Rural health services and the task of community participation at the local community level: a case study

2018 ◽  
Vol 42 (1) ◽  
pp. 111 ◽  
Author(s):  
Elena Wilson ◽  
Amanda Kenny ◽  
Virginia Dickson-Swift
Keyword(s):  
Health Policy ◽  
Health Service ◽  
Health Services ◽  
Community Participation ◽  
Rural Health ◽  
Service Planning ◽  
Rural Health Services ◽  
Case Study Methodology ◽  
Rural Health Service

Community participation in health service decision making is entrenched in health policy, with a strong directive to develop sustainable, effective, locally responsive services. However, it is recognised that community participation is challenging to achieve. The aim of the present study was to explore how a rural health service in Victoria enacts community participation at the local level. Using case study methodology, the findings indicate that enactment of community participation is desired by the health service, but a lack of understanding of the concept and how to enact associated policy are barriers that are exacerbated by a lack of resources and community capacity. The findings reveal a disconnect between community participation policy and practice. What is known about the topic? The need to involve communities in health service planning, implementation and evaluation is a feature of health policy across major Western countries. However, researchers have identified a dearth of research on how community participation is enacted at the local service level. What does this paper add? The study that is presented herein addresses a gap in knowledge of community participation policy enactment within a rural health service. Insights are provided into the challenges faced by rural health services, with a disconnect between policy ideal and the reality of implementation. What are the implications for practitioners? Health service staff need clear direction from chief executive officers about the purpose of community participation policy and the expectations for individual roles. Community advisory committees need clarity about the community member role and the processes for making decisions. Services and their boards would benefit from targeted government funding to resource community participation activity.

scholarly journals Index of Access: a new innovative and dynamic tool for rural health service and workforce planning

2017 ◽  
Vol 41 (5) ◽  
pp. 492 ◽  
Author(s):  
Matthew R. McGrail ◽  
Deborah J. Russell ◽  
John S. Humphreys
Keyword(s):  
Health Service ◽  
Rural Health ◽  
Workforce Planning ◽  
Service Planning ◽  
Rural And Remote ◽  
Health Service Planning ◽  
Planning Decisions ◽  
Primary Health ◽  
Rural Health Service

Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific ‘fit-for-purpose’ access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is demonstrated using a case study to hypothetically model changes in rural PHC workforce supply. What are the implications for practitioners? The Index of Access has significant potential for identifying how rural and remote primary health care access inequities can be addressed. This critically important information can assist health service planners, for example those working in primary health networks, to determine where and how much redistribution of PHC services is needed to correct existing inequities.

scholarly journals How to increase the value of self-reported health service data by using data linkage: a case study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Peng ◽  
J Maguire ◽  
A Hayen ◽  
J Adams ◽  
D Sibbritt
Keyword(s):  
Data Collection ◽  
Health Service ◽  
Health Services ◽  
Stroke Prevention ◽  
Data Linkage ◽  
Recurrent Stroke ◽  
Service Planning ◽  
Stroke Survivors ◽  
Reported Data

Abstract Background This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments? Methods 45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis. Results A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures. Conclusions Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants. Key messages Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.

Planning health services

2020 ◽  
pp. 402-411
Author(s):  
David Lawrence
Keyword(s):  
Health Service ◽  
Health Services ◽  
Conceptual Framework ◽  
Service Planning ◽  
Health Service Planning ◽  
Soft Systems ◽  
Successes And Failures

This chapter shows you how to contribute to planning health services successfully at strategic and operational levels. It first explains what health service planning is and the nature of health services as mainly ‘soft’ systems. It provides a conceptual framework for planning and then goes through steps and tasks in planning. It then suggests some ways of overcoming pitfalls, notes some common fallacies about planning, and provides a real planning case study with its successes and failures. Finally, it notes ways to assess how well you are doing

An exploration of the longer-term impacts of community participation in rural health services design

2015 ◽  
Vol 141 ◽  
pp. 64-71 ◽  
Author(s):  
Jane Farmer ◽  
Margaret Currie ◽  
Amanda Kenny ◽  
Sarah-Anne Munoz
Keyword(s):  
Health Services ◽  
Community Participation ◽  
Rural Health ◽  
Rural Health Services

Limitations of Rural Health Services and Assessment Pregnant Mothers in the Pandemic Covid-19 of the Papua Province Indonesian

2020 ◽  
Vol 7 (7) ◽  
pp. 723-731
Author(s):  
Semuel Piter Irab
Keyword(s):  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Rural Health ◽  
Virus Disease ◽  
Provincial Government ◽  
Rural Health Services ◽  
Corona Virus ◽  
Integrated Health ◽  
Pregnant Mothers

Background Pandemic infectious diseases cause morbidity and deaths to increase over time globally. Corona virus disease-19 (Covid-19) is an infectious disease found in China in Wuhan City, and spread very quickly to Indonesia and Papua Province. The purpose of this study was to determine limitations of the rural health services, and  assessment of the pregnant mothers in the pandemic covid-19 Papua Province of Indonesian. Methods The cross sectional study design, is a type of research to see the relationship between the limitations of rural health services, according to the assessment pregnant mothers in the pandemic covid-19 Papua Province. Jayapura City and Jayapura Regency research sites, which represents all Cities/Regencies in Papua Province. The population is all pregnant mothers  in Jayapura City and Jayapura Regency. The samples was 89 pregnant mothers living in rural areas. Data analysis using the Chi-Square test (χ2). Results The limitation of integrated health service post was very less 38,2% and very good 22,5%. The community health center is very less 41,6% and good 22,5%. Hospitals are very less 31,5% and very good 25,8%. The practice of doctors / midwife is less 30,3% and very good 31,5%. The limitations of antenatal care were very less 38,2% and good 22,5%. The limitation treatment of the sick pregnant mothers was 39,3% and good 22,5%. The prevalence covid-19 rural is very high 40,4% and low 20,2%. Assessment of the significant pregnant  mothers with  prevalence covid-19 of rural, the limitations of integrated health service posts, community health centers, hospitals, doctor/midwife practices, limitations in pregnant mothers, and limitations of treatment for sick pregnant mothers. Conclusion The adverse effects of the pandemic covid-19 are increasing day by day, the provincial government of Papua implements health protocols to protect the public, in other parts of pregnant mothers who don't suffer from corona virus, but suffering from other illnesses and wanting to visit a health service unit is limited.

First impressions: towards becoming a health-literate health service

2014 ◽  
Vol 38 (2) ◽  
pp. 190 ◽  
Author(s):  
Anne Johnson
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Health Information ◽  
First Impressions ◽  
Phone Call ◽  
Literacy Environment ◽  
Rural Health Service ◽  
Lack Of Information

A ‘health-literate organisation’ recognises that miscommunication is very common and can negatively affect consumer care and outcomes, and makes it easier for people to navigate, understand, and use health information and services. This paper reports on the First Impressions Activities conducted by consumers to assess aspects of the literacy environment of a rural health service. The First Impressions Activities consists of three tools to assist health services to begin to consider some of the characteristics of their organisation that help and hinder a consumer’s ability to physically navigate their way to and about the health service. The results show that navigation to and within the rural health service was made more complex due to lack of information, difficulty finding information, inconsistent terminology used in signage, missing signage, signage obscured by foliage, and incorrect signage. What is known about the topic? The environment of a health service represents the health literacy expectations, preferences and skills of those providing health information and services. What does this paper add? This case study offers insight into the literacy demands placed on consumers, as well as an effective tool to assess aspects of those health literacy demands. What are the implications for practitioners? Health services can use the First Impressions Activities to actively engage consumers in the assessment of their first impressions of the health service shaped by a phone call, a visit to the website and a walk to the entrance and to different destinations. These activities can assist a health service to begin to examine the navigation of the service through ‘fresh eyes’, using a structured process to identify ways to decrease the health literacy demands on consumers.

scholarly journals Faith in the 'cultural fix': limits to a planned cultural change program in a rural health service

2000 ◽  
Vol 23 (4) ◽  
pp. 187
Author(s):  
Kerry Mahony
Keyword(s):  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Cultural Change ◽  
Cultural Analysis ◽  
Cultural Control ◽  
Cultural Integration ◽  
Attitudes And Beliefs ◽  
Beliefs And Practices ◽  
Rural Health Service

This paper, by way of a narrative on the author's participation, explains the limits to a planned cultural changeprogram in a large rural health service. Cultural change was identified by the CEO as crucial to the success of a majorrestructuring of the service, and the attitudes and beliefs of the 'old guard' were considered to be constraining progress.Advocates of cultural integration contend that shared core values across an organisation can overcome such obstacles.This is a matter of faith. An application of Habermasian theory suggests that organisational leaders are drawing ontraditional/religious beliefs and practices to bolster their visions and missions at a time of motivational crisis.Though a need for cultural change in some sectors of the health services is acknowledged, the particular challenges inattempting to manipulate the traditionally embedded culture and sub-cultures of the health services is highlighted.An analysis of some of the ideas and beliefs surrounding authority, deference and discipline is undertaken. It is arguedthat the ritualistic reinforcement of these beliefs and the reproduction of sub-cultures along material and ideal interestsmilitate against the implementation of objectives delineated by the CEO.While cultural analysis has revealed the irrational face of organisations and can bring to conscious awareness the taken-for-granted beliefs which inform behaviour, the cultural integrationists have a further agenda. They aim tomanipulate organisational culture to subtly control employees' beliefs and hence behaviour. Cultural control is a covertform of top down authority that can be just as directive and centralising as bureaucratic control. The author alsomaintains that cultural change programs alone cannot fix a problem that arose in the macro-economic sphere: a chroniclack of resources ever since the state responded to the economic crisis by cutting funds to health and welfare services.

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