Lægedage Velkommen til Lægedage Familielæger i udvikling - hvordan kan du komme ud at virke for global sundhed?

Lægedage Mål - 4 delmål (1-4) Fra Kursusbeskrivelsen: ”På dette kursus tages udgangspunkt i primær sundhedstjenestes betydning for global sundhed (1), og med dette afsæt gives eksempler på danske bidrag hertil(2). Samtidig bliver kursisterne klædt på til selv at kunne spille en aktiv rolle og få mod på, færdigheder til samt en platform at virke fra, såvel ude som hjemme(3). Der bliver således også lagt vægt på, hvad deltagere i sådanne projekter tager med hjem som bidrag til udvikling af dansk almen praksis(4).”

Lægedage Program og mål (1-4) Introduktion og generelt om primær sundhedstjenestes betydning for global sundhed (1) Eksempler på danske bidrag hertil – Partners in Practice og Læger uden Grænser (2) Kaffepause Kursisterne indgydes mod og klædes på (3) Hvad får man med hjem? (4)

Lægedage (1) Introduktion og generelt om primær sundhedstjenestes betydning for global sundhed

Medicine Health Curative care Holistic care Specialised hospital care for the few Local health care for many Biological determinants of diseaseSocio-economic explanations Partners in Practice

Primary Health Care Principles I Evolves from economic conditions and sociocultural and political characteristics Evolves from economic conditions and sociocultural and political characteristics Adresses main health problems by promotive, preventive, curative and rehabilitative services Adresses main health problems by promotive, preventive, curative and rehabilitative services Includes health education, nutrition, safe water, sanitation, maternal and child health, family planning, immunisation prevention and treatment of common diseases and essential drugs schemes Includes health education, nutrition, safe water, sanitation, maternal and child health, family planning, immunisation prevention and treatment of common diseases and essential drugs schemes

Primary Health Care Principles II Involves all related sectors Involves all related sectors Requires and promotes community and self-reliance and participation Requires and promotes community and self-reliance and participation Is sustained by integrated referral systems giving priority to those most in need Is sustained by integrated referral systems giving priority to those most in need Relies on health workers also trained to work as a health team Relies on health workers also trained to work as a health team

CIHAU

Revitalisation of PHC - Almaty 2008 “I call for a revitalization of primary health care as an approach to strengthening health systems” “I am convinced that we will not be able to reach the health-related Millennium Development Goals unless we return to the values, principles, and approaches of primary health care” Margaret Chan 2008 Director-General WHO

WHO World Health Report 2008

Free and accessible Cost-effective and efficient Comprehensive and sustained by a mutually supportive referral system to secondary care Structured according to the Alma-Ata ideals Partners in Practice

Implicit knowledge of the wonders of a well- functioning Primary Health Care system Experienced community facilitator and collaborator Ready and able for global responsibility By doing so maintaining local integrity and enthusiasm Partners in Practice

A formal body for partnerships, project development and fund-raising purposes Promoting and facilitating local initiatives Providing professional and administrative assistance Partners in Practice

Curriculum development pre-/postgraduate Organisational support between colleges ”Teaching the teachers” courses Inspirational study visits E-mentoring professional development Operational comparative research ”You name it ……” Partners in Practice

Let forebyggelige sygdomme Familielæger i udvikling Hvorfor?

Familielæger i udvikling Antal arbejdende læger

Lægedage (2) Eksempler på danske bidrag hertil – Partners in Practice – Rwanda v. Lars Bønløkke

Lægedage Sundhedssystemet i Rwanda Familielæger i udvikling Community health workers Sygeplejersker Uddannelseslæger i familiemedicin m.fl. Speciallæger m.fl. Universitetshospital Distriktshospital Sundhedscenter Sundhedscenter Evt klinik Sundhedscenter Sundhedscenter Distriktshospital Distriktshospital

Lægedage Rwandas sundhedsvæsen 4 Referral hospitals (3 somatiske, 1 psykiatrisk) 40 District hospitals 453 Health centers ”Landsbyer” (umudugudu) med i alt Community health workers 786 læger til en befolkning på ca 12 mill

Lægedage Nogle udfordringer i afrikanske sundhedsvæsener: Få læger – stor mangel på speciallæger incl. Family- and Community Physicians Næsten ingen kontinuitet Manglende sammenhæng – kløft mellem Distriktssygehus og perifert i sundhedsvæsenet ”Double burden” – både klassiske fattigdomssygdomme og livsstilssygdomme

Lægedage

(2) Eksempler på danske bidrag hertil – Læger uden Grænser v. Søren Brix Christensen

Lægedage Kaffepause – 14.50

Lægedage (3) Kursisterne indgydes mod og klædes på Hvad kan danske almen medicinere bidrage med i sundhedsvæsener, der er så forskellige fra vores almen praksis? (4) Hvad får man med hjem?

Lægedage “Doctors for Tomorrow: Family Medicine in South Africa”. Jannie Hugo & Lucie Allan, 2008.

Lægedage Doctors in family medicine are aware of the challenges, attempt to understand them better and work to address them… The issues of principles and values, relationships and meaning are not left to chance, but become an important element of service, systems, training and research. Preface: A message of hope Archbishop Emeritus Desmond Tutu Johannesburg, 2008

Lægedage This gives me hope of a transformation in the health service that can take care of our people, which can guide us through this difficult time. This hope is not only for South Africa, but also for our brothers and sisters in the rest of the continent and the rest of the world. If the family medicine movement can play that role, let us join hands and realise that dream. Preface: A message of hope Archbishop Emeritus Desmond Tutu Johannesburg, 2008

Lægedage Tak for i dag Velkommen som: Familielæger i Udvikling og som medlemmer af Partners in Practice og Læger uden Grænser