62nd General Assembly, March Meeting 2013–Washington, D.C., USA (AMSA-USA)

The American Medical Student Association (AMSA), the nation’s oldest and largest, independent association for physicians-in-training, has been selected to host the 62nd General Assembly of the International Federation of Medical Students’ Associations (IFMSA) in March 2013, the world’s largest gathering of medical students. More than 2,500 physicians-in-training from more than 100 countries are expected to attend the event, which will be held in Washington, D.C., March 5-15, 2013. AMSA’s Annual Convention will be held March 14-17, 2013.

“The General Assembly is going to be an amazing opportunity for the world’s future physicians to come together on one stage, in the powerful city of Washington D.C., to champion health access, health equality and the social determinants of health for our global citizens,” says Danielle Salovich, AMSA national president, 2011-2012. “As we continue to fight for women’s health rights, access to medicines across the globe and healthcare for all, there has never been a more important time for medical students to join together.”

The theme of the meeting will be AMSA hopes to empower attendees and provide them with the tools they need to improve health care by using their voice to shape the policies that influence the medical profession. Advocacy has increasingly been recognized as a core element of medical professionalism. Due to their role in society and the unique features of the doctor-patient relationship, physicians and physicians-in-training are uniquely suited to advocate with and for patients.

“As part of the General Assembly, thousands of medical students will rally for social justice in the U.S. health care system and across the globe,” says Elizabeth Wiley, JD, MPH, and AMSA president-elect. “We are also looking forward to the hands-on workshops for attendees to gain advocacy training surrounding specific topics of interest: social determinants of health, medical professionalism and conflict of interest, patient safety, mental health and more.”

As a unique post General Assembly option, delegates will have the opportunity to attend AMSA-USA’s 63rd Annual Convention in Washington, D.C. Before the meeting, delegates may travel to NYC, Boston or Philadelphia.

AMSA joined IFMSA and became the United States’ National Member Organization (NMO) in 2008. The last IFMSA General Assembly held in the United States was more than 35 years ago.

For more information, visit

Written by: Kim Cunningham pr@amsa.org

61st General Assembly, August Meeting 2012–The Indian Experience (MSAI-India)

The next IFMSA General Assembly, August Meeting 2012 will be held in Mumbai, India. The host is one of our most recent candidate members MSAI (IFMSA-India). The theme will focus on universal health care. Need for Universal Health Care

Theme: Universal Health Care – The Time is Now!

Universal health care – sometimes referred to as universal health coverage, universal coverage, universal care or social health protection – describes health care systems organized around providing a specified package of benefits to all members of a society with the end goal of providing financial risk protection, improved access to health services, and improved health outcomes (World Health Report, 2010).

Last year, our Federation renewed its commitment to the vision of Alma Ata – a world where health is a fundamental human right, a universal societal goal, and a state of well-being enjoyed by everyone. In short, health is for all.

Our tracks…

  • In March Meeting 2011 in Jakarta, Indonesia we looked into the gross disparities in health that continue to afflict the majority of the world’s peoples.
  • Our 60th anniversary General Assembly in Copenhagen, Denmark last August Meeting 2011, we imagined the future of health and looked into various ways towards achieving a healthier and more just world. Image
  • March Meeting 2012 in Accra, Ghana, we recognized action on social determinants of health as the key intervention for achieving global health equity.

Action…

Beginning by addressing health inequalities through action on social determinants of health?

The WHO Commission on Social Determinants of Health identified the health system as one of the crucial determinants of health within countries, and proposed that universal access to health care as a starting point. Today, nearly 100 countries are investing huge resources, establishing agencies, commissioning researches, and holding consultations as they all rush towards the finish line of universal health coverage.

In line with IFMSA’s commitment on this, Universal Health Care will be the theme for the IFMSA General Assembly this August Meeting 2012.

India is a great place to collaborate, share, exchange and build efforts surrounding universal health care. India is a country experiencing a transition towards provisions of easily accessible and affordable health care to all Indians by 2022. A national health-insurance scheme geared towards increasing access for the poor started rolling in April 2008, and so far it has enabled 100 million to have cashless, paperless, portable access to inpatient health care provided by more than 8,000 public and private hospitals across the country. India is more than willing to share its universal health care journey to IFMSA, and to learn from other health systems through IFMSA’s medical students from around the world.

Through the theme events of IFMSA-India and the OC, they hope to gather in one room the leaders of the Universal Health Care movement in India and the amazing medical student-advocates of IFMSA, and spark dynamic discussions about how universal health care can be a reality – and how we doctors-in-training can play our part.

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Mumbai

Mumbai being the hosting city for IFMSA’s 62nd GA – AM 2012 India is, known as the commercial capital of India. Before 1996, Mumbai was known as ‘Bombay. Its original name ‘Bombay’ emerged from the Portugal term ‘Bom Bahai’ meaning good bay/harbor. It is also known as Manchester of India. With the opening up of the Suez Canal in 1869 the city’s future as India’s primary port, was assured. Now, it is the second biggest city in the world.

IndiaImage

India, officially the Republic of India, is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world. Bounded by the Indian Ocean on the south, the Arabian Sea on the south-west, and the Bay of Bengal on the south-east, it shares land borders with Pakistan to the west, China, Nepal, and Bhutan to the north-east; and Burma and Bangladesh to the east. In the Indian Ocean, India is in the vicinity of Sri Lanka and the Maldives; in addition, India’s Andaman and Nicobar Islands share a maritime border with Thailand and Indonesia.

ImageHome to the ancient Indus Valley Civilization and a region of historic trade routes and vast empires, the Indian subcontinent was identified with its commercial and cultural wealth for much of its long history. Four of the world’s major religions—Hinduism, Buddhism, Jainism, and Sikhism—originated here, whereas Zoroastrianism, Christianity, and Islam arrived in the 1st millennium CE and also helped shape the region’s diverse culture. Gradually annexed by and brought under the administration of the British East India Company from the early 18th century and administered directly by the United Kingdom from the mid-19th century, India became an independent nation in 1947 after a struggle for independence that was marked by non-violent resistance and led by Mahatma Gandhi.

The Indian economy is the world’s tenth-largest by nominal GDP and third-largest by purchasing power parity (PPP). Following market-based economic reforms in 1991, India became one of the fastest-growing major economies; it is considered a newly industrialized country. India is a federal constitutional republic governed under a parliamentary system consisting of 28 states and 7 union territories. India is a pluralistic, multilingual, and multi-ethnic society.

IFMSA-INDIA (MSAI)

MSAI – The Medical Students Association of India is India’s largest represented Medical Student Organization & the offical organization that represents IFMSA – India

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Mission
To be a forum for medical students throughout the world to discuss topics related to health, education and medicine; to formulate policies from such discussions and to carry out appropriate activities; To promote humanitarian ideals and medical ethics amongst medical students; To act as a mechanism for medical students’ professional and scientific exchange and projects; To be a body through which cooperation and contacts with other international organizations are established; To act as a mechanism for member organizations to raise funds for projects recognized by the IFMSA.

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Description
India finally joined the IFMSA family and today Medical Students’ Association of India is also known as “IFMSA INDIA.” Our mission is to improve the medical education and public health care management in India & our vision is to enhance medical education, facilitate & establish communication between student organization, not to forget organize rural health programs in the country.

 

http://www.msa-india.org

Author: Roopa Dhatt, IFMSA VPE 2011/12

Contacts:

OC Chair || Pratap Naidu A. Contact: am2012india@msa-india.org

IFMSA Requests: gs@ifmsa.org


WCSDH in Rio: Chile: Steps forward and backward equity

Live from Rio, Cristobal Cuadrado, former president of IFMSA-Chile and member of the IFMSA Delegation to the WHO World Conference on Social Determinants of Health, writes about the Chilean experience in fighting health inequities and acting on social determinants of health. This October, IFMSA-Chile, with Cristobal as general coordinator, organized the First Congress on Health and Poverty in Santiago. The conference was graced by Professor Sir Michael Marmot, head of the 2008 WHO Commission on Social Determinants of Health.

In the context of the World Conference on Social Determinants of Health at Rio de Janeiro, we are having a wide discussion about evidence and experiences of different countries into this field. This entry talks about the Chilean situation on Health Equity from the perspective of the Social Determinants of Health. Dr. Jeannete Vega, past Health Minister Deputy of Chile during the government of Michelle Bachelet, had summit a draft paper (nº25) entitled “Steps towards the health equity agenda in Chile”, this represent a summary and reflection of this paper.

Generalities about Chile and its Health System.

US$ 14,300 in 2010; the minimum wage rose to US$ 350 in 2010 and the current inflation and unemployment rates are 1.4% and 8.6% respectively. Chile scores high in several health indicators, such as life expectancy at birth (81.2 years for women and years for men), infant mortality (8.3 per 1000 live births). The Health System in Chile it is decentralized with 29 local Public Health Services that serve approximately 75 % of the population. The other 25% of the population is covered by a private insurance and provision scheme administered by a number of private insurance institutions (ISAPRE) that provide mainly curative services mostly to those with the highest income, and of younger ages.

As a little history, the actual shape of the Chilean health system is related with the undertaken by the Pinochet military government following the coup d’état in 1973, establishing competition between public and private health insurers and promoted private health services, following neoliberal principles. These principles have changed very little since the early 90ths were the democracy had come again to our country.

The employee mandatory contribution accounts for 7% of the salaries and goes to either the public insurance (FONASA) or the private insurance companies. The National Health Fund (FONASA, Fondo Nacional de Salud) manages public health insurance. All citizens in Chile are insured by Fonasa unless they choose to contribute to a private insurer (ISAPRE). Individuals covered by FONASA may receive health services from either public facilities or a preferred private provider. The Ministry of Health manages vertical programs, public health interventions, and the health care personnel from public facilities. The focus on Primary Heath is location of the health centers and the income level of the municipality, where a health center located in historical context leading to action on Social Determinants and Health Equity

Timeline on Health&Equity issues during the past 20 years

1990-2000

Two streams of social policies were developed during the 1990’s. Firstly, sectoral policies, such as education, health and housing, centered on guaranteeing an adequate level of services and benefits for all the population in an equal opportunity perspective. Secondly, specific programs directed towards disadvantaged vulnerable groups to ensure access to the opportunities available through the sectoral policies, economic growth and development in general.

2000 -2010

Between 2000 and 2006 the emphasis was put in introducing programs to improve structural social determinants: improving neighborhoods conditions (Chile Barrio), diminishing extreme poverty (Chile Solidario) and others. All these programs had in common a policy and programmatic approach centered on the perceived needs of the person, in a family and in a community, rather than on the supply based normative needs, with services built around them on an integrated (intersectoral) manner.  The landmark social program of the last government of this period is Chile Crece Contigo, a program with deep roots on the perspective of SDH, so we will go a little bit further on this experience.

 

Chile Crece Contigo (Chile Growth with you): an intersectoral approach to tackle inequities from the beginning.

The central principle on this program is “Equity from the beginning”. Chile Crece Contigo initiative for action included the Rights of Children and the State’s responsibility to ensure them as a universal principle, creating a integrated system based on rights during the life course. The Ministries of Planning and Finances leveraged funding to investigate policy alternatives, systematize and evaluate innovative local projects and develop possible interventions, including pilot experiences. The evidence base of effective interventions, that the Ministry of Planning and other sectors were building, also looked at international experience

After a long work, in October 2006 President Bachelet announced the creation of the integrated and integral social protection system for early child development, called Chile Crece Contigo. Its social equity goal was ambitious and aimed to eliminate socioeconomic differences in achieving maximum development potential across the social gradient.

The system would accompany children and their families from gestation until they entered the school system in pre-kinder, age 4 years. Chile Crece Contigo would provide all boys and girls access to universal benefits and services to take care of their necessities and support their development in each stage of the life cycle, during early childhood. Additionally, it would contribute to induce basic conditions in the psycho-emotional and physical environment in order to favor harmonious and integral development, in accordance with the evolution of their life course. During 2007 new programs were introduced that required integrated action by two or more sectors: Support for Biopsychosocial Development (Ministry of Health, Ministry of Development, the Fund for initiatives to support local child development initiatives (Ministry of Planning– municipalities) and Fund for Childhood Initiatives (Ministry of Planning – public, private and community agents).

Chile Crece Contigo offers different levels of support and guaranties for all boys, girls and their families. To each according to his/her specific needs.

  1. Strengthened legislation and standards of protection for maternity and paternity for all population.
  2. Free Nursery and Preschool access for the 60% of more vulnerable families
  3. Improved quality in prenatal care.
  4. Humanized birth (with participation of the father)
  5. Improved well child care, especially for the first 2 years (Biopsychosocial support)
  6. Strengthened access to health care for all boys and girls from the first prenatal control until entry into the school system
  7. Increased support and guarantees for boys and girls from the 60% of homes with lesser income or in special situations of vulnerability.

The process of implementation of Chile Crece Contigo to date includes the action in all the Municipalities within the Country through generation of the local intersectoral networks in charge. Since 2007:

  • More than 649.132 pregnant women have enter the program
  • Almost 75% of eligible births (non-emergency) have occurred with the presence of the father since 2009.
  • More than 90.000 visits to the households of pregnant women with social risk.
  • More than 1.000.000 educational sessions to promote early child development (ECD) with families of children at risk.
  • More than 270.000 visits to the household of families with children at risk in their development.
  • Since September 2009, every child born in Chile receives a set of basic implements for initial child care including a cradle, a baby carrier, massage oil, diapers, and much information on first care needed by babies and infants.

The decree that accompanied the Law established a Committee of 9 Ministers, headed by the Minister of Planning and including Health, Education, Justice, Women’s National Service (SERNAM), Finance, Presidency, Labor, Housing. The national technical committee has also been expanded to include all the public services related to children. The preeminence of Health for early child development is expressed in a permanent working group.

The principles of intersectorial approach, equity as a key social goal, focus on education and early childhood, high political commitment and social participation are remarkable aspects of this program that probably will produce outstanding results on the future development of the Chilean society.

National Agenda on SDH. And some lessons of the Chilean experience.

Given the presidential mandate to improve Equity in health as part of the broader objective of improving social Equity, in early 2008, the Chilean Ministry of Health decided to create the Executive Secretariat on Social Determinants of Health, as part of the Subsecretariat of Public Health, within this area an special plan had been create: the “13 pasos hacia la Equidad” (13 steps towards Equity – www.equidad.cl) initiative, aimed at improving the level and distribution of health within the population of Chile. As part of the agenda, six objectives were defined, each of them involving concrete actions aimed at contributing to equity in health in Chile:

Specific objectives of the agenda:

  1. To contribute to the reduction of social inequalities which generate health inequities
  2. To reduce inequities which restrict and limit access to health and health services
  3. To implement actions for the “social inclusion” of excluded groups and territories
  4. To develop competencies on equity and social determinants of health within the Ministry of Health staff
  5. To generate tools for planning, monitoring and evaluation of the SDH and equity in the health sector
  6. To establish bodies and mechanisms for the coordination and integration of various sectors to develop the necessary actions to reduce health inequities

The first of these objectives had been addressed partially through the Chile Crece Contigo that we had already talked about. Another example is the objective 3 had become practical with the implementation of the programs “Vulnerable Counties” and “Vulnerable Neighborhood” focusing on the 96 most vulnerable counties and 68 neighborhood of the country with the goal to promote the reduction of inequities in health in the most communities, by means of interventions aimed at the main barriers of access to health services and to the social protection system, which were identified and prioritized by the community itself.

This Secretariat and his worked until March 2010 promoting a work agenda. We had to make the point that one of the first actions of the new central right party Goverment was to close this important secretariat

Some lessons

The “13 pasos” agenda is also one of few experiences in Chile where the Ministry of Health has been able to play a true leading role. The process of developing and implementing the “13 pasos” agenda influenced the philosophy of people within the ministry of Health but also from other sectors. During the process, we learned some lessons that could be generalizable to others that are involved in similar processes.

  • Lesson 1: In order to strengthen health equity, there must exist explicit political commitment at the highest level
  • Lesson 2: The need for an explicit agenda with incentives
  • Lesson 3: Building trust is a must
  • Lesson 4: Intersectoral relationships are crucial
  • Lesson 5: The community is essential
  • Lesson 6: Training as a strategy for institutionalization

Actual challenges, civil society participation and the future

 

The inequalities in Chile area a huge problem. On income measures for example, the richest 10% earn 36 times more than the poorest 10% and the 20% richest group of Chile share about 50% of the GDP of the country. Taking some health examples, with a very good Infant Mortality Rate of 7.7 as average, there is a 3-fold difference between the less educated and better educated groups. Even more, in life expectancy, the gap increase till 14 and 10 years between the richest and poorest groups, for woman and men respectively. Nevertheless, the worst statistical analysis is that the trends are not diminishing but increasing in the last decades.

In this context we organize and held at Santiago, past 7,8,9 and 15 of October the first Congress on Health and Poverty in Chile, as a voice from the Civil Society to contribute to maintain the health and equity issues and social determinants of health approach into the national agenda. IFMSA was of course involved. It was more concretely, a Health and Equity congress, to widely discuss this issue, the actual policies and problems, gathering civil society, politicians, academicians and other stakeholders with a perspective of future. For Spanish speakers you could enter to our webpage to have more information and access to the presentations. Soon we will have all the conferences online for free access.

At the actual context, the urgent situation and critical inequalities on our country, the civil society is reacting and taking their own responsibility. So different NGOs and young leaders are getting around a platform todiscuss, propose, advocate and create whole society awareness of the needed actions to tackle the terrible inequalities of our country. Heath&Equity will be the future on that. You could check a small presentation with the graphs and a wider analysis and some proposals from the Health&Equity civil society movement in Chile for the future: http://www.saludypobreza.cl/wp-content/uploads/2011/10/Towards-Equity-in-Health.pdf

Do you want to know more about Chilean experience on Health and Equity? Discuss a little bit about? Share your troughs? More than welcome. ccuadrado@saludypobreza.cl

Cristobal Cuadrado