SARAJEVO, BOSNIA AND HERZEGOVINA
8 SEPTEMBER, 2008
Even in the developed and richest
countries, there are differences and differentials in health for women and men
that are not taken into account. Although „women live longer than men, they
suffer a greater burden of morbidity. Women are over-represented among the
poor, while their income is on average only 70% of that of men.“[1]
Although women throughout the world are healtier than ever and thier life
expectancy rates are raising. „Over half a million women around the world die
from pregnancy – related causes every year, while another 15 million suffer
serious long-term complications. Women now account for nearly half of all new
causes if HIV infections.“ [2]
Women utilize the public health
care system more than men. Women are more likely to experience depression and
stress linked to their experience of inequality and discrimination, to
experience chronic conditions such as arthritis and osteoporosis, and to suffer
ill health and death as the result of abuse.
In BiH war
impose a whole range of stressors, it is reasonable to presume that the
population’s need for mental health care increased. The war has almost completely destroyed the
health system, the evidence of which is in the data of the Institute of Public
Health of the Federation of BIH. According to the report based on Smajkić A. in
year 1997 the „population’s health is such two times more people are affected
by epidemics than before the war, and tuberculosis rate has increased. Also,
the number of chronic mental health patients is three times lesser, which
suggests that many patients from this category have not survived the war.“[3]
However, the evidence women’s health priorities across Europe and even in Bih may differ
between countries. Special attention should be paid to the special health
problems of more than four million women belonging to migrant groups, refugees
and ethnic minorities. Yet, progress has not always been even, and some part of
the world have suffered resent reversal. There are many places in the world
were women's „average life expectancy is less than 50 years and where the great
majority of women can either read nor write. And in the country , women consitue
the majority of the poor, accounting for more 70% of the world's 1.3 billion
people living in poverty.“[4]
These result shows that, women have the advantage of a disease resistant
biology, but the disadvantage of lower social status and less access to wealth.
Hence, men and women have, to a certain degree, different patterns of ill
health. This is due to their different biology, to the reproductive function of
women, and to the fact that their lifestyles and risk factors differ because
their gender roles are different.
Inspite of the situations in all part
of the world, these essay will provide to understand the context of „Health in the 21st century“[5],
which will serves as a sample framework for BiH to construct systematic
policies and strategies for improving the health of their populations.
CONCLUSION
Target-setting has been a traditional approach in the European Region’s Health for All policy formulation. Recently, however, there has been a consensus that establishing common targets for all countries in the Region can often be artificial, unfair or simply uninspiring. It does not take into account significant differences in Member States’ public health and economic development. Nonetheless, setting targets can be an important exercise at national and sometimes sub-national levels. National targets can be an excellent implementation and guidance tool, as well as a means for a country to articulate its degree of ambition. And when all stakeholders are involved, the formulation of national health targets can help ensure their joint ownership of health policy. The recommendations included in this update are not exhaustive, nor do they cover every field of public health. Instead, the focus is on fields and methods that are either new or have evolved significantly since 2000. Even though Health21 was adopted a short time ago, the intervening period has seen many significant changes in the health systems of Member States. Some of the experience and knowledge they have acquired is presented here. In other words, rather than attempting to produce an authoritative document that finalizes the Region’s Health for All policy, this update aims to encourage an open-ended Health for All process. The Health for All policy frameworks can then be continuously enriched by the broad range of Health for All activities that individual countries themselves choose to carry out. Some countries may decide to develop and analyze national case studies.
Other Member
States may regard this update as an invitation to re-examine and revisit their
health policies. Still others might devote special attention to the
communications challenge – how best to communicate the Health for All values,
the concept of health and human rights, and the model of ethical governance to different
audiences and stakeholders. There may also be countries that elect to develop
concrete benchmarks against which to measure the implementation of Health for
All policies. Meanwhile, a given country might focus on the local level because
it sees decentralization and the meeting of local health needs as essential in
successfully implementing Health for All. Finally, a group of countries could
invest effort in developing national and sub-national health targets and
linking them to the United Nations Millennium Development Goals (MDGs).
Member States have been urged to consider the
Health for All concept when formulating policies and action plans. It was
believed that, by interpreting Health for All in a national social, political
and developmental context, each country would be able to contribute to the
global aim of health for all by the year 2000. The call for health for all was,
and fundamentally remains, a call for social justice, equity and solidarity,
and a societal response that strives for unity in diversity. Rather than
enshrining a single finite goal, Health for All is instead a process of
bringing countries to progressive improvement in the health of all their
citizens.
The Health on the 21st century in the form
of a policy guide, enable the targets to be considered from the perspective of
women. It emphasized that the health care delivery system plays a vital role in
assuring the health of the public. Academic institutions train health and
public health workers and conduct essential health related research. Communities
function as both sites where health is supported or undermined and, through
their various organizations and constituent entities, as potential partners
within a public health system. Business and employers play important roles in shaping population health, not only in the occupational
setting, but also through environmental impacts, as members of communities, and
as purveyors of products available for mass consumption. The media has
tremendous importance as people increasingly purchase, socialize, and gather
information through electronic media and the Internet. News and entertainment
media also play a major role as shapers and reflectors of popular culture,
interests, and priorities.
The common customer service challenges include
improving coordination, access, and services for patients traveling from outlying
areas to provide the best patient experience possible and keeping rural-based
physicians and providers connected with the main campus to support their
professional and personal development.
The Media has important contribution to
advocate and recommend to
government agencies and others. The Public health and
communication researchers should develop an evidence base on media influences
on health knowledge and behavior, as well as on the promotion of healthy public
policy.
The academia should take steps to expand the
external peer review mechanism for review of investigator-initiated research,
allow more generous time lines, often required by prevention research,
establishing a central mechanism for coordination of investigator-initiated
proposal submissions. While the state or any institutions should increase the
portion of its budget allocated to population and community-based prevention
research that evaluates the application and impact of new discoveries on the
health of the population, focuses on behavioral and/or environmental factors
associated with primary and secondary prevention of disease and disability in
populations.
The public health practitioners need in
order to work at the inter - section of the following areas on built
environment and health; work and health; housing and health; media and health; public
interest law and health; tax structure and health and corporate business and
health. And the initiative will
encourage getting other sectors to involve as a partner in public health work
for action.
However, this paper also
highligthened the importance of role of women in all spheres of health should
be re-examined. Women are one of the strongest means for improving health in
families and communities. They form the huge majority of those working in
health care, mostly being in underpaid jobs with serious occupational hazards. Empowering
women and avoiding medicalization are health promoting strategies that should
be integrated into health care organizations. Self-help and patients’ rights
groups should be institutionalized as main interested parties in all health
programmes. It should be ensured that women’s interest groups and consumer
organizations lobbying for patients’ rights receive adequate funding to
represent the weakest groups within the health care system.
Women themselves should be
encouraged to be actors, partners and decision-makers in all work in women’s
health. Women’s voices have often been ignored in policy development, programme
design and priority setting. The voices of women are essential as both
providers and consumers of health information, service and care.
[1] World Health Organisation. Women's Health
Strategic Planning International Cooperation Europe. Copenhagen: Regional Office for Europe. 2001. p.10.
[2] Neft, Naomi, Levine, Ann D. „An International
Report on the Status of Women in 140 Countries 1997 – 1998.“ Women' in
Today's World. USA:Random House New York. 1997. p.5.
[3] Smajkic A, and associates. Health Status of
Population Bosnia and Herzegovina, Report 2005. Council of Ministers Ministry
of Civil Affairs. Institute for Public Health of B&H, Sarajevo. 2006.
[5] HEALTH21. „European Health for All Series.“ The health for all policy framework for the
WHO European Region. Copenhagen:
WHO Regional Office for Europe. No. 6. 1999
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