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IMPROVING THE IMPACT ON HEALTH: THE SOCIAL ACCOUNTABILITY APPROACH

The world is changing dramatically as a combination of unprecedented demographic, epidemiological, economic and political factors has a major influence on people's health. We need to understand what is really at stake and how we can adapt to preserve the highest possible level of health for all citizens in our society. It is essential that societal health needs and social accountability principles be clearly defined to ensure relevant and efficient action is taken in whatever system, organization and institution we work in. If health, as defined by World Health Organization as a complete state of physical, mental and social wellbeing is indeed the focus, then acting on the spectrum of political, economic, cultural, environmental determinants of health is imperative. Therefore, major stakeholders, such as policy making bodies, professional associations, health service organizations, health insurance companies, academic institutions, industry and civil society, should work synergistically towards the attainment of basic values of quality, equity, relevance and cost-effectiveness in health care. It is in reference to those core values that new roles and strategies for institutions, professionals and civil society should be designed and implemented.

Among those stakeholders, health professional schools are in a privileged position to create a momentum for partnership in health if they are truly engaged in reorienting their educational, research and health care provision functions to better serve current and anticipated priority health needs and challenges of society. With respect to their educational function, for instance, it is obvious that the range of competences of health professionals needs revisiting to respond to a more person centered approach requiring coordinated services to cater for comprehensive needs of an individual, particularly at times when chronic diseases and multiple discomfort affect aging populations.

Similarly for their research and service functions, important transformations are required, as stated in the Global Consensus for Social Accountability of Medical Schools (www.healthsocialaccountability. org), whose principles apply equally to nursing schools.

The social accountability approach for a nursing school - as well as for any stakeholder in health- is featured by a triple capacity: the identification of current and future health challenges, the implementation of strategies to address them, and the demonstration of impact. Social accountability is the highest level of social obligation compared to what is commonly called social responsibility or social responsiveness.

A socially responsible school is implicitly aware of society's priority needs and is mainly guided by intuition and common sense, while a socially responsive school has an explicit knowledge of needs by a critical appraisal of facts and is therefore in a better position to direct its action programs and resources to clearly identified goals to obtain measurable results. The added value of a socially accountable school is in its commitment to ensure its "products", ie. graduates, research findings or health care models, are really making an impact for an efficient and equitable health system resulting in people's improved health status. In this case, a solid partnership with main health stakeholders is a requested.

In the context of economic crisis and political uncertainty, people's expectations can only be met if health actors become more aware and accountable for the short and long term consequences of their deeds. With a growing quest for greater transparency on the performance of health professional schools, recognition of excellence should be attributed to institutions able to demonstrate their direct and indirect impact on health of the public. At national level, new norms and procedures for evaluation and accreditation should be designed and rewards provided accordingly. It is unique opportunity for researchers in any health field, including nursing, to critically examine how progress can be made towards greater social accountability of health institutions and map out areas requiring reforms.

Publication Dates

  • Publication in this collection
    July-Sep 2015
Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br