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Implementing Madrid Plan of Action on Ageing: What learnings in the last 15 years? What future directions?

Abbreviations

Abbreviations: MIPAA: Madrid International Plan of Action on Ageing; DHS: Demographic and Health Surveys; MICS: Multiple Indicator Cluster Survey; AAI: Active Ageing Index; ECE: Economic Commission for Europe

Short Communication

It's no secret that the world's population is aging. As fertility declines and life expectancy increases, the proportion of people in older ages is projected to grow in all regions of the world. Therefore, it is increasingly important to develop metrics that assess the effectiveness of policies and programmes affecting older people. The Madrid International Plan of Action on Ageing (MIPAA), developed in 2002, is central to this measurement agenda. It set out three priorities to guide countries in their policies:

a) Older persons and development (in particular

promoting social protection).

b) Advancing health and well-being into old age.

c) Ensuring enabling and supportive environments.

Fifteen years later, it is timely to assess the effectiveness of the Madrid Plan and indeed reviewing it is a theme of the next UN Commission for Social Development. The MIPAA started with great promise as one of the only international policy frameworks to focus on older people. The latest UN review of MIPAA shows that despite progress in policy formulations, its implementation remains uneven across countries and the three policy priority directions. Major constraints include lack of resources, political will and data.

So, what have we learned from the process? What do we need to do now?

The MIPAA experience so far offers one major lesson: its monitoring lacked a comprehensive global approach. This was partly because of lack of age-disaggregated data in many countries, but mainly for the fact that the MIPAA monitoring toolkit has not been properly developed. In such introspection, another critical question is: how MIPAA stays relevant when the international community is committed instead to its newest and most comprehensive policy framework to date, the 2030 Agenda of sustainable development.

MIPAA Monitoring Lacks a Comprehensive Global Approach

While progress is being made in the implementation of the MIPAA, there is no comprehensive global approach towards its monitoring. Metrics are an area that some feel was underdeveloped in the Plan. This in turn has led to a disproportionate submission of anecdotal, descriptive and self-defined information, with little evaluation of the relationship between outputs and policy impact. In particular, the limited use of indicators in national reporting has hampered comparisons of country-level progress. Such inconsistency and varied reporting is unsurprising in such a voluntary system. A specific example is on reporting progress towards sensitising and reducing elder abuse. Nordic and Western European countries introduced programmes that led to increased reporting and development of policies to prevent violence against older persons.

In contrast, very limited information is available in many Eastern European countries on the extent of violence, abuse and neglect of older persons. Even where data are available, cases are often underreported and prevention policies are lacking. Greater national capacities are needed: not only to design comprehensive policies for the older population but also to provide specific guidelines in assessing their progress. Detailed guidance on data collection, including timescales for reporting, is an area where investment will have significant impacts on the success of the MIPAA. This is even more important now that demographic aging has taken hold within developing as well as developed countries.

Lack of Age-Disaggregated data has been a Major Constraint

Fundamental to the successful implementation of the MIPAA is reliable country-level data collection and research, areas for which there was little guidance in the MIPAA's recommendations. In developing countries, the lack of data disaggregated by age and sex for even basic sociodemographic and health indicators is acute and makes tracking implementation of the MIPAA difficult. For example, in the majority of African countries, much of the available data are for younger age groups. Data that is especially important to older persons. It is not surprising that many African countries were not represented in Help Age International's Global Age Watch Index. Part of the problem lies in the fact that many surveys stop short of collecting data on older persons. USAID's Demographic and Health Surveys (DHS) and UNICEF's Multiple Indicator Cluster Survey (MICS) serve as two of the biggest tools for generating global statistics and they focus mainly on children and women under the age of 49. There could be the option of removing the age-cap in these existing global surveys, as has been done by South Africa.

However, a more desirable option will be that countries invest in collecting data using the specialised survey instruments and methodologies to collect data on older men and women. The new national survey on older persons in Iran, to be conducted during 2018, is a good practice example in this respect where policymaking communities in a resource-constrained country appreciate the value of high-quality evidence base on older people. The formation of the new UN Titchfield City Group on Ageing and Age-disaggregated data provides us a unique opportunity to ensure that countries learn from each other in the collection of age-disaggregated data and monitor progress in the implementation of the MIPAA.

The MIPAA Monitoring took it needs to be Developed

I believe an investment in global assessment tools is also vital to ensure that the MIPAA is implemented seriously. I suggest that a dashboard of indicators aligned with the key priorities of the MIPAA - including an adaptation of the Active Ageing Index (AAI) - should serve as the toolkit for monitor MIPAA implementation in the future. The composite AAI will help point to priority countries by comparing the index value. The dashboard of indicators can then help identify in which areas a country is doing well (or falling short) and what learnings can be drawn from the good global policy practices.

The AAI comprises 22 indicators, organised around four domains:

a) Employment;

b) Social Participation;

c) Independent, healthy and secure living and

d) Capacity and enabling environment for active ageing.

The AAI indicators are disaggregated by gender and in large part focus on people aged over 55. The AAI evidence can be summarised in an aggregated country-level score, facilitating global comparisons and the production of a league table. It identifies contexts in which older people fare better, and point to policy interventions that are effective in empowering older people and ensuring their rights. The AAI indicators was used by the UN Economic Commission for Europe (ECE) in the third cycle review of MIPAA, starting in 2015, to reflect the outcomes of ageing policies and to measure the untapped potential of older people. The latest AAI results for European countries show that Sweden, Norway, Switzerland and Iceland are at the top of the ranking, followed closely by Denmark, the Netherlands, Finland, the UK and Ireland.

Future Directions for MIPAA Implementation

I believe that the Sustainable Development Goals of the 2030 Agenda have put ageing back onto the international development agenda. The two pledges made, 'Leaving no one behind' and 'Reaching the furthest behind first', give us a strong momentum to seek inclusion of older people in all policymaking. We are therefore aspiring to live in a world in which no development process is complete without the objective of the promotion of quality of life of vulnerable groups of society, such as the older population, and where the older population's participation make them key contributors to the development process (Figure 1).

To read more articles in Journal of Gerontology & Geriatric Medicine

Please Click on: https://juniperpublishers.com/oajggm/index.php

For more Open Access Journals in Juniper Publishers

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RN III – ICU Open Heart

Overview:

Welcome to St. John’s Regional Medical Center.

At Dignity Health, we believe in the healing power of kindness. Since 1912, we have been giving something forward to the people of Oxnard, California. St. John’s Regional Medical Center is a 266-bed facility employing more than 1,200 caring professionals and a medical staff of more than 600 active physicians. We offer a 23-bed acute rehabilitation center, and provide a wide array of programs and services that include oncology, cardiovascular, maternity care, orthopedic, weight loss surgery, spinal disease treatment, community outreach and more.

Our passion for inspiring a stronger, healthier world compels us to lead with our hearts as we serve the community of Oxnard. One of the most beautiful areas in the country, Oxnard is nestled between Los Angeles and Santa Barbara, and offers residents spectacular beaches, clean air and open spaces, as well as easy access to California wine country. We invite you to join us in delivering humankindness, one person at time.

Dignity Health Central Coast is comprised of five hospitals, all recognized for their quality of care, safety and service, primary care offices, premier ambulatory surgery centers, technologically advanced imaging centers, outpatient services and comprehensive home health services. Hospitals in the Dignity Health Central Coast region include Arroyo Grande Community Hospital in Arroyo Grande, French Hospital Medical Center in San Luis Obispo, Marian Regional Medical Center in Santa Maria, St. John’s Pleasant Valley Hospital in Camarillo and St. John’s Regional Medical Center in Oxnard. Each hospital is supported by an active philanthropic Foundation to provide additional funding to support new programs and services, as well as to advance the community’s access to health care. For more information, visit: https://ift.tt/2AdatE4

#RN-DH

ResponsibilitiesAbout this position: In keeping with the Dignity Health core values, the Clinical Nurse III is an advance practitioner who is an expert in bedside nursing care and is also capable of directing/coaching staff in the daily operations of the nursing unit. Completes daily operations of the nursing unit. In this role the RN Clinical Nurse III will act as a mentor, preceptor, and resource for the Clinical Nurse I and II; as well as other staff members in the unit. The incumbent must be able to provide advance consultation in patient care problems for a given patient population. KEY WORDS: RN, REGISTERED NURSE, MEDICAL, SURGICAL, INTENSIVE CARE, HOSPITAL, CA, CALIFORNIA

#RN@DH

QualificationsMinimum Requirements:

Three (3) years current medical/surgical experience in an acute care setting or in a specialty area.

Heart experience required.

ACLS, PALS and BLS certifications required.

Current CA RN license required.

Preferred Qualifications:

Bachelors of Science in Nursing preferred.

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Connect With Us! Not ready to apply, or can’t find a relevant opportunity? Join one of our Talent Communities to learn more about a career at Dignity Health and experience #humankindness. Equal Opportunity Dignity Health is an Equal Opportunity/ Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here. Dignity Health will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c).

External hires must pass a post offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). Dignity Health participates in E-verify.

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[optometrist0]

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