Charalampos Economou Barriers and facilitating factors in access to health services in Greece World Health Organization, Regional office for Europe, Copenhagen, 2015

No abstract

Why Has the Health-Promoting Prison Concept Failed to Translate to the United States?

Two decades since the World Health Organization Regional Office for Europe published a report on health promotion in prison that stimulated further debate on the concept of the “health-promoting prison,” this article discusses the extent to which the concept has translated to the United States. One predicted indicator of success for the health-promoting prison movement was the expansion of activity beyond European borders; yet 2 decades since the European model was put forward, there has been very limited activity in the United States. This “Critical Issues and Trends” article suggests reasons why this translation has failed to occur.

Coercion in Europe

Modern psychiatry developed in Europe with Pinel in the Enlightenment: the concept of human rights was first conceived and the first laws to protect citizens’ rights in psychiatry were introduced. However, Europe is also where some of the worst violations of human rights in psychiatry have taken place. Europe has developed several international institutions such as the European Union and the European Court of Human Rights. Their covenants, along with those from the United Nations, have repeatedly attempted to address the issue of freedom and coercion in medicine and in psychiatry. The World Health Organization Regional Office for Europe has paid extensive attention to coercion and human rights in psychiatry. Europe has a long history and tradition of mental health care and there are significant variations between countries in its delivery and legislation. This chapter outlines some key historical events and attitudes regarding coercion in European society ,with particular attention being paid to coercion in the community.

Implementation of the World Health Organization Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation

Background: The increase in disease burden has continued to weigh upon health systems in Africa. The role of the laboratory has become increasingly critical in the improvement of health for diagnosis, management and treatment of diseases. In response, the World Health Organization Regional Office for Africa (WHO AFRO) and its partners created the WHO AFRO Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (SLIPTA) program.SLIPTA implementation process: WHO AFRO defined a governance structure with roles and responsibilities for six main stakeholders. Laboratories were evaluated by auditors trained and certified by the African Society for Laboratory Medicine. Laboratory performance was measured using the WHO AFRO SLIPTA scoring checklist and recognition certificates rated with 1–5 stars were issued.Preliminary results: By March 2015, 27 of the 47 (57%) WHO AFRO member states had appointed a SLIPTA focal point and 14 Ministers of Health had endorsed SLIPTA as the desired programme for continuous quality improvement. Ninety-eight auditors from 17 African countries, competent in the Portuguese (3), French (12) and English (83) languages, were trained and certified. The mean score for the 159 laboratories audited between May 2013 and March 2015 was 69% (median 70%; SD 11.5; interquartile range 62–77). Of these audited laboratories, 70% achieved 55% compliance or higher (2 or more stars) and 1% scored at least 95% (5 stars). The lowest scoring sections of the WHO AFRO SLIPTA checklist were sections 6 (Internal Audit) and 10 (Corrective Action), which both had mean scores below 50%.Conclusion: The WHO AFRO SLIPTA is a process that countries with limited resources can adopt for effective implementation of quality management systems. Political commitment, ownership and investment in continuous quality improvement are integral components of the process.

Health inequities in the European Region and the new health policy frame work of the World Health Organization

In this chapter the authors describe the rationale of a new health strategy for the promotion, and protection of population health and for the reduction of health inequities. At the time of writing, this strategy - known as Health 2020 - is being developed by the World Health Organization Regional Office for Europe in collaboration with its 53 member states. A dramatic reduction of health inequities is one of its central objectives. The authors describe the reasons that brought about the development of a new health strategy, and summarize the various patterns of health inequities in Europe. Policy approaches are revisited in search of credible interventions for tackling health inequities in the WHO European Region.