Academic literature on the topic 'Supplementary healthcare assistance'

<p align="center"><strong>Abstrak</strong><strong> </strong></p><p><em>Pengabdian masyarakat berjudul Pelatihan dan Pendampingan Kader Posyandu Lansia di Desa Cimuning Wilayah Kerja Puskesmas Cimuning bertujuan untuk </em><em>membangun kesadaran masyarakat mengenai kesehatan pada usia lanjut. Metode pelaksanaan kegiatan pengabdian ini yaitu </em><em>pendekatan persuasive dengan tahapan-tahapan pelaksanaan yaitu (1) melakukan pendekatan persuasive kepada masyarakat sebagai kader posyandu, (2) Penyuluhan kesehatan/ceranah interaktif, diskusi kelompok, tanya jawab, dan simulasi, (3) pemeriksaan fisik (4) serta pencatatan dan pelaporan hasil pemeriksaan isik kesehatan masyarakat lanjut usia. Di kelurahan Cimuning baru terbentuk 8 Posyandu Lansia dari 26 RW yang ada, sehingga perlu dibentuk lagi posyandu lansia pada RW yang belum memiliki posyandu lansia. Dengan demikian Program Kerja Sama Mitra (PKM) dalam pengabdian masyarakat menawarkan solusi antara lain dengan pelatihan dan pendampingan kader posyandu lansia. Kegiatannya antara lain: Sosialisasi pentingnya posyandu lansia melalui Forum Kelurahan/RW, rekrutmen dan pelatihan kader posyandu lansia, layanan posyandu lansia, penyuluhan kesehatan, PMT, penimbangan, vitamin dan permainan-permainan yg menyenagkan dan menyehatkan, peningkatan kesehatan, komunikasi interpersonal yang bekerjasama dengan masyarakat sekitar. </em><em>Kesimpulan</em><em> bahwa </em><em>pelatihan dan pendampingan kader posyandu lansia kelurahan Cimuning sangat bermanfaat dalam meningkatkan status kesehatan dan kualitas hidup lansia pelayanan kesehatan lansia di posyandu.</em></p><p><strong>Kata kunci :<em> Lansia, Pengabdian, Posyandu</em></strong></p><p> </p><p align="center"><strong>Abstract</strong></p><p><em>Community service titled Training and Assistance for Elderly Posyandu Cadres in Cimuning Village Cimuning Health Center Work Area aims to build public awareness about health in old age. The method of implementing this community service activity is a persuasive approach with stages of implementation, namely (1) carrying out a persuasive approach to the community as a posyandu cadre, (2) health education / interactive stories, group discussions, questions and answers, and simulations, (3) physical examinations ( 4) as well as recording and reporting the results of health examinations for the elderly. The elderly posyandu services emphasize promotive and preventive services without ignoring curative and rehabilitative efforts. In Cimuning Village, only 8 Elderly Integrated Healthcare Center was formed from 26 existing RWs, so it is necessary to re-establish elderly Integrated Healthcare Center for RWs that do not yet have elderly Integrated Healthcare Center. Therefore the Partnership Cooperation Program in community service offers solutions including, among others, training and mentoring for elderly Integrated Healthcare Center cadres. The activities socialization of the importance of Integrated Healthcare Center for the elderly through the Village Office Forum, recruitment and training of elderly Integrated Healthcare Center cadres, elderly Integrated Healthcare Center services, health counseling, supplementary feeding, weighing, vitamins and games that are fun and healthy, improving health, interpersonal communication in collaboration with surrounding communities. The Conclusion that the training and assistance of elderly Integrated Healthcare Center cadres in Cimuning Village are very useful in improving the health status and quality of life of elderly health services in the Integrated Healthcare Center.</em></p><p><strong>Keywords:<em> Integrated Healthcare Center, Elderly, Devotion</em></strong></p>

Subject area Innovation, information technology, e-marketing and sales, strategy and entrepreneurship. Study level/applicability The case is intended for use in advanced graduate and executive education level management and technical programs of study. The case is high inter-disciplinary appropriate for all courses dealing in use of innovation, information technology, entrepreneurship, marketing and sales and strategy. Case overview Practo Technologies Pvt Ltd is a company established in 2008 by entrepreneurs Shashank, N.D. along with Abhinav Lal. At Practo Technologies engineers practice to create technology that supports healthcare industry. In India, there is not enough assistance given to the patients in terms of searching for appropriate doctors and fixing an appointment with them easily. The patient's data lie scattered in reports and the patient's medical history goes unrecorded. Practo provides a robust platform for doctors and patients to collaborate together under one umbrella. It provides patients with open basket of doctor profiles and special search based on doctor's specialty. The case showcases the journey of transformation healthcare sector in India has gone through. The change was resisted, it never came that easy! The case explores issues in implementing information technology for clinics and hospitals in India. This case illustrates interesting facts Indian healthcare and the preparation they need to equip with to manage global technology tide. Expected learning outcomes The case can be used for teaching service innovation. Managing innovative practices and low-cost online business models is illustrated. In particular, it deals with how the early start up employs innovation to set up new working ideas. The case is designed to stimulate discussions of broad array of issues regarding deployment of IT services specifically in the hospitals and clinics across India. Evaluate the advantages and liabilities of expanding globally at a very early start up stage. The case focuses on Practo early development with only concept in hand and transforming it into a profit generating business. Evaluate the advantages and challenges of innovation, technology development, deployment and training of manpower to use it. The case offers students opportunity to understand and take view of strategically building early start up and management of concerns with no prior experience. To identify business opportunities and explore various possibilities of expansion into IT healthcare business. The students are given base to explore sales and marketing strategies for online model. The students get overview of cutting edge business offerings and surviving the dynamic competition in the era of globalization. Supplementary materials Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

INTRODUCTION:Severe aortic stenosis with symptoms or left ventricular dysfunction has commonly a poor prognosis. Aortic valve replacement is usually performed for these patients aiming at improving their functional class and survival rate. Transcatheter aortic valve implantation (TAVI) is often presented as an option in patients with high surgical risk for conventional surgical valve replacement.(1) Nonetheless, in this group of patients, the literature has yielded conflicting evidence suggesting that benefits of TAVI for patients of high or intermediate surgical risk is not consistent.(2,3)METHODOLOGY:This retrospective study aimed to evaluate the mortality rate from a cohort of patients after the correction of aortic valve dysfunction with TAVI. It consisted of a convenience sample of patients at high risk for open surgery for the correction of aortic valve dysfunction treated with TAVI from 2013 to 2016. All included patients were being provided healthcare assistance by a private nonprofit health maintenance organization (HMO) operating in Belo Horizonte, Brazil. Since TAVI is not currently covered by the Brazilian supplementary healthcare system, reimbursements were enforced by lawsuits. Data was extracted from an administrative database, using the software Oracle Business Intelligence®. Continuous variables were expressed as mean and standard deviation. The Kaplan-Meier method was used to adjust the 1-year survival curve using the software STATA 13.1 (Stata Corp, College Station, TX, USA). This historical cohort resulted in no interventions, neither during the course of the instituted treatment nor after the observed outcome. Privacy of subjects and the confidentiality of their personal information were handled in accordance to the ethical principles of the Declaration of Helsinki.RESULTS:Overall, seventeen patients with a mean age of 80.5 years (68-91) underwent TAVI; 59 percent were women. Peri-operative mortality rate was 23.5 percent (n = 4) and accumulated overall one-year mortality was 35.3 percent (n = 6). Mean length of hospital stay was 26.9 ± 16.6 days. Prolonged hospital stay (≥ 7 days) occurred in 14/17 cases (82.3 percent), with a maximum of 51 days.CONCLUSIONS:In similarity to our findings, other authors described a high early and late mortality rate in patients undergoing TAVI. The strategy to use TAVI as an alternative in patients at high risk for open surgery is still under debate and should be carefully discussed taking into consideration the local team expertise as well as local healthcare available recourses.

Social interventions such as cash transfers provide the much needed support to vulnerable people. People living with disabilities continue to remain economically deprived, experiencing high levels of poverty. In Wajir County, this crisis is more exacerbated by the nomadic setting where disabled persons are left behind as other individuals move. They are left to cater for themselves due to their mobility constraints. The welfare of these people continue to deteriorate since they are unable to work and highly depend on others and hence do not have the capacity of self-sufficiency. These people remain dependent on the government and non-governmental agencies. The effect of cash transfer programs however, is not fully known. This study sought to assess the effect of cash transfer on the economic well-being of people with severe disabilities in Wajir County. The study is founded on the Maslow’s theory of needs, the sustainable livelihoods framework and the rights-based approach. The study employed mixed methods research design and targeted all family heads for all the 183 under the Persons with Severe Disabilities Cash Transfer in Wajir North and Tarbaj sub-Counties as at 2015 and 19 senior officials working with the sub-counties’ social development offices. The study used primary data obtained through semi-structured questionnaires and interview guides. Data analysis methods that be employed involved quantitative and qualitative approaches. The qualitative data was analysed using content analysis where the information obtained was reported in a narrative form and direct quotes. Quantitative data was analyzed using descriptive statistical methods. Quantitative data analysis was facilitated by the Statistical Package for Social Sciences Version 20. Descriptive statistics such as the rate of response, frequency distribution, mean and standard deviation were used. Inferential statistics generated included correlation and regression analysis. The study findings showed that cash transfer supported household income, healthcare access, investment in productive activities and empowerment had positive and significant effect on the economic wellbeing of persons living with disabilities in Wajir County. The study concluded that if the cash transfer programme was to achieve its objectives and transform the economic wellbeing of the beneficiary households, the aforementioned support areas needed to be adequately embedded in the programme’s plan. The study made several recommendations among them that the Ministry of Labour, Social Security and Services Programmes should consider increasing the monthly disbursements given to persons living with disabilities so that they can venture in to activities that would give them supplementary incomes. There can be other activities within the programme meant to support the beneficiaries to be self-reliant so that they do not have to rely on the transfers throughout. The study also recommends that the officials overseeing the cash transfer programme for persons living with disabilities should have follow up programs especially for beneficiaries who have ventured in to productive activities so that they can support them to expand their income generation activities. The programme can partner with other development partners such as donors and NGOs and also the county government to create a fund where beneficiaries can get more assistance both financial and non-financial in order to expand their activities. The study further recommends that the programme should provide networking programs were beneficiary households can interact with various organizations so as to secure livelihood opportunities such as employment among others.

Bean (Phaseolus vulgaris L.) intakes in the United States (US) lag behind dietary recommendations despite their positive nutrition profile, health benefits for reducing chronic disease risk, and inclusion in nutrition assistance programs. Low-income groups, including Hispanics, have an increased risk of cardiovascular disease, type 2 diabetes, obesity, and some cancers. Hispanic dietary quality and bean consumption may decline with increasing acculturation. Intakes at recommended levels could improve health in all vulnerable low-income populations. The study objectives were to describe dry and canned bean preferences, consumption frequency, and attitudes among low-income Hispanic and non-Hispanic white women, and to assess if these characteristics differed by ethnicity and acculturation level among the Latinas. A convenience sample of 158 women, aged 18–65 years, completed a written survey in English or Spanish at two healthcare clinics, one Special Supplemental Nutrition Program for Women, Infants and Children office, and five County Extension nutrition education and outreach programs in Iowa. Less acculturated Latinas consumed beans more often, preferred dry to canned, bought in bulk, valued color and shape in dry bean selection, and held less positive attitudes toward canned beans in contrast to bicultural/more acculturated and non-Hispanic white women. Ethnicity and acculturation level have a role in varying purchase patterns and attitudes regarding dry and canned beans. Culturally-held differences should be considered in nutrition programs and leveraged to increase consumption and improve health.

Abstract Older adults who experience food insecurity (4.6 million) often have worse health outcomes. Food insecure older adults consume less nutrients, which puts them at greater risk of developing chronic diseases. They are at increased risk of falls due the impact of poor nutrition on muscle mass, bone density, and balance. Low-income older adults are often forced to choose between buying groceries and paying other bills. The Supplemental Nutrition Assistance Program (SNAP) plays an important role in reducing food insecurity. SNAP enables older adults to buy the nutritious food they need, while freeing up resources to pay for everyday things to meet their health needs such as prescription drugs. Research shows that medication adherence increases when low-income older adults enroll in SNAP. Despite the beneficial impact of enrolling in SNAP, it’s estimated that 55% of eligible adults age 60 and older are not participating in this critical program. To understand which older adults are missing out on SNAP, the National Council on Aging engaged researchers at Leading Age LTSS Center at UMass Boston to analyze data from the 2014 Health and Retirement Study. The results show that some of the most vulnerable older adult populations are less likely to participate in SNAP even though they are eligible (i.e., Hispanic, age 75 and older, those who are not utilizing healthcare, etc.). The findings suggest that more targeted outreach to these groups is needed to ensure that the most vulnerable populations of older adults access this critical benefit.

Background: The relationship between nursing staffing and healthcare-associated infections (HAIs) has been explored previously, with conflicting results. Intensive care units increasingly struggle to maintain trained staff. In May 2019, clinical coordinator (CC) roles changed to include 50% of time in direct patient care rather than supportive roles. In this study, we used shift records to explore the impact of staffing on HAI risk. Methods: Daily staffing records from December 2018 August 2019 for the medical-respiratory unit (MRICU) and the cardiac surgery unit (CSICU) were reviewed. Both units staff a fixed 2:1 patient:nurse ratio (1:1 for specific cardiac surgeries). Staff deficiency was defined as assignments filled by nurses pulled from other units/supplemental/or CC roles. Staff support comprised nursing assistants and unit secretaries. Census, admissions, and complexity score for number of devices were used to estimate care acuity. In CSICU, additional points were added for continuous renal replacement therapy, extracorporeal membrane oxygenation, ventricular assist devices, transplant, operative cases. NHSN definitions were used for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). The Spearman correlation coefficient was used to determine relationship between staffing, acuity, and risk window for HAI (days 1–10 preinfection). Linear regression was used to determine whether staffing deficiencies and/or support associate with the risk window prior to HAI. The final model included census and complexity score as control variables. The statistical analysis was performed using SAS version 9.4 software (Cary, NC). Results: Overall, 8 HAIs occurred in the study period: medical-respiratory intensive care unit (MRICU: 3 CAUTIs and 1 CLABSI) and cardiac surgery intensive care unit (CSICU: 1 CAUTI and 3 CLABSIs). Staffing and census fluctuated daily (Table 1). Total number of nurses correlated with complexity scores (r = 0.35; P < .0001) and daily census (r = 0.31; P < .0001) in the CSICU, and the census (r = 0.12; P = .04) in the MRICU. Nursing deficiencies correlated with days 1–10 before infection (r = 0.20; P = .0013) in the CSICU. In the regression model for the CSICU, nursing deficiencies increased in the time prior to HAI (P = .004), and support staff decreased in the time prior to HAI (P = .034) while controlling for census and complexity. These relationships were not significant in the MRICU. Conclusion: The lack of core nurses to support the staffing structure in CSICU correlated with periods prior to CLABSI or CAUTI in this small, unit-based study. Failure to recruit and retain highly skilled core staff may produce HAI risks, particularly for CLABSI in specialized units.Funding: NoneDisclosures: Michelle Doll, Research Grant from Molnlycke Healthcare

Purpose: In this pilot study, researchers explore an online animated simulation as an educational tool for emerging health professionals to promote cultural competence of poverty, food insecurity, and the Supplemental Nutrition Assistance Program.Methods: Researchers recruited participants in the allied health sciences for focus groups to explore the effectiveness of an online animation in promoting cultural competence of poverty, food insecurity, and public assistance programs. Participants were asked about their experience with the educational tool and changes in cultural competence regarding poverty, food insecurity, and the Supplemental Nutrition Assistance Program. Participants also responded to five survey questions about their experience of the educational tool and cultural competence of poverty. Transcripts from focus groups were coded according to the five constructs of the Campinha-Bacote model for cultural competence, and further coded for recurring themes within these constructs. Results: Eleven participants across four allied health professions including nutrition, occupational therapy, nursing and pre-physical therapy participated in two focus groups. Researchers found all five constructs of the Campinha-Bacote model in analysis of focus group transcripts, with awareness and desire expressed more frequently and intensely. Participants stated the animated simulation increased their empathy for people who experience poverty, food insecurity and who need public assistance programs. Conclusion: Researchers find that this online animated simulation was an effective tool to improve cultural competence of poverty for emerging healthcare professionals. Use of similar animations by educators of healthcare professionals may also change existing negative views towards those who rely on the Supplemental Nutrition Assistance Program benefits and reduce the barrier of stigma associated with the program.

Introduction: The 2018 Farm Bill represents a major opportunity to reduce disparities in diet and health. The largest component is the Supplemental Nutrition Assistance Program (SNAP), feeding 1 in 6 Americans. Potential options include subsidizing fruits & vegetables (F&V), restricting sugar-sweetened beverages (SSBs), or implementing a broader food incentive/disincentive framework that preserves choice. Their comparative health impacts and cost-effectiveness are not established. Methods: Using a validated microsimulation model (CVD PREDICT), we estimated changes in CVD events, quality-adjusted life-years (QALYs), costs, and cost-effectiveness of 3 policy scenarios in SNAP adults: 1) 30% subsidy on F&V; 2) 30% F&V subsidy + SSB restriction; and 3) 30% subsidy on F&V, whole grains, nuts/seeds, seafood, plant-based oils, and 30% disincentive on SSBs, junk food, and processed meats. Model inputs included national data from NHANES (2009-2014), policy effects from SNAP pilots and food pricing meta-analyses, diet-disease effects from meta-analyses, and policy, food subsidy, and healthcare costs. Results: From a societal perspective, all 3 scenarios were cost-savings at 5, 10, 20 y and lifetime ( Table ). At 5 y, a F&V subsidy would prevent 32,218 CVD events, gain 18,072 QALYs, and save $1.04B ($6.05B lifetime). Corresponding values for a F&V subsidy + SSB restriction were 63,898, 45,772, and $4.47B ($38.83B); and for a broader incentive/disincentive framework that preserved choice, 65,078, 26,663, and $3.98B ($29.90B). Government affordability varied by program duration and by whether subsidy costs for SNAP adults or all SNAP participants were included. Scenario 3 was generally most cost-effective or -saving, followed by scenario 2 and then scenario 1; all were cost-effective over a lifetime from a government affordability perspective. Conclusions: Financial incentives/disincentives through SNAP could generate substantial health benefits and be cost-effective or cost savings.

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Ones of most important strategical decision that are placed for the Brazilian hospitals is how expand its activities for other markets which the same still not been covering. Several strategies are being adopted, and the opening of Satellites Units is one of them and has been adopted by a private hospital in São Paulo. Considering this fact, the objective of this study was to carry through a case study on one of these units, analysing the financial and marketing impacts caused by the implantation of the satellite unit. For this analysis, internal information of the unit had been raised and interviews had been carried through with some managers or people who had relationship with the process of implantation and management of the unit. Futhermore, usuaries had been also interviewed, with the aim to detect theirs perceptions of the unit. The results showed that the users are very satisfied with the Unit. However, there is a clear dissatisfaction in relation to the covering of the supplementary assistance sector. By this fact, it has an important restriction in the access to the unit, that is the main explanation for the negative financial results that the Unit is presenting since its implantation. Due to this results, the unit needs to improve the relationship between the hospital adminsitration and the supplementary health assistance companies in order to revert such situation.
Umas das importantes mais importantes decisões estratégicas que está sendo colocada para os hospitais brasileiros diz respeito à decisão de como expandir sua atuação para outros mercados-alvos no qual o mesmo ainda não tem uma boa cobertura. Diversas estratégias estão sendo adotadas, sendo que a abertura de Unidades Satélites é uma delas e que foi adotada por um hospital privado de grande porte do Estado de São Paulo. Sendo assim, o objetivo do trabalho foi realizar um estudo de caso sobre uma dessas unidades, procurando verificar os impactos financeiros e mercadológicos causados pela implantação da mesma. Para isso, foram levantadas informações internas da unidade e entrevistas foram realizadas com alguns gestores ou pessoas que de algumas forma estiveram relacionadas com o processo de implantação e gerenciamento. Além disso, também foram entrevistados usuários, procurando detectar a percepção dos mesmos sobre a Unidade. Os resultados mostraram que os usuários de modo geral estão muito satisfeitos com a Unidade em termos de atendimento. Entretanto, existe uma clara insatisfação com relação à cobertura do setor de assistência supletiva na Unidade. Em virtude desse fato, há uma restrição importante quanto ao acesso à mesma, o que é uma das mais fortes explicações para os resultados financeiros negativos que a Unidade vêm obtendo desde a sua implantação. Dessa forma, fazem-se necessárias melhorias no relacionamento hospital-operadoras a fim de reverter tal situação.

Mayotte département d’outre-mer français depuis 2011, fait partie de l’archipel des Comores ; elle est séparée des îles de l’État de l’Union des Comores depuis 1975. L’instauration d’un visa en 1995 et l’ordonnance n° 2002-688 du 12 juillet 2004 entréeen vigueur le 1er avril 2005 relative à l’extension de la sécurité sociale à Mayotte exclut les malades étrangers du système de santé mahorais. Ceci entraine des processus d’évacuation sanitaire par la voie d’une immigration clandestine qui provoque des naufrages et des violations des droits du patient. L’attrait de Mayotte et de la France métropolitaine pour les populations défavorisées occasionne des situations de conflits et de concurrence pour l’accès à la protection sanitaire et sociale. Les populations défavorisées de Mayotte, qui se battent pour combler leur retard par rapport à la métropole, vivent mal cette concurrence ; tandis que les populations immigrées vivant dans la clandestinité et sous la menace d’une expulsion imminente, rencontrent des difficultés pour faire valoir leur droit aux soins et au bénéfice à l’assistance du système social. Les obstacles sont nombreux et souvent considérables, dus notamment à la discrimination, à une disparité de difficultés sociales et économiques et à leurs conditions de vie généralement très difficiles. La maîtrise des flux migratoires et la lutte contre l’immigration irrégulière demeurent des priorités de la politique du gouvernement français en matière d’immigration. Laspécificité de la situation du département de Mayotte ainsi que l’importance des flux migratoires qui y sont constatés ont conduit les autorités sanitaires à gérer les flux migratoires liés aux évacuations sanitaires par la voie illégale. La France mène une politique sanitaire en continuant de soutenir l’Union des Comores dans l’amélioration de l’accessibilité et de laqualité des soins, à travers les programmes d’appui au secteur de la santé. Ces programmes auront pour finalité l’amélioration de la santé des mères et des enfants, notamment la réduction des mortalités maternelle et néonatale. La France à travers son organisme Agence française de développement (AFD) entend appuyer le ministère de la Santé dans l’élaboration et la mise en oeuvre des politiques publiques et contribuer au renforcement du cadre institutionnel et juridique du secteur. Il s’agira notamment d’appuyer l’État comorien dans la mise en place de mécanismes de régulation du service privé dans le secteur public et de réformer la pharmacie nationale. Cette recherche pointe les enjeux liés au droit de la protection sociale et au droit de la santé des étrangers sur le territoire national, aussi bien en France métropolitaine qu’à Mayotte. La diversité des droits nationaux applicables à Mayotte constitue une entrave sérieuse face aux dispositifs locaux relatifs à l'accompagnement sanitaire et social. Il est donc indispensable de chercher des solutions juridiques relatives à l’uniformisation de ce droit sanitaire et social afin d’améliorer le système de santé. Les résultats de cette recherche ont montré que les dispositifs locaux tels que le « bon rose » et le « bon AGD » ne sont pas du tout équivalents aux dispositifs nationaux (l'AME et la CMUc)
Mayotte a French overseas department since 2011, is part of the comorian archipelago from which it was separated from the State of Union of the Comoros islands since 1975. The introduction of a visa in 1995 and the order n° 2002-688 delivered on 12 july 2004 and entered into force on April 1st 2005 with regard to the extension of social security in Mayotte exclude the foreign sick from Mayotte's health system. This leads to a process of medical evacuation following an illegal immigration way that causes shipwrecks and the violation of the patient's rights. The attraction of Mayotte and Mainland France for disadvantaged populations lead to conflict situations and competition in the access to health and social protection. Mayotte's disadvantaged populations, who are struggling to catch up with the mainland, do not get along with that competition. At the same time the illegal immigrants living clandestinely and with the threat of expulsion are facing difficulties to assert their right to health care and to benefit from social system assistance. Obstacles are numerous and most of the time considerable, mainly because of discrimination, because of their judicial status, of disparity in their social and economical difficulties and because of their generaly very hard living conditions. The control of migratory flow and the fight against illegal immigrant remain the top priorities of the French government policy as far as immigration is concerned. The singularity of the situation in the department of Mayotte and the huge migratory flows that have been observed led healthcare authorities to handle migratory movements related to illegal medical evacuations. France has a healthcare policy and continues to support the Union of Comoros in the effort to improve healthcare access and quality, through support programs to health sector. These programs aim at improving the health of mothers and children, mainly in reducing maternal mortality. Through its organisation AFD, France aims at supporting health ministry in elaborating and implementing public policies and helping comorian state to put in place regulatory mechanisms of a private service within public sector and to reform the national pharmacy. This work focus on the issues related to the right to social protection and the health law for foreigners on the national territory, in mainland France and in Mayotte as well. Diversity of national laws applicable in Mayotte is a significant barrier to local devices in terms of medical and social assistance. It is necessary to seek legal solutions related to standardization of this health and social law in order to better the healthcare system. During our field research we observed that local devices such as the "pink warrant" and the "good AGD" are not at all equivalent to the national devices (AME and CMUc)

Seniors face complex legal concerns that are often different from what they faced when they were younger. A range of federal protections and laws exist offering guidance and regulatory structure to the aging population. Examples reviewed in this chapter include federally supported financial assistance for healthcare and benefits, such as Medicare, Supplemental Nutrition Assistance Program (SNAP), Senior Health Insurance Program (SHIP); elder abuse reporting and interventions; consumer protections; and decision-making for aging and incapacitated persons. Elder law attorneys focus their practice on the legal needs of seniors and work with a variety of legal tools and techniques to specifically meet the goals of the older client, in order to maximize their autonomy and quality of life.