This case study examines the role of the overseas social worker in the National Programme on Community Based Rehabilitation for Persons with Disabilities in Sri Lanka. We used document data from the official reports written by overseas social workers (n=3), and complementary data from the author’s field notes and previous research, whilst collecting official documents related to the CBR core group officers, amongst others. Data were chronologically and descriptively summarised in line with the role of the overseas social worker as well as CBR core group officers. The roles of the overseas social workers were classified into four categories as follows: (1) to assess and evaluate in the community; (2) to introduce new practice and promote model practice; (3) to enhance existing local resources; and (4) to coordinate multi-professionals. Finally, we discuss implications of these findings from the viewpoint of community-based inclusive development, twin-track approach, social model and human rights model, which show a basic framework of their role at the grass-roots level. The results also indicate the importance of a perspective of community’s ownership and professional’s indirect support.
Background The Millennium Development Goals were put forth to strengthen maternal and child health, and because infectious disease has become a trend in the world, ensuring the quality and quantity of nursing is important. We report on a survey detailing the current status of legal frameworks and qualification systems in nursing in four countries: Cambodia, Lao People’s Democratic Republic (PDR), Myanmar, and Vietnam. Method We conducted a semi-structured interview with nursing administrative officers, and then we confirmed those information in their countries in 2012 and 2013. We categorized the existing nursing legal framework, nursing qualification systems, professional association and council. Results The King of Cambodia stipulated to a royal decree, which was established by the nursing council. In Lao PDR, following the Law on Health Care, two nursing and midwifery related regulations were developed. The Union of Myanmar enacted the Nurse and Midwife Law. In Vietnam following the Law on Medical Examination and Treatment, two Circulars were issued by the Ministry of Health to regulate the scope of practices and norms. We report on the current situation of the qualification and registration systems for nursing of each country. In addition, the development of qualifications and regulations should be reported based on the ASEAN Mutual Recognition Agreement (MRA). Conclusion We conducted a comparison of four countries to ensure the quality of nursing. A challenge for the future is compliance and dissemination of the laws and regulations that have been developed. ASEAN MRA has become a driving force for improvement of these legal systems.
A Health Promoting Schools (HPS) program was conducted among primary and secondary school children in Southern Province, Sri Lanka. The HPS program included implementation of health education and workshops, as well as publication of school newsletters that communicated the material the children discussed and learned in school to their families. The study aimed to determine whether the HPS program had any effects on the health of the school children, their parents and teachers. A total of 22 adults (nine parents, nine school teachers, and four school principals) were invited for in-depth individual interviews and reported their views on changes after the implementation of the project. The interviewees reported that the school children substantially improved their behaviors regarding dietary habits, basic hygiene, lifestyle, and exercise. They also expressed that the school environment improved. They indicated direct and indirect changes in their own awareness and attitudes, as well as in other family members. After the implementation of the HPS program, improved health behaviors and subsequent improved health across two generations were observed. Beyond providing students with health knowledge, more emphasis on motivating children to spread their health knowledge in their communities will make a more effective health intervention.
The Government of Indonesia (GOI) implemented a social security program, however, not all the population are covered as the Constitute of the Republic of Indonesia guarantee at its article 28th and obligate the GOI provide social security to all population. In 2004, the GOI introduced a new social security system targeting all population in order to achieve an improved coverage and integrated it into a unified system. The GOI has introduced a National Health Insurance System ahead of other social security systems on the 1st January 2014. It is also obligated foreigners who have lived in Indonesia for more than 6 months to participate. However, dissemination of the new system to the public was not enough at the timing of the introduction. Especially for foreigners as there is not enough information in any foreign language. The new system follows some parts of the previous program which was introduced for lower income population in 2005, the focuses are prioritizing on primary care and introducing a payment system for health care services. For accessing the health care services under the insurance system, all insurance holders have to attend the primary care institution at the beginning. Improving the quality and quantity of primary care service institutions requires important key factors to enhance the system and to increase the coverage. This article reviews the previous social security system and studies the laws and regulations relating to it, especially the new national health insurance system which was introduced in January 2014. It also discusses the challenges in enhancing the health insurance system and achieving Universal Health Coverage.