Greener Primary Care

By Pim de Graaf

Does Primary Care have a big environmental footprint? Do we produce much waste and CO2 emissions? Do we use much energy, more than necessary?     I suspect we have no data. There are data for the health system as a whole, though, as the Health care climate footprint report describes. 
Can we, as Primary Care professionals, contribute to greener health care, by identifying and exchanging good and bad practices? I propose to try and discuss with interested members of the EFPC. Does anybody want to join a first meeting and see what we experience and the ideas we have?
 

 

“Primary care professionals in different parts of the world have initiated ‘on the spot’ innovative approaches to allow for ‘medical distancing’ in almost all countries while continuing the delivery of care through virtual consultation and monitoring, and the use of patient apps where possible.
Laws and practice guidelines are often being rapidly adjusted and reimbursement codes are developed to overcome the barriers of telehealth in an effort to reduce healthcare-related COVID-19 transmissions, and to protect health personnel
The pandemic presents important lessons to strengthen health systems through better connection between public health, primary care, and secondary care to cope better with future waves of this and other pandemics.”

Read more
 

EFPC 2021 Bergen Conference - Call for Abstracts

In addition, the conference scientific committee kindly invites EFPC members to submit an outline for workshops of 45 or 90 minutes on specific themes before mid-May 2021. Please check for further guidance PIE and visit the list of EFPC 2021 Bergen Conference – Themes for inspiration.

Deadline 1 May 2021
Submit your abstract here!

Ps: In case we have to cancel the conference in Bergen, due to the pandemic situation, the conference will be shifted into an online event. All the accepted abstracts will be included in it.

Presentation at the workshop EU4Health Programme 2021: potential solutions for a healthier European Union

This full-day workshop was built on the outcome of the 22 January EU4Health Webinar and explored potential solutions for EU-wide health challenges under the four strands of the Programme by gathering stakeholders feedback. 
The webinar was open to all relevant stakeholders: NGOs, associations, businesses, Member States’ policy makers, patients’ organisations, etc.
The workshop gathered input on potential solutions to health challenges that could contribute to the objectives of the EU4Health programme.
Please, find here the presentation of Jan De Maeseneer, former chairman of the EFPC.

The EU4Health programme marks the final step towards making €5.1 billion available to strengthen the resilience of health systems and promote innovation in the health sector. EU4Health will make a significant contribution to the post-COVID-19 recovery by making the EU population healthier, supporting the fight against cross-border health threats and boosting the EU's preparedness and capability to respond effectively to future health crisis, as part of a future strong European Health Union.

Call for Interest: Self-Care Learning and Discovery Series
White Ribbon Alliance (WRA), on behalf of the Self-Care Trailblazer Group (SCTG), is calling for interest among SCTG members* to organize thematic sessions at the inaugural Self-Care Learning and Discovery Series beginning 24 June - 27 August 2021. Please complete the session organizer interest form by 18 April 2021.
The Self-Care Learning and Discovery Series is a highly interactive virtual forum to exchange and incubate ideas, experiences and solutions on a variety of self-care topics. Open to all, objectives include:

• Increase knowledge and understanding of different aspects of self-care and their intersections
• Connect people within and across the self-care movement and inspire new partnerships
• Exchange self-care approaches and learnings across contexts
• Catalyze new self-care champions at all levels
• Elevate community perspectives and solutions on self-care

New on Primary Health Care Research & Development (PHCR&D)

Strengthening health system building blocks: configuring post-COVID-19 scenario in Pakistan
Babar Tasneem Shaikh
 
The global COVID-19 outbreak and its subsequent repercussions and implications, after being declared as a pandemic by the World Health Organization (WHO), exposed all the inherent, lingering, and acute shortcomings of the health systems in many developing countries and Pakistan was no exception.
A detailed literature review was done and concluded that good governance with interprovincial harmony, increasing fiscal space for health, investing in human resources for health, establishing an inventory management system, promoting the use of information for decision-making, and tailoring service delivery by recognizing the local context and wider systems ‘values’ are essential elements to strengthen the health system. An overarching political will is needed to ensure whether interventions in each block are succeeding. Well-integrated and locally grounded health system may be more resilient to external shocks like COVID-19.

Exploring the capacity of communitybased organisations to absorb health system patient referrals for unmet social needs
Hogg‐Graham, Rachel et al;
This study examines the perspectives, resources, role and services provided by community‐based organisations (CBOs) in response to the integration of health and social services to address individual unmet social needs, as well as the impact on organisational carrying capacity related to the ability to receive referrals from health system partners. Mixed methods combining qualitative interviews with 24 organisations and Social Network Analysis with 75 organisations were completed in 2018 in two communities (Denton, Texas and Sarasota, Florida) with robust examples of health and social systems alignment. Findings suggest that while community organisations are embedded in robust cross‐sector networks, the potential increase in referrals from clinical settings is not something they are fully aware of, or prepared for, as evidenced by inadequate funding models, misalignment between capacity and capability, and a lack of coordination on screening and referral activities. Misalignment between clinical and CBO understanding of demand, needs and capacity present a potential risk in building strategies that integrate health and social services to address unmet social need. Failing to build a strong cross‐sector screening and referral infrastructure that considers CBO capacity from the start could undermine the goal of improving population health through the integration of clinical and social care.
 

Building back better requires strengthening primary care
Ann C. Greiner and Elizabeth Mitchell
Quote:
“As the pandemic enters its second year, the health care workers who care for patients with Covid-19 and other serious conditions deserve our gratitude and support. Many on the frontlines are not just tired but are also in precarious financial straits and lack the resources to “build back better.”
This is a dangerous place for the country. A key response to the pandemic is fundamental reform in how we pay — and how much we pay — primary care providers.
After years of underinvestment, primary care is more vulnerable to external shocks like Covid-19 than most other parts of our health care system. Small and independent primary care practices have not received targeted relief from the $178 billion provider relief fund created in the CARES Act, even as primary care has become more valuable than ever, given its critical role in triaging and managing Covid-19 patients and in addressing worsening health inequities.”

What has the COVID-19 pandemic in Peru showed us?
Dr. Farady Baldoceda Espinoza
Peru, with 1,250,000 confirmed cases and more than 44,000 deaths, experienced the second most deaths as a country in Latin America in proportion to its population.
The Peruvian health system is administered by four entities: the Ministry of Health (MINSA), which offers health services for 60% of the population; the social health insurance (ESSALUD), which covers 30% of the population; the Armed Forces (Armed Forces) and the private sector, which provides health services to the remaining 10%. This pandemic finds Peru with a fragmented health system fractured by the corruption of recent governments.
Currently due to the pandemic, we see everyone who needs medical attention, especially cases of people with COVID19.  We evaluate them, manage them, treat them and refer serious cases. Every day we face difficulties that we try to overcome such as lack of health personnel, lack of medicines, lack of oxygen, and difficulty in referring serious cases because hospitals are full.

Keeping up in Kenya: Maintaining Essential Health Services in Crisis and Calm
Dr. Agatha Olago and Maisoon Chowdhury
What impact has COVID-19 had on primary health care (PHC) systems, and what are the opportunities to overcome barriers and make “PHC for UHC” a reality? This blog looks at experience in Kenya.

Long COVID and Health Inequities: The Role of Primary Care
Zackary Berger et al.
Primary Care will be increasingly critical to providing equitable care for vulnerable patients with long COVID. To address the growing burden of these COVID-related chronic conditions, the authors advocate for stronger PHC, better quality data and a renewed focus on addressing structural inequities.

Interested in “Long COVID”? Please join our starting working group on this theme, which will work in close connection with the WHO Primary Care unit in Almaty.

Transcript: A Conversation with UNICEF Executive Director Henrietta Fore
Interview with UNICEF Executive Director Henrietta Fore.
Ms. Fore underscores the importance of increasing access to primary health care clinics for families to both receive their routine immunizations and COVID-19 vaccines.

COVID-19 pandemic and health-care disruptions: count the most vulnerable
Jogender Kumar, Praveen Kumar 
The effect of the pandemic on vulnerable populations needs to be compared not only with the non-vulnerable population, but also with the pre-pandemic status of those populations. The disparities related to resource levels, ethnicity, race, gender, religion, and caste among these vulnerable populations also need to be explored.
We should obtain these data through community health workers, such as accredited social health activists and Anganwadi workers in India, and social leaders to measure the true burden and identify the barriers in accessing health care during the pandemic.

Estimated Effect on Life Expectancy of Alleviating Primary Care Shortages in the United States
Sanjay Basu et al.
Prior studies have reported that greater numbers of primary care physicians (PCPs) per population are associated with reduced population mortality, but the effect of increasing PCP density in areas of low density is poorly understood. In order to estimate how alleviating PCP shortages might change life expectancy and mortality they performed this study.
Using models based on existing county-level data, researchers projected that a greater density of primary care providers would lead to higher life expectancy across the country.