Primary Health Care
Excellent Reform Model
Primary health care is a reform initiative that offers a usable model for other types of societal reform initiatives. These principles include:

- Accessibility (services are universally available to all people regardless of geographic location or social strata);
- Public Participation (people are involved in the initiative, not just handed the result);
- Health Promotion (involves public education, empowerment strategies, balanced need fulfillment);
- Appropriate technology (innovative use of new media technologies);
- Inter-sectoral cooperation (links health policy to economic and social policy. This means health professionals collaborate and work with experts in other sectors such as education, housing, employment, immigration, and so on to achieve reform goals).

Nurses have the Insight
Reform in any Context
The general population are more than mere stakeholders in societal reform, they are slowly becoming active participants in the petitioning and planning of societal changes. Nurses are in a unique position to facilitate this new development both as agents of change themselves, and as guides/advocates for individuals, groups and communities working for change and social justice.

Reform is the Goal!
It makes sense that reform, of some kind, is the ultimate goal of any activist initiative - whether it is health reform, social reform, political reform, educational reform, and so on.

Mere regurgitation of social justice and health reform theory is not enough to spark activism in nurses: instead it often becomes mere rhetoric. To make a real impression, actual praxis is needed. Praxis refers to reflection applied to action, meaningful and intentional activity grounded in theory and knowledge yet expressed through activity and purpose.

Since the early 1990's, the social determinants of health have been promoted as a framework to assess levels of health and well-being on a global scale. These determinants identify income inequality, social inclusion and exclusion, employment and job security, working conditions, contribution of the social economy, early childhood care, education level, food security and housing as key factors that shape health and well-being in individuals, families, and communities.

Nurses view the social determinants of health as foundational to their work with human health and optimal wellness. They regard these determinants as the root of most health inequalities and know that it is their role to work actively to reduce the effects of a lack of social determinant maintenance. In time, nurses come to question how health policy and practice is initiated and to brainstorm ways to influence health reform.




Reformation of Health Care

“What narrative will capture the imaginations, feelings, intellect and will of political decision-makers and the broader public and inspire them to action?” (W.H.O. Commission on the Social Determinants of Health, 2005).