With the COVID-19 pandemic persisting into 2022, the burden on the healthcare system is unprecedented. Despite several new strategies and innovations being adopted and implemented by healthcare organizations to combat the pandemic, there needs to be greater emphasis on the social determinants of health to tackle the lasting social impact caused by the pandemic.
Social Determinants of Health
WHO explains social determinants of health as the sociodemographic conditions an individual is a part of in the community. Categorically speaking, there are five core social determinants of health:
1) Economic Stability of individuals mainly include their employment status, household income and expenditure, and healthcare expenditure
2) Neighborhood and Physical Environment of individuals, which accounts for the quality of housing, neighborhood safety, and physical accessibility to the area
3) Accessibility of Quality Education to individuals specifically, to children
4) Social and Community Context of individuals include the larger social system the individual is a part of and includes the social norms and practices that govern health-seeking behaviors
5) Accessibility to Quality Healthcare is the most direct determinant that healthcare organizations have the most control over as it includes the healthcare workforce and quality of healthcare services.
While addressing all of these is a tall order, here are a few strategies that healthcare organizations can adopt to dynamically and holistically tackle the social determinants of health.
- Training of Healthcare Workforce
By focusing on improving the direct accessibility and quality of healthcare, the impetus needs to be placed on the development and training of the healthcare workforce. The healthcare workforce comprises doctors and nurses, both of whom have been critical in battling the COVID-19 pandemic. While there’s no shortage in the workforce, a large chunk of the workforce, especially nurses, have become victims of the pandemic, leaving a gap to be filled.
Now, the healthcare sector demands senior nurses to fill the gap of nurse leaders. For this purpose, they can train their existing nurses to secure leadership positions by providing eLearning opportunities. They can encourage nurses to enroll in online degrees to hone leadership skills and take on senior roles.
Since these programs are manageable alongside work, nurses can complete them within a year. The structured and accommodating nature of these programs enhances nurses’ capacity to provide quality patient care and reduce negative health outcomes such as mortality and morbidity in health facilities.
- Mobile and Online Healthcare Programs
The pandemic and the following lockdowns have given rise to mobile and online healthcare programs. These approaches have yielded positive results, such as setting up mobile testing facilities for COVID-19 and online awareness programs. These programs need to be scaled up to increase access to medicine and healthcare services to far-flung areas. Medical vans consisting of healthcare staff, equipment, and medicine are a potential consideration that can be used for increasing access to COVID-19 and other vaccinations alongside basic health services. What’s more, these approaches can be gendered by incorporating maternal, neonatal, child, and reproductive health services to address the inequitable access of women and children to healthcare services.
To cater to a different population segment – youth, online services would be a good strategy to increase youth’s access to quality healthcare. Organizations can set up websites, helplines, and apps to cater to youth’s medical issues, raise awareness around critical health problems and connect them to service delivery points.
- Equitable Access of Healthcare Services
Theoretically, the healthcare system and services should be accessible to every individual. Unfortunately, inequity is spread at large in the healthcare sector regarding how the services are provided. To address these, healthcare organizations must devise programs that cater to low-income households and ensure that people from those households can access essential healthcare services. The “Robin Hood” approach can be used whereby revenue earned from high-income individuals is used to finance services for low-income individuals. This approach ensures that equitable healthcare services are accessible to all income-tiers of the populace.
Similarly, public health workers need to draft policies and programs that cater to the health needs of marginalized communities. Healthcare organizations can provide the necessary platform, funding, and resources to carry out this mission.
- Evidence-based Programming
Considering the drastic impact of the COVID-19 pandemic on the social and community context, healthcare organizations must invest in community-based research for developing programs. Evidence-based programming has been hailed as an effective methodology whereby organizations first research to understand the healthcare outcomes and social determinants of health in a particular context. Later on, they subsequently utilize the research findings to develop effective programs.
Research has shown that these programs are tailored to societal needs and yield a greater positive response from the beneficiaries.
- Behavior Change Communication
Behavior Change Communication (BCC) is a communication strategy that emphasizes adopting healthy behaviors in communities. Healthcare organizations should utilize BCC to conduct community awareness programs to improve people’s attitudes towards health-seeking behaviors. BCC programs often utilize participatory tools that encourage participation and dialogue between communities and organizations.
These programs are often implemented through healthcare workers that conduct household visits and organization awareness seminars at the community level. It increases community engagement and increases the community’s trust in the healthcare programs allowing healthcare organizations to change social norms. Moreover, healthcare organizations can conduct such programs in educational institutes to raise awareness among youngsters and young adults.
- Social and Political Advocacy
To institutionalize these strategies for long-term sustainability, healthcare organizations should advocate for these approaches to the governments and stakeholders. High-level advocacy catalyzes the process of policy development. It brings these issues and strategies to the larger public for debate and institutionalization. While changing policy is often not realistic, bringing the issues and strategies to the public invigorates academic, sectoral, and public interest, which bodes well for healthcare providers and beneficiaries.
Conclusively, addressing the social determinants of health should be an organizational impetus for healthcare organizations. Medical interventions aren’t merely accountable for the critical factors that determine an individual’s health and accessibility to healthcare. Organizations can study and adopt these strategies to remain adaptive and effective in providing quality, accessible, and equitable healthcare services.