Cyprus Epidemiology and Public Health Association

22/08/2026

Ερώτηση: Πώς ακριβώς προκύπτει το συμπέρασμα ότι η λύση στα προβλήματα του ΓεΣΥ είναι… περισσότεροι ΟΑΥ;

Το παράδοξο είναι ότι όλα όσα αναφέρονται στην ανάρτηση είναι πράγματι υπαρκτά προβλήματα και σωστές προτεραιότητες για το ΓεΣΥ - Οργανισμός Ασφάλισης Υγείας:

➡️ «ανταγωνισμό στην ποιότητα και στην εξυπηρέτηση»
➡️ «δημοσίευση συγκριτικών αποτελεσμάτων για χρόνους αναμονής, ποιότητα υπηρεσιών, κόστος, αποτελέσματα υγείας και ικανοποίηση των ασθενών»
➡️ «ισχυρότερα κίνητρα για πρόληψη»
➡️ «καλύτερη πρωτοβάθμια φροντίδα και διαχείριση των χρονίως πασχόντων»
➡️ «μεγαλύτερο συντονισμό μεταξύ προσωπικών γιατρών, ειδικών, νοσοκομείων, εργαστηρίων και φαρμακείων»
➡️ «περισσότερη καινοτομία και τεχνολογία»
➡️ «καλύτερη διαχείριση ραντεβού και αξιοποίηση των δεδομένων προς όφελος του ασθενούς»
➡️ «ισχυρή και ανεξάρτητη κρατική εποπτεία»

Όμως, από αυτή τη διάγνωση μέχρι το συμπέρασμα ότι η θεραπεία είναι να κατακερματίσουμε τον έναν ΟΑΥ σε δύο, τρεις ή τέσσερις οργανισμούς υπάρχει ένα μεγάλο νοητικό άλμα.

Δεν εξηγείται με ποιον μηχανισμό αυτή η αλλαγή θα επιλύσει τα προβλήματα που όλοι γνωρίζουμε ότι υπάρχουν.

Άσε που υπάρχει και μια μικρή ειρωνεία στον όρο «ΓεΣΥ 2.0». Γιατί, αν πάρουμε το σημερινό σύστημα με τις ίδιες αδυναμίες και απλώς το κατακερματίσουμε σε περισσότερους οργανισμούς, μάλλον δεν θα έχουμε δημιουργήσει ΓεΣΥ 2.0. Θα έχουμε δημιουργήσει ΓεΣΥ 1.1, 1.2, 1.3 κ.ο.κ.

Δηλαδή περισσότερες εκδοχές του ίδιου συστήματος, με τα ίδια άλυτα προβλήματα — και πιθανώς με επιπλέον προβλήματα συντονισμού και κατακερματισμού.

Γιατί το βασικό πρόβλημα σήμερα δεν είναι ότι έχουμε «μόνο έναν ΟΑΥ».

Είναι η διαχρονική δυσκολία του ΟΑΥ —και θα ήταν εύλογο να αναρωτηθούμε γιατί δεν θα την αντιμετώπιζαν και οι ΟΑΥ 1.1, 1.2 και 1.3— να λειτουργήσει ως πραγματικά στρατηγικός αγοραστής υπηρεσιών υγείας: να εφαρμόσει κατευθυντήριες οδηγίες και πρωτόκολλα, να αναπτύξει μηχανισμούς ελέγχου και διασφάλισης ποιότητας, να καθορίσει ουσιαστικούς δείκτες ποιότητας και αποτελεσμάτων και να συνδέσει με αυτούς τη συμβατική σχέση και την αποζημίωση των παρόχων.

Και, κυρίως, να τους δημοσιοποιεί.

Γιατί εδώ η αρχική ανάρτηση βάζει ίσως ένα από τα σημαντικότερα ζητήματα: «δημοσίευση συγκριτικών αποτελεσμάτων για χρόνους αναμονής, ποιότητα υπηρεσιών, κόστος, αποτελέσματα υγείας και ικανοποίηση των ασθενών».

Ακριβώς. #Δημοσιοποίηση. Όχι απλώς συλλογή δεδομένων. Όχι δείκτες που παραμένουν εσωτερική πληροφορία του συστήματος. Δημόσιοι, συγκρίσιμοι και ουσιαστικοί δείκτες ποιότητας και αποτελεσμάτων ανά #πάροχο, ώστε ο πολίτης να γνωρίζει, να μπορεί πραγματικά να επιλέγει και οι ίδιοι οι πάροχοι να λογοδοτούν για την ποιότητα των υπηρεσιών τους.

Όμως, εδώ καλά-καλά δεν έχουμε καταφέρει να συμφωνήσουμε ότι αυτοί οι δείκτες πρέπει να δημοσιοποιούνται. Ακόμη και η συζήτηση του θέματος συναντά αντιστάσεις, με διάφορες προφάσεις για το γιατί «δεν μπορεί» ή «δεν πρέπει» να γίνεται.

Αν λοιπόν χρειαζόμαστε περισσότερο ανταγωνισμό, ας δημιουργήσουμε πρώτα πραγματικό ανταγωνισμό μεταξύ των παρόχων στη βάση διαφανών, δημοσιευμένων και συγκρίσιμων κριτηρίων ποιότητας. Εκεί η επιλογή του πολίτη μπορεί πράγματι να λειτουργήσει ως μοχλός βελτίωσης.

Ασφαλώς το ΓεΣΥ χρειάζεται πρόοδο και εξέλιξη (όχι απαραίτητα μετεξέλιξη). Αλλά, αυτό δεν σημαίνει ότι πρέπει να ξεκινάμε από μια οργανωτική λύση, επειδή υπάρχει κάπου αλλού, και να αναζητούμε ποια από τα δικά μας προβλήματα μπορεί να λύσει.

Ας αναρωτηθούμ: ποιά είναι τα πραγματικά προβλήματα (τα γνωρίζουμε και πάνω-κατω συμφωνούμε όλοι) και ποιοι οι πραγματικοί λόγοι που τα δημιουργούν ή/και τα συντηρούν (εδώ είναι που δεν συμφωνούμε πάντα). Μόνο έτσι οι παρεμβάσεις θα είναι στοχευμένες.

Διαφορετικά, αντί για το ΓεΣΥ 2.0 που πράγματι χρειαζόμαστε, θα καταλήξουμε με πολλά ΓεΣΥ 1.x.

Ή, κατά την παροιμία, "αντί να δείρουμε τον γάιδαρο, δέρνουμε το σαμάρι".

18/08/2026

An interesting and rather unsettling read about the return of ideas and practices that we might have assumed modern medicine and public health had left behind long ago.

👉 COVID undoubtedly contributed to the loss of in science, medicine and public health.
❓️But was COVID really the - or did it simply expose, accelerate and amplify something that was already happening?

■ It is increasingly difficult to see what is happening in in isolation from what is happening in other areas of our lives.

■ We seem to be living through a broader questioning, even active dismantling, of things that, perhaps rather complacently, we had come to regard as settled principles of modern social life.

■ And this extends far beyond evidence-based policy and practice:
○ human rights and civil liberties;
○ equity and social justice;
○ gender equality and inclusion;
○ respect for the rule of law and democratic institutions;
○ ethical reasoning and professional standards;
○ scientific expertise and academic freedom;
○ solidarity and collective responsibility;
○ the value of the common good;
○ and, importantly, an understanding that many societal problems have structural and systemic roots rather than simply reflecting individual choices, behaviours or failings.

■ And somewhere in this sits a growing culture: the idea that challenging the established position is inherently evidence of independent thought; that consensus itself should make us suspicious; that expertise is establishment; and that almost anything associated with “woke” thinking (however loosely that term is defined) is something to be reversed.

Public health certainly needs to reflect on its own role in creating the conditions for mistrust. One comment in the article is particularly important:

👉“I think being critical of people who draw the wrong conclusions is one of the major errors in public health.”

Exactly❗️❗️

The people who turn to misinformation, questionable treatments or simplistic explanations are not the cause of the problem. They are often its recipients — even its victims. Focusing criticism on them is rather like focusing on people experiencing poor health while ignoring the conditions that produce it.

That is, after all, one of the most basic principles of public health: look upstream.

□ Why are people losing trust?
□ Why are simple explanations more attractive than complicated evidence?
□ Why do alternative systems fill the gaps left by institutions?
□ Why does contrarianism resonate? And what structural, social, commercial and political forces benefit from that mistrust?

There is a revealing line elsewhere in the article:

👉 "When we don’t acknowledge structural issues, people tend to look for other systems to fill in the gaps.”

❓️Perhaps COVID was a remarkable amplifier of all this. But is COVID where the story started?❓️

Perhaps, what we are witnessing is not simply an anti-science or anti-public-health moment at all.

It is part of a much wider debate about what counts as progress and whether some of the things we thought society had learned are now being deliberately unlearned.

https://edition.cnn.com/2026/08/16/us/modern-wellness-medieval-middle-ages-cec

11/08/2026

💉🥤 If we are going to measure in soda bottles, perhaps — just for Public Health fun — we should also measure in vaccine doses.

Before, we should clarify that the claim that children have the equivalent of a soda-bottle of liquid, "with an explosive combination of vaccines", “pumped into their bodies” through vaccination is simply not true. It is false. No question about that.

But, it is a powerful image. And, a communication trick, when it comes down to it.

So, let’s reverse it. Instead of vaccines (falsely) being measured in soda bottles, let's measure soda in vaccine doses(accurately).

🥤 🥤 According to an estimate cited by the American Academy of Pediatrics, children in the United States consume more than 30 US gallons of sugary drinks, on average, every year.

(This estimate refers to American children, but let's run with it - it' d be interesting to know how this figure compares with Cypriot children)

💉 Measured in 0.5 mL typical volumes, that is roughly: 227,124 vaccine doses of soda. And that is every year. So, imagine an infinite supply of syringes filled with soda for every child, every year!

Yet, perhaps, this image (even though, it is actually based on true estimates) may not have quite the same emotional punch as imagining a bottle-sized cocktail of vaccines being “pumped” into a child. And that is the problem.

📏 Units can help us understand scale.
They can also be used to manufacture alarming images.

Paint a sufficiently alarming imaginary picture, especially one that plays to pre-existing fears and confirmation bias, and the image may stick, even when the claim behind it is simply false.

Sometimes, when extraordinary and unfortunate comparisons (soda, really!!?) become the of the day, a little arithmetic may be the most useful function of all. 😉

07/08/2026

❓️Ever heard of the Cyprus Malaria Eradication Programme?
❓️Ever heard of Mehmet Aziz?
❓️Ever wondered how malaria was actually eradicated from Cyprus?
❓️Ever wondered about the legacy of one of the most famous eradication programmes in the history of public health — a story that we, Cypriots, have barely heard of?

❓️And ever wondered how, today, we respond to new invasive species and the re-emergence of vector-borne diseases?

🎥 Tonight, The by After Malaria group is being screened as part of the International Documentary Festival

■ At its centre is Mehmet Aziz — the Cypriot public health pioneer who led the extraordinary campaign that resulted in the elimination of malaria from Cyprus.

■ A campaign that mobilised hundreds of people, reached every village and every corner of the island, and made Cyprus, the first country in the world to eliminate malaria through a systematic eradication programme.

❗️But The Flycatcher is about much more than one man. And the story of malaria eradication is about much more than mosquitoes.

It is a story about the origins of public health in Cyprus — about science and epidemiology, but also about people and communities; colonialism and political power; poverty and living conditions; labour and organisation; geography and the environment; cooperation and conflict.

It is, ultimately, a story about Cyprus and its people.

And perhaps most strikingly, it is a story that many of us have never heard. Or, if we have heard it, we may only know parts of it.

🏫 Our children may encounter the Cyprus malaria eradication programme at school.

They may learn about Sir Ross, mosquitoes and malaria as an example of ecology, science and intervention in a Geography class.

■ But how many would recognise the name of Mehmet Aziz?

■ How many learn about the hundreds of Cypriots who carried out the work?

■ How many learn about the social and political circumstances in which this extraordinary public health achievement took place?

❗️Because this could just as easily be a History lesson. Or a Biology lesson. Or Anthropology, Sociology or Political Science. And, of course, Epidemiology and Public Health.

In fact, this is a story that could follow us through the , from nursery school to university— each time revealing another layer of this extraordinary (hi)story.

🌍 And it is not only .

As climate and environmental change alter the distribution of mosquitoes and other vectors, as invasive species establish themselves in new places, and as vector-borne diseases again challenge countries across Europe and our region, the questions faced by Aziz and his contemporaries — about surveillance, prevention, environment, communities, collective action and political commitment — remain remarkably relevant.

"The Flycatcher" gives us an opportunity to rediscover a remarkable chapter of our own public health history — but also to look at the story we thought we knew from a different perspective.

🎬 Tonight at the Limassol International Documentary Festival at 18.30.

A story worth discovering.
A story worth discussing.
And a public health legacy worth remembering.

06/08/2026

> "Over the course of the pandemic, virtually any virus-curbing measure—save for vaccines and therapeutics—would come to be characterized as 'lockdowns'."

🤔 As the article says, before answering whether "lockdowns" really worked, we first need to define both what we mean by the term "lockdown" and what their purpose actually was, in order to be in a position to assess their "success".

And that is only the starting point.

We then have to consider:
🔹 What the alternatives were at each point in time as the pandemic unfolded.
🔹 What harms these measures caused in order to achieve their purported goals.
🔹 How those harms compared with the benefits.

🎯 These questions are necessary not only for accountability (which is not really what is happening in the US right now—but that is a whole different story), but also for developing a shared, as much as possible, understanding of what happened.

Such understanding is a prerequisite for better preparedness for the next pandemic, when measures broadly described as "lockdowns" will inevitably once again be among the public health response options.

🌍 Several countries have undertaken such a process of reflection—admittedly, some better than others.

Some, however, are once again seizing the opportunity to politicise the issue.

Other countries have yet to engage in what one might call a mature reflection—whether in written form or otherwise—on their public health response during the pandemic, with a proper assessment of the measures they adopted (or did not adopt), why they did so, and how the inevitably mixed outcomes compared, given differences in implementation, context, and both the short- and long-term balance of benefits and harms.

💭 It is not an easy task. But unless we ask the question, "What would or should we have done differently?, we will never be able to answer the question, "What will or should we do differently next time?"

Note that "would" and "should" are not necessarily the same question.

🔹 *Would* points to a retrospective assessment based on knowledge we now possess but did not have at the time.
🔹 *Should* points to the principles that ought to guide the response, irrespective of information availability.

In many ways, it is actually easier to answer "should" questions than "would" questions. (Again, none of this is really what is happening in the US right now.)

🏛️ It also needs to be pointed out that this kind of institutional reflection is not the same as collective societal reflection. But the former can—and should—facilitate the latter.

❓Has each one of us done our own reflection on what happened during COVID?

Have we questioned enough our own role in the "public health" response—that is, our personal response as members of the public in protecting not only our own health but also the health of others?

As we look for accountability in our governments' response—good, bad, or ugly—do we also seek accountability in our own response?

Have we settled, in our own minds, questions of:
• proportionally necessary versus unnecessary?
• harmful versus precautionary?
• freedom versus restrictions?
• autonomy versus responsibility?
• collective efficacy versus imposed measures?
• bottom-up community action versus top-down orders?
• and the ever-recurring false dichotomy of economy versus health?

🤝 The public's response to the response was, to a considerable extent, the responsibility of governments. So too is creating the conditions for meaningful public reflection after the pandemic.

Not everyone will agree on what really happened during COVID. But have we perhaps lost an opportunity to talk about it openly? To understand each other's perspectives? And perhaps establish some common ground?

To learn. To grow. To prepare.

⚖️ Anything less than that risks turning accountability into persecution masquerading as accountability.

Republican lawmakers and Trump administration officials berated Dr. Anthony Fauci last week, blaming the former chief medical adviser to the White House for causing unnecessary suffering in the Covid pandemic, including lockdowns. But did that even happen? If "lockdowns" could be understood as severe restrictions on movement, the US did not "lock down" on an organized, national scale. The country's pandemic response instead manifested as a patchwork of state and local decision-making. https://cnn.it/4w3Xivj

03/08/2026

🏥 A timely WHO/ European Observatory report on ΓεΣΥ - Οργανισμός Ασφάλισης Υγείας GeSY - and some thoughts on what comes next

The new report on strengthening primary healthcare in Cyprus comes at exactly the right time. It acknowledges GeSY's major achievements in expanding access and reducing financial barriers, but also turns the discussion to the next phase: how to improve quality, efficiency and long-term sustainability through a stronger primary healthcare system.

Many of its recommendations are not entirely new. Several reflect principles that formed part of the original philosophy and architecture of GeSY or ideas that have been discussed, promoted—and at times actively debated—throughout its implementation.

Their value lies not necessarily in their novelty, but in bringing them together within a coherent, evidence-based framework informed by international experience.

💭 Perhaps the most important message, however, is that the themselves are only half the story.

The real challenge is .

The report identifies several important prerequisites, while others are mentioned only briefly or remain implicit. Reading it in the Cypriot context therefore requires us, to some extent, to read between the lines.

Here are a few reflections.

📊 1. Aligning incentives and measuring performance

The report recommends a blended payment model for Personal Doctors, combining capitation, targeted fee-for-service payments and pay-for-performance.

A particularly important distinction is between process indicators (e.g. preventive care, chronic disease management) and outcome indicators, recognising that meaningful performance measurement depends on robust health information systems, appropriate risk adjustment and clinically relevant indicators.

👉 Performance-based payment is only as good as the quality of the data behind it. Reliable indicators, routine evaluation and locally generated evidence are not technical details—they are fundamental prerequisites for reform.

👨‍⚕️👩‍⚕️ 2. Investing in primary care capacity

The report emphasises manageable patient lists, multidisciplinary teams and continuing professional development.

🔹 Patient lists: This recommendation is likely to reopen an important discussion. Interestingly, the original philosophy of GeSY envisaged smaller patient lists that would allow sufficient time for prevention, continuity of care and chronic disease management.

During the design of GeSY, however, the medical profession strongly lobbied for substantially larger lists, and it is reasonable to expect that any attempt to revisit this issue may once again encounter resistance.

👉 Ultimately, optimal list size should be determined by evidence on quality, accessibility and sustainability—not remain fixed through historical compromise.

🔹 Multidisciplinary teams: The report rightly highlights multidisciplinary primary care teams.

This has been discussed for years, yet implementation remains limited.

Nurses in particular continue to be significantly underutilised despite the strong international evidence supporting their role in prevention, chronic disease management, patient education and care coordination.

Importantly, this is not simply a workforce shortage issue. It is also about how professional roles are organised and utilised within GeSY. In fact, if multidisciplinary primary care were implemented as envisioned, current workforce shortage estimates would probably prove to be underestimates.

It is also worth reflecting on why previous incentives encouraging multi-doctor practices achieved only limited uptake. Understanding why organisational reforms fail may be just as important as designing new incentives.

🔹 Continuing professional development: Although CPD has now been institutionalised, implementation is still evolving.

The challenge is no longer simply providing educational activities, but ensuring they address genuine practice needs—and perhaps even more importantly—cultivating a culture where lifelong learning is viewed as part of professional excellence rather than merely another regulatory obligation.

📈 3. Quality-driven contracting

Quality-based contracting may ultimately prove to be one of the most transformative—but also one of the most contested—recommendations.

Resistance from parts of the medical community should not come as a surprise. This is precisely why Recommendation 1 is so important.

👉 Without transparent, clinically credible and widely accepted performance indicators, quality-driven contracting simply cannot work.

Performance measurement is therefore not another recommendation—it is the prerequisite upon which selective contracting depends.

🤝 4. Realigning patient expectations and supporting shared decision-making

The report recommends strengthening public understanding of the role of Personal Doctors and developing decision-support tools.

Public awareness is undoubtedly important. However, previous campaigns have tended to focus almost exclusively on changing patient behaviour.

Patients matter—but healthcare professionals arguably shape the system even more. Referral patterns, continuity of care and the way patients navigate GeSY are strongly influenced by clinical practice. Sustainable change therefore requires behavioural change on both sides of the consultation.

Equally welcome is the emphasis on decision aids. These are far more than informational leaflets. They help patients understand benefits, risks and trade-offs, allowing them to participate meaningfully in decisions about their care.

At the same time, shared decision-making should not be viewed simply as educating patients. It represents a fundamental shift in professional practice, requiring new communication skills, a different consultation style and a genuine partnership between clinician and patient.

👉 Decision-support tools and professional training therefore go hand in hand.

🎓 One area that deserves even greater attention

Perhaps the one issue that deserves even greater emphasis than it receives in the report is the role of the academic and public health community.

Reading the recommendations together, it becomes clear that has a much broader contribution to make than conducting Health Needs Assessments.

It can contribute to:
✔️ Developing and evaluating performance indicators
✔️ Workforce planning
✔️ Designing and evaluating decision-support tools
✔️ Developing and evaluating public awareness campaigns
✔️ Supporting continuing professional development
✔️ Evaluating reforms as they are implemented
✔️ Training future healthcare professionals to work effectively within an evolving health system.

These are not isolated research projects. They are continuous functions of a learning health system.

Many of these evidence needs are highly local and operational. And here is the catch:

■ They are unlikely to be addressed through competitive international research funding alone, while the organisations responsible for planning and purchasing healthcare understandably have limited internal research and analytical capacity.

■ At the same time, Cyprus still lacks clear and institutionalised mechanisms through which public organisations can routinely collaborate with the academic and public health community through commissioned research, evaluation, implementation support and professional education.

❗️❗️❗️Strengthening this research–policy may ultimately prove just as important as any individual reform proposed in the report.

While the report rightly recognises the value of collaboration with the academic and public health community, this remains largely implicit.

Research continues to be treated as an activity that supports the system from the outside, rather than as an embedded function of the health system itself.

Likewise, collaboration with academia appears more as a wish than a strategic plan. There is little discussion of how such partnerships should be organised, governed or sustainably funded, despite the fact that many of the report's recommendations—from performance measurement and workforce planning to decision-support tools, training and evaluation—depend on precisely this type of collaboration.

If Cyprus is to develop a genuinely learning health system, the research–policy interface must move from the margins to the centre of health system governance.

💡 Final thought
Overall, the report suggests that the next phase of GeSY is less about introducing new ideas and more about implementing well-established principles effectively.

Reliable data, meaningful performance measurement, multidisciplinary primary care, shared decision-making, continuous professional development and systematic evaluation are all interconnected.

👉 The challenge for Cyprus is no longer deciding what needs to be done. It is creating the institutional capacity, partnerships and culture that will allow these reforms to be implemented, evaluated and continuously improved.

Publicaciones de la Organización Mundial de la Salud

25/07/2026

🤔 Όταν λέμε «Δημόσια Υγεία», τι ακριβώς εννοούμε;

Αφορμή για τη σημερινή ανάρτηση στάθηκε μια ακόμη χρήση του όρου «δημόσια υγεία» για να περιγράψει τις υπηρεσίες υγείας που παρέχονται από τα κρατικά νοσηλευτήρια.

Η αλήθεια είναι ότι αυτή η χρήση είναι τόσο συνηθισμένη στη χώρα μας, που σχεδόν δεν μας κάνει πια εντύπωση.

Τουλάχιστον, το "δ" και το "υ" ήταν με μικρό. Αφού συνηθίσαμε κι εμείς να κάνουμε αυτό το διαχωρισμό για να διακρίνουμε τη Δημόσια Υγεία (δηλαδή, την υγεία του πληθυσμού) από τη δημόσια υγεία (δηλαδή, τις υπηρεσίες υγείας που παρέχονται στους πολίτες από το κράτος).

💡 Αλλά ας το σκεφτούμε λίγο παραπάνω...διότι οι λέξεις έχουν σημασία, και προσδιορίζουν τον τρόπο που σκεφτόμαστε τα πράγματα.

Λέμε, για παράδειγμα, "δημόσια εκπαίδευση", όταν αναφερόμαστε στα σχολεία του δημόσιου τομέα, επειδή υπάρχουν και ιδιωτικά σχολεία.

Άρα, με την ίδια λογική, συνεχίζουμε να λέμε δημόσια υγεία, επειδή υπάρχει ακόμα και... ιδιωτική υγεία; Δηλαδή, στη μεταΓεΣΥ εποχή, με αυτό τον όρο αναφερόμαστε στα νοσηλευτήρια που δεν είναι συμβεβλήμενα; Ή, σε όλα του ιδιωτικού τομέα ακόμα κι αν παρέχουν τις υπηρεσίες τους μέσω ΓεΣΥ - Οργανισμός Ασφάλισης Υγείας ; 🤔

Αυτό είναι η δημόσια υγεία; Όπως η δημόσια εκπαίδευση; Κάτι δεν κολλάει...

Η Υγεία του πληθυσμού (η Δημόσια δηλαδή Υγεία, δεν είναι ούτε δημόσια ούτε ιδιωτική.

Αυτό που μπορεί να είναι δημόσιο ή ιδιωτικό είναι οι υπηρεσίες φροντίδας υγείας, οι πάροχοι υπηρεσιών υγείας ή ο τρόπος χρηματοδότησής τους.

Και σήμερα, στην εποχή του #ΓεΣΥ, αυτό γίνεται ακόμη πιο εμφανές. Η φροντίδα υγείας παρέχεται τόσο από δημόσιους όσο και από ιδιωτικούς παρόχους, μέσα στο ίδιο σύστημα υγείας.

Επομένως, ο όρος «Δημόσια Υγεία» (με κεφάλαια, έτσι για να ξεχωρίζει!) δεν μπορεί να χρησιμοποιείται ως συνώνυμο των κρατικών νοσοκομείων ή των υπηρεσιών φροντίδας υγείας που παρέχει το κράτος, πόσο μάλλον να αναφερόμαστε μόνο στα νοσηλευτήρια του ΟΚΥπΥ.

❤️ Αν όχι αυτό... τότε τι είναι η Δημόσια Υγεία;

Οι περισσότεροι γνωρίζουμε βέβαια τον ιστορικό ορισμό του Παγκόσμιου Οργανισμού Υγείας, σύμφωνα με τον οποίο η υγεία είναι:

■ «μια κατάσταση πλήρους σωματικής, ψυχικής και κοινωνικής ευεξίας και όχι απλώς η απουσία ασθένειας ή αναπηρίας.»

Συχνά επαναλαμβάνουμε αυτόν τον ορισμό ως μια όμορφη —ίσως και κάπως ιδεαλιστική— φράση.

Σπάνια όμως στεκόμαστε πραγματικά στο νόημά της.

Αν η υγεία δεν είναι απλώς η απουσία ασθένειας, τότε προφανώς δεν αρχίζει και δεν τελειώνει στο νοσοκομείο.

Η Υγεία αφορά το που γεννιόμαστε, μεγαλώνουμε, μορφωνόμαστε, εργαζόμαστε, ζούμε, γερνάμε και συμμετέχουμε στην κοινωνία.

Αφορά τη σωματική, την ψυχική και την κοινωνική μας ευεξία.

Ίσως, όταν κατανοήσουμε πραγματικά τι κρύβεται πίσω από αυτή τη σύντομη φράση, να αρχίσουμε να κατανοούμε καλύτερα και τι σημαίνει #Δημόσια #Υγεία.

🌱 Η Δημόσια Υγεία είναι πολύ περισσότερα από τα νοσοκομεία

Αυτό βέβαια δεν σημαίνει ότι οι υπηρεσίες φροντίδας υγείας δεν αποτελούν μέρος της Δημόσιας Υγείας.

Το αντίθετο.

Η πρόληψη, η διάγνωση, η θεραπεία και η αποκατάσταση αποτελούν αναπόσπαστα στοιχεία της.

Η Δημόσια Υγεία όμως δεν εξαντλείται στις υπηρεσίες υγείας.

Επεκτείνεται σε όλους εκείνους τους παράγοντες που διαμορφώνουν την υγεία του πληθυσμού πριν ακόμη χρειαστεί κάποιος να επισκεφθεί έναν επαγγελματία υγείας ή ένα νοσοκομείο.

Γι' αυτό και το βασικό της πεδίο δράσης είναι η #κοινότητα

🏡 οι γειτονιές μας
🏫 τα σχολεία
🏢 οι χώροι εργασίας
🌳 οι δήμοι και οι κοινότητες
🚶 οι δρόμοι και οι χώροι άθλησης
💧 το καθαρό νερό και ο καθαρός αέρας
🚭 η πρόληψη του καπνίσματος
💉 οι εμβολιασμοί
🧠 η ψυχική υγεία
🥗 η υγιεινή διατροφή και η σωματική δραστηριότητα
⚖️ η μείωση των κοινωνικών ανισοτήτων στην υγεία.

Με άλλα λόγια...

■ Η μεγαλύτερη επιτυχία της Δημόσιας Υγείας δεν είναι να θεραπεύει αποτελεσματικά την ασθένεια.

■ Είναι να συμβάλλει ώστε οι άνθρωποι να μη χρειάζεται να αρρωσταίνουν τόσο συχνά, να ζουν περισσότερα χρόνια με υγεία και καλύτερη ποιότητα ζωής.

Και όταν τελικά χρειαστούν υπηρεσίες υγείας, αυτές να είναι ποιοτικές, ασφαλείς, αποτελεσματικές και προσβάσιμες για όλους.

🌍 Και μετά το εξιτήριο;

Ακόμη όμως και το καλύτερο και δικαιότερο σύστημα υγείας δεν αρκεί από μόνο του για να εξασφαλίσει ίση υγεία.

Δύο άνθρωποι μπορεί να λάβουν ακριβώς την ίδια θεραπεία στο ίδιο νοσοκομείο, αλλά η πορεία της ανάρρωσής τους να είναι τελείως διαφορετική.

Γιατί; Επειδή, όπως η υγεία έτσι και η αποκατάσταση της υγείας συνεχίζεται έξω από το νοσοκομείο.

Εξαρτάται από τις συνθήκες, τις περιστάσεις, τις ευκαιρίες ή τις δυσκολίες που έχει ο καθένας και η καθεμία από εμάς.

💬 Ίσως λοιπόν, όταν αναφερόμαστε στις υπηρεσίες υγείας που προσφέρονται στους πολίτες από το σύστημα υπηρεσιών υγείας, να είναι πιο ακριβές να χρησιμοποιούμε όρους όπως:

✔️ Δημόσιες Υπηρεσίες Υγείας
ή
✔️ Δημόσια Φροντίδα Υγείας

αντί για Δημόσια Υγεία (με μικρό ή κεφάλαιο δ)

😊 Άλλωστε, ο σκοπός της Δημόσιας Υγείας δεν είναι η ασθένεια αλλά η υγεία.

Θα ήταν λίγο σαν να μετονομάζαμε το Υπουργείο Άμυνας σε Υπουργείο Πολέμου (στις εποχές που ζούμε, το είδαμε κι αυτό) 😄

Όλοι όμως καταλαβαίνουμε ότι σκοπός της άμυνας είναι να αποτρέψει τον πόλεμο, όχι να τον παράγει.

Με τον ίδιο τρόπο, σκοπός της Δημόσιας Υγείας δεν είναι απλώς η διαχείριση της ασθένειας.

Είναι η δημιουργία των συνθηκών ώστε όλοι οι άνθρωποι να μπορούν να ζουν περισσότερο, υγιέστερα και με καλύτερη ποιότητα ζωής.

📌 Οι λέξεις δεν είναι απλώς λέξεις.

Διαμορφώνουν τον τρόπο που αντιλαμβανόμαστε τα προβλήματα, τις προτεραιότητες που θέτουμε και, τελικά, τις πολιτικές που σχεδιάζουμε.

Η Δημόσια Υγεία δεν αρχίζει στην είσοδο του νοσοκομείου.

Αρχίζει πολύ νωρίτερα.

Εκεί όπου δημιουργείται η Υγεία.