International Policy on Health

The paper recognises the many settings in which social workers function. In developed or highly industrialised countries they carry numerous health-related roles in community health and social service centres, in hospitals and in other institutional settings. There they work, together with other health professionals, for the treatment and restoration to normal living of sick or disabled persons. Some social workers in developing countries are similarly employed; many others are engaged in work in which health measures are linked with endeavours in sectors concerned with macroproblems of scarcity, deprivation and poverty.

Whether in developed or developing countries, social workers share values and commitments to human advancement that transcend the differences of their geo-political and workaday settings. Accordingly, this policy statement affirms the fundamental values of social work that include belief in the worth and dignity of each individual person and faith in the capacity of people everywhere to work individually and collectively for their own health and for the health and well-being of others.

Effective strategies on international health call for informed support by individual social workers and social work organisations on a range of broad public policies that include the following: policies on the equitable distribution of land and income; policies on population and family planning; policies on the production, import and export of food; policies to eliminate adult illiteracy and to offer every child and young person the knowledge and skills needed for socially and economically productive lives; policies on housing, shelter and space for secure family and communal living; policies on the provision of education on health and safety and on occupational and lifestyle hazards; policies on the provision of child and maternal health services, immunisation and nutrition.

The provision of health services is most effectively achieved within the ambit of "primary health care", WHO's conceptual framework which extends to the macro policies referred to above as well as focusing on direct measures for individual and communal health. Health needs are best met when the functions and activities of medical, nursing and other health workers are integrated with social workers similarly trained in health prevention and promotion.

Throughout its history, from its beginnings in 1928, IFSW has been closely associated with other international bodies. In the non-governmental area it has had linkages with the International Association of Schools of Social Work (IASSW) and the International Council on Social Welfare (ICSW). Of increasing significance are its linkages with the United Nations and the UN's relevant specialised agencies. It has consultative status with the Economic and Social Council and the United Nations Children's' Fund (UNICEF), and has "special list" recognition with the International Labour Organisation (ILO).
The work of the WHO has been of increasing significance for IFSW's member organizations and individual social workers for many reasons, the most prominent, in recent years, having to do with the HIV/AIDS pandemic. IFSW has acted on WHO's call for world-wide action on what is now recognised as the most serious health problem facing humanity. Among other measures, IFSW adopted an International Policy on Strategies for Responding to HIV/AIDS at its General Meeting in Buenos Aires in 1990 and that document may be seen as complementary to this statement.
Of no less importance to IFSW and its member organisations was the action taken by WHO in association with UNICEF at the Alma Ata conference in 1978 to proclaim the objective of Health For All by the Year 2000 and to outline the Primary Health Care Strategy by which the objective was to be achieved. Out of the Primary Health Care approach and embracing its central ideas in more easily interpreted terms, has emerged Health Promotion.
Health Promotion has been extensively developed by WHO as a comprehensive approach in addressing and dealing with issues that go beyond health care and is congruent with the philosophy, goals and methods of social work. Health Promotion policy combines diverse but complementary endeavours ranging from the promotion of healthy lifestyles to fiscal and taxation measures designed to eliminate poverty and ensure an equitable distribution of income.
These various commitments and sustained global actions of WHO focused on health promotion and other measures extending to broad environmental issues, point to the desirability of IFSW achieving consultative status with this specialised agency of the United Nations. WHO's objectives are increasingly recognised as congruent with the basic tenets of IFSW.

The importance of the issues associated with international health implies responsibility for members of IFSW to become familiar with its extensive body of relevant knowledge, partly outlined as follows:

The inextricable linkages between health policies and human rights policies including those relating to the rights of the child, the rights of oppressed minorities and of refugees fleeing from oppression; The structures and programmes of international governmental and non-governmental organisations, and of multinational corporations, that have an impact on health and illness; WHO's Health for All Objective, the Primary Health Care Strategy and the developing concept of Health Promotion involving, inter alia, Healthy Communities and Healthy Public Policy; The psychosocial aspects of illness, disability and disease; The factors that promote positive health and well-being; The range of social, economic, cultural and political factors that cause or contribute to illness and disability; The range of positive and negative factors in the physical environment that affect the quality of air, water and food; The range and nature of physical, mental and emotional illnesses and disabilities throughout the world; The factors affecting the HIV/AIDS pandemic and the mammoth measures needed to prevent its proliferation, to ameliorate and treat its physical, emotional, and social symptoms and to seek its cure; The special need for health care and other supportive measures for women and, especially, women caring for children; Theories of the prevention of illness, disability and communicable diseases; The range of measures and modalities that have been developed to prevent illness, disability and disease, including lifestyle illnesses associated with smoking, alcohol consumption and other forms of substance abuse, eating disorders, lack of physical activity and the operation of vehicles under unsafe conditions; The range of measures and modalities, including traditional and modern medicine, for the treatment of illness, disability and disease; The impact of working conditions on the health of workers and on family life; The various roles and responsibilities, including the responsibility to contribute to development of healthy social policy, of public health workers, traditional healers, auxiliary workers, health technicians, physicians, nurses, social workers and other health care professionals engaged in the prevention and treatment of illness, disability, and disease; The functioning of inter-disciplinary teams and other forms of collaboration among different categories of health personnel that contribute to healthy social policy; The role of consumers of health services, both as recipients of the services of others and in self-help roles; Critical issues affecting the delivery of health care services, notably the forces arrayed for and against two alternative models: the medical market model, and the public delivery model – the latter stressing the universality, comprehensiveness, and accessibility of health care services.

IFSW members, both collectively and individually, have a body of knowledge, professional values and practice skills that are identified with the social work profession and constitute the profession's special contribution to human well-being. It follows that they have a responsibility to:

Take an active part in dealing with health problems, through policy analysis and development, and through political advocacy and action as individuals, as members of their professional organisations, and in conjunction with other professionals; Work for the continued improvement of social work education and training, through collaboration with schools of social work, training institutions, hospitals and health facilities that offer academic or experiential learning; Work for the extension of knowledge of social work and health, through systematic evaluation and research; Apply the ethical standards of the codes of ethics of IFSW and of their national professional associations to the complex ethical issues that arise in the provision of health care and related social services; Ensure that social workers in both public and private practice with clients or patients referred for health reasons have the requisite qualifications, and are subject to discipline for breaches of professional ethics; Promote the utilisation of social workers in all appropriate aspects of the health field, including ministries and public departments concerned with health policy, programmes of primary health care, community mental health programmes, and hospital social work departments and clinics.

As IFSW's member associations and individual social workers recognise and act on their opportunities and responsibilities in relation to health, the profession, as a global entity, will contribute increasingly to improvements in the health of the people of the world.

This is an updating of the policy paper adopted in July 1984 and included in the IFSW's 1988 Publication, International Policy Papers.
The writing of the initial paper, as with the present one, was co-ordinated by Richard Splane. It reflected suggestions on earlier drafts of the document made by IFSW members
at Grenada in 1981 and at Brighton in 1982 and had received further inputs from the Asia and Pacific Region obtained and transmitted by Vera Mehta.
The Canadian Social Workers who contributed to the initial paper were Gayle Gilchrist James of the University of Calgary (Edmonton Campus) who was then President of the Canadian Association of Social Workers, Winnifred Herrington, University of Toronto, and Susan Watt of McMaster University. They have also contributed to the present paper, Gayle Gilchrist James, as President of IFSW, bringing the mandate for the update from the meetings in Buenos Aires where the policy paper on HIV/AIDS was adopted.
The editorial group who met in Vancouver and worked on the present paper in February 1992 were Richard Splane and Sharon Manson Willms of the University of British Columbia, and Brian Wharf of the University of Victoria.