barangay (village) governance,Community planning;Community ImplementationCommunity Monitoring and Evaluation
CBHDP
Team up with existing health system structure at the village levelTraditional healersMidwives
Linkages with the Municipal doctor and nurses, and district hospital
CBHDP
Mainly through Community Empowerment towards Sustainable HealthEducation and Capability BuildingDevelopment of Community Based
TechnologiesActive participation and Community
managementSupervision, Monitoring, and Evaluation
Given the conceptual framework of sustainable health, what are
the roles of universities in its promotion?
What will be the key objectives of RCE models for Sustainable Health?
Proposed Objectives for the RCE model/s
At the end of the summer program, the participants will be able to:
Enumerate roles by which a University can play to empower a community
Define sustainable health under the context of education for sustainable development
Illustrate/Propose an example of how they can apply the principle in their local community
Integration of Traditional Medicine into Basic Health Care Services and Health
Sciences Curricula
Integration of Traditional Medicine in Basic Health Care Services and Health
Sciences CurriculaResearch and Use of Medicinal Plants
for MDG 4 and MDG 5 (Child Health and Maternal Health) at the community level.
Integration of Sustainable Health in ESD in Health Sciences Curricula
ESD Higher Education and Sustainable Health
RCEs as monitor of international ethical recruitment guidelines of health professionals and “Migration Watch”
Participation of RCEs in the Country Panels for negotiation of bilateral win-win agreements in the ethical recruitment of international health professionals
Why Traditional Medicine and Integrative Medicine and
Complementary Medicine in Medical and Health Sciences
Education?
Why Study Traditional Medicine?
W.H.O. recommendation of integration of Traditional Medicine in Medical and Health Sciences Education and Primary Health Care since 1978
World Health Assembly resolutions since 1981 called upon member-states to integrate Traditional Medicine in their health care systems
Why Integrative and Complementary Medicine in the Medical and Health Sciences
Curricula?Evidence Based Medicine already being applied in
Complimentary and Alternative Medicine
NIH Bethesda actively promoting through the National Center for Complementary and Alternative Medicine
North American, European and Asian Medical and Health Sciences Schools already incorporating Integrative Medicine and Complementary and Alternative Medicine
Why Integrative and Complementary Medicine in the Medical and Health Sciences
Curricula?Evidence Based Medicine already being applied in
Complimentary and Alternative Medicine
UP College of Medicine offering elective courses in Traditional and Alternative Medicine during 4th year medical school
Masters Program in Integrative Medicine started in UERMMC (Phils.)
Challenges in the Philippines
Research Agenda in Filipino Traditional Medicine
Generation of Research QuestionsDevelopment of Research ProtocolsHerbal medicine researchAnimal and mineral medicine researchInventory/survey of Filipino healersBottom-up Code of Ethics or Standards of
Practice
Challenges to the Research Community
1. Majority of Philippine medicinal plants with centuries of ethnomedical history, remain untapped.
2. Evidence supporting Philippine traditional medicine practices is still in the early developmental stage and its potential has not been fully explored.
3. Lack of collaboration among research institutions, private sector and academe
More Challenges to the Research Community
4.Lack of investments in research and development, raw material production, post harvest processing and herbal manufacturing.
5.Low level of scientific technology in herbal medicine research and manufacture among small and medium enterprises.
6. Low support for traditional medicine research in the academic community.
More Challenges to the Research Community
7. Need for market and government incentives like the ones given to rice, corn, coconut, sugar, bananas, pineapples and mangoes.
8. Need for standardized procedures/ accreditation/recognition in Filipino traditional medicine practices.
Philippines - The Heart of AsiaPhilippines - Islands of Wellness and the Center of
Health and Wellness in Asia
Philippines - The Global Capital for Tropical Medicinal Plants
The Filipino Hilot Traditional Massage - a brand name in all spas of the world in the next 5 years
Philippine Health Care - the Best of Asia with the Best of Europe and North America
Terima Kasih!Arigato Gosaimas!
Maraming Salamat po!
Allison E. Gocotano, MDRaymond Francis R. Sarmiento, MD
Jaime Z. Galvez Tan, MD, MPH
HEALTH FUTURES FOUNDATION INC.