scholarly journals The health promotion shift into Primary Health Organisations: Implications for the health promotion workforce

2011 ◽  
Vol 3 (1) ◽  
pp. 41 ◽  
Author(s):  
Sarah Lovell ◽  
Pat Neuwelt
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Sector ◽  
Primary Health ◽  
Primary Care Sector ◽  
Care Health

INTRODUCTION: Reconciling the primary care sector’s traditional concern for individual health outcomes with a population health approach is integral to the implementation of New Zealand’s Primary Health Care Strategy, and a key challenge for health promotion in New Zealand. The purpose of this study was to examine the views of health promoters, their funders and managers toward the implementation of the Primary Health Care Strategy’s health promotion agenda. METHODS: Focus groups and interviews were carried out with 64 health promoters and 21 health sector managers and planners and funders over the 12 months beginning March 2008. Interview and focus group transcripts were analysed thematically. FINDINGS: Primary Health Organisations (PHOs) have been perceived as both an opportunity and a threat to health promotion. The opportunity was seen to lie in the development of health promotion responsive to the needs of communities. Yet the numerous PHOs that emerged spread funding and capacity for health promotion thin, particularly amongst smaller PHOs. CONCLUSION: The failure of the Ministry of Health to engage the health promotion workforce in the development and implementation of the Primary Health Care Strategy has led to a clear sense of vulnerability among health promoters. Ideological divisions between primary care and public health have been exacerbated by the restructuring of health promotion funding and delivery. Within non-governmental organisations and public health units concern continues to surround the legitimacy of health promotion approaches undertaken within the primary health care sector. KEYWORDS: Health promotion; primary health care; health policy; Primary Health Organisations; New Zealand; restructuring

How the Institutional and Policy Context Shapes the Establishment of Nurse Practitioner Roles and Practice in New Zealand’s Primary Health Care Sector

2020 ◽  
pp. 152715442096553
Author(s):  
Sue Adams ◽  
Jenny Carryer
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Nurse Practitioner ◽  
Central Government ◽  
Health Sector ◽  
District Health ◽  
Policy Context ◽  
Primary Health

The implementation of the nurse practitioner (NP) workforce in primary health care (PHC) in New Zealand has been slow, despite ongoing concerns over persisting health inequalities and a crisis in the primary care physician workforce. This article, as part of a wider institutional ethnography, draws on the experiences of one NP and two NP candidates, as they struggle to establish and deliver PHC services in areas of high need, rural, and Indigenous Māori communities in New Zealand. Using information gathered initially by interview, we develop an analysis of how the institutional and policy context is shaping their experiences and limiting opportunities for the informants to provide meaningful comprehensive PHC. Their work (time and effort), with various health organizations, was halted with little rationale, and seemingly contrary to New Zealand’s strategic direction for PHC stipulated in the Primary Health Care Strategy 2001. The tension between the extant biomedical model, known as primary care, and the broader principles of PHC was evident. Our analysis explored how the perpetuation of the neoliberal health policy environment through a “hands-off” approach from central government and district health boards resulted in a highly fragmented and complex health sector. Ongoing policy and sector perseverance to support privately owned physician-led general practice; a competitive contractual environment; and significant structural health sector changes, all restricted the establishment of NP services. Instead, commitment across the health sector is needed to ensure implementation of the NP workforce as autonomous mainstream providers of comprehensive PHC services.

scholarly journals The Pacific primary health care workforce in New Zealand: What are the needs?

2009 ◽  
Vol 1 (2) ◽  
pp. 126 ◽  
Author(s):  
Luisa Ape-Esera ◽  
Vili Nosa ◽  
Felicity Goodyear-Smith
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Health Care Workforce ◽  
Pacific People ◽  
Advantages And Disadvantages ◽  
Pacific Population ◽  
Primary Health ◽  
The Impact

AIM: To scope future needs of the NZ Pacific primary care workforce. METHOD: Semi-structured interviews with key informants including Pacific primary care workers in both Pacific and mainstream primary health care organisations and managers at funding, policy and strategy levels. Qualitative thematic analysis using general inductive approach. RESULTS: Thirteen stakeholders interviewed (four males, nine females) in 2006. Included both NZ- and Island-born people of Samoan, Tongan, Niuean, Fijian and NZ European ethnicities; age 20–65 years. Occupations included general practitioner, practice nurse, community worker, Ministry of Health official and manager representing mainstream and Pacific-specific organisations. Key themes were significant differences in attributes, needs and values between ‘traditional’ and contemporary Pacific people; issues regarding recruitment and retention of Pacific people into the primary health care workforce; importance of cultural appropriateness for Pacific populations utilising mainstream and Pacific-specific primary care services and both advantages and disadvantages of ‘Pacific for Pacific’ services. CONCLUSION: Interviews demonstrated heterogeneity of Pacific population regarding ethnicity, age, duration of NZ residence and degree of immersion in their culture and language. Higher rates of mental disorder amongst NZ-born Pacific signpost urgent need to address the impact of Western values on NZ-born Pacific youth. Pacific population growth means increasing demands on health services with Pacific worker shortages across all primary health care occupations. However it is not possible for all Pacific people to be treated by Pacific organisations and/or by Pacific health workers and services should be culturally competent regardless of ethnicity of providers. KEYWORDS: Pacific Islands, New Zealand, manpower, ethnic groups, Oceanic Ancestry Group, primary health care

scholarly journals Discussing issues of health promotion and research in the context of primary care during the ongoing austerity period: an exploratory analysis from two regions in Greece

2019 ◽  
Author(s):  
Vicky Sbarouni ◽  
Elena Petelos ◽  
Apostolos Kamekis ◽  
Stylianos Ioannis Tzagkarakis ◽  
Emmanouil K Symvoulakis ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
National Health System ◽  
Average Score ◽  
Primary Health ◽  
Prevention And Health Promotion ◽  
Baseline Information ◽  
Administrative Governance

Background. In Greece, both Primary Health Care (PHC) system and National Health System (NHS) in general, were plagued by several inefficiencies even prior to the financial crisis; the imposed austerity measures dramatically worsened the level of health provision and access, especially for vulnerable social groups, resulting in an exacerbation of existing disparities and access gaps.  Aim and methods. The current branch study was conducted in two regions of Greece, namely Crete and Epirus, with the main aim of eliciting responses to gather baseline information regarding crucial PHC-related aspects, using questionnaires with dichotomous questions. Directors or managers (physicians who have been assigned administrative/governance duties), of the Primary Health Care Centres (PHCCs) in two Greek geographic and administrative regions of Crete and Epirus, were invited to participate and to contribute to the investigation of issues on the provision of prevention and health promotion services, e-health topics and primary care research. Thirty directors/managers were approached and twenty-eight agreed to participate. Data processing and analysis of the responses was performed for the completed questionnaires.   Results. Data analysis did not demonstrate a surprisingly substantial deviation in the average score of positive responses of directors/managers in the PHCCs of Crete in comparison to those of directors/managers in the PHCCs of Epirus. The findings show that several gaps exist in terms of prevention and health promotion resources and activities in both regions, while e-health, electronic health record (EHR) and telemedicine services are poorly developed.  Conclusion. The study confirms that the Greek PHC is characterized by several inefficiencies, which may affect the quality of the services provided. An overall deficit has been emerged for PHCCs in both regions, a fact that indicates crucial points lacking in terms of overall PHC provision, thus adversely impacting upon living conditions, health quality and prevention.    

scholarly journals Strengthening primary health care through primary care and public health collaboration: the influence of intrapersonal and interpersonal factors

2018 ◽  
Vol 19 (04) ◽  
pp. 378-391 ◽  
Author(s):  
Ruta K. Valaitis ◽  
Linda O’Mara ◽  
Sabrina T. Wong ◽  
Marjorie MacDonald ◽  
Nancy Murray ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Influencing Factors ◽  
Effective Communication ◽  
Key Informants ◽  
Primary Health ◽  
Interpersonal Factors ◽  
Beliefs And Attitudes

AimThe aim of this paper is to examine Canadian key informants’ perceptions of intrapersonal (within an individual) and interpersonal (among individuals) factors that influence successful primary care and public health collaboration.BackgroundPrimary health care systems can be strengthened by building stronger collaborations between primary care and public health. Although there is literature that explores interpersonal factors that can influence successful inter-organizational collaborations, a few of them have specifically explored primary care and public health collaboration. Furthermore, no papers were found that considered factors at the intrapersonal level. This paper aims to explore these gaps in a Canadian context.MethodsThis interpretative descriptive study involved key informants (service providers, managers, directors, and policy makers) who participated in one h telephone interviews to explore their perceptions of influences on successful primary care and public health collaboration. Transcripts were analyzed using NVivo 9.FindingsA total of 74 participants [from the provinces of British Columbia (n=20); Ontario (n=19); Nova Scotia (n=21), and representatives from other provinces or national organizations (n=14)] participated. Five interpersonal factors were found that influenced public health and primary care collaborations including: (1) trusting and inclusive relationships; (2) shared values, beliefs and attitudes; (3) role clarity; (4) effective communication; and (5) decision processes. There were two influencing factors found at the intrapersonal level: (1) personal qualities, skills and knowledge; and (2) personal values, beliefs, and attitudes. A few differences were found across the three core provinces involved. There were several complex interactions identified among all inter and intra personal influencing factors: One key factor – effective communication – interacted with all of them. Results support and extend our understanding of what influences successful primary care and public health collaboration at these levels and are important considerations in building and sustaining primary care and public health collaborations.

scholarly journals Characteristics of nurses providing diabetes community and outpatient care in Auckland

2013 ◽  
Vol 5 (1) ◽  
pp. 19 ◽  
Author(s):  
Barbara Daly ◽  
Bruce Arroll ◽  
Nicolette Sheridan ◽  
Timothy Kenealy ◽  
Robert Scragg
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
New Zealand ◽  
Diabetes Management ◽  
Practice Nurses ◽  
Primary Health ◽  
District Nurses ◽  
Primary Care Nurses ◽  
Specialist Nurses

INTRODUCTION: There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. AIM: To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. METHOD: Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006–2008. RESULTS: Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. DISCUSSION: These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access. KEYWORDS: Community health nursing; diabetes mellitus; internet; nurses; primary health care

scholarly journals Renewing primary care: the bottom-up experience of an Italian health professional movement

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Sessa ◽  
C Milani ◽  
G Occhini ◽  
G Marini ◽  
A Sarro
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Medical Education ◽  
Primary Health Care ◽  
Learning Environments ◽  
Health Professionals ◽  
Interprofessional Education ◽  
Training Session ◽  
Primary Health

Abstract Sustainability of the National Health Systems (NHS) has been facing different challenges. A community-oriented Comprehensive Primary Health Care (CommOr C-PHC) could help its survival. Such a framework, focused on health promotion, primary prevention, not communicable disease management, requires new capabilities among health professionals. Considering teamwork and interprofessional collaboration (IPC) as PHC core elements, there is growing recognition of the need of interprofessional education (IPE). Nevertheless, italian medical education is distant from other disciplines and mainly based on hospital care settings. Since this situation represents an obstacle to implement a CommOr C-PHC model of health service, new ways of training students and retraining actual health workers should be developed. The aim of the project is to design IPE programs and to improve IPC within the C-PHC framework, shared learning environments placed in the community were developed. At the end of 2017 a group of young italian health professionals (public health resident, young general practitioner, social assistant, nurse, medical anthropologist, etc) founded the Campaign “2018 Primary Health care: Now or never”, a cultural movement of public health advocacy. Its goals are: The creation of a common cultural background through the study of PHC evidence and best italian and international practices. Organization of workshops all over Italy: peer education training session, site-visits, lectures with Italian and foreigner health professionals, based on need assessment methods. Individuation of learning environments placed in the community and in a primary care setting where students can apprehend social determinants of health, exercise critical thinking and develop transprofessional knowledge. Key messages Young health professionals from Italy, starting from the need for a different educational framework, based on IPE, created a movement to defend the NHS and promote PHC principles. The success and large participation of a national campaign sustaining PHC and aimed at promoting interprofessional education shows the need for a change in the medical education field.

scholarly journals Editorial

1995 ◽  
Vol 1 (1) ◽  
pp. 2
Author(s):  
Heather Gardner
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Continuity Of Care ◽  
Health Sector ◽  
Community Health Services ◽  
Continuing Care ◽  
Australian Health ◽  
Primary Health

The advent of the Australian Journal of Primary Health - Interchange reflects the changes which are taking place in the Australian health sector and the increased and increasing importance of primary health care and community health services. The significant role of primary care in maintaining health and enhancing wellbeing is at last being recognised, and the relationships between primary care, continuing care, and acute care are being redefined and the connections made, so that improvement in continuity of care can be achieved.

scholarly journals The use of Artificial Neural Networks in the diagnosis of manageable factors on Brazilian Primary Health Care

2021 ◽  
Vol 10 (1) ◽  
pp. e31010111740
Author(s):  
Kerla Fabiana Dias Cabral ◽  
Fábio Ribeiro Cerqueira ◽  
Rodrigo Siqueira-Batista ◽  
Marco Aurélio Marques Ferreira ◽  
Bruna Rodrigues de Freitas
Keyword(s):  
Neural Networks ◽  
Primary Care ◽  
Health Care ◽  
Artificial Neural Networks ◽  
Primary Health Care ◽  
Health Sector ◽  
Welfare Programs ◽  
Primary Health ◽  
The Social ◽  
Artificial Neural

The social determinants of health are relevant in the main strategies of Primary Health Care. However, it is known the difficulties of the health sector to overcome the factors that negatively interfere with the health of the population. Thus, it was aimed to create a computer model to present in detail the factors that somehow are related to the Primary Health Care, enabling public health managers to make decisions efficiently. Using artificial neural networks, it was possible to create a classifier model that could show which variables are related to the efficiency in Primary Care and which lead to inefficiency. Moreover, it was used the NICeSim simulator as a tool to evaluate the behavior of each variable identified as relevant to the efficiency in Primary Care of cities. The results demonstrate that the created model was superior to previously proposed models. Furthermore, our model has been demonstrated to be very effective in identifying variables that affect Primary Health. The created model shows that factors, such as illiteracy and welfare programs, considerably affect the efficiency of health care, reinforcing the argument that the focus of the public policies should be dealt in an intersectoral way, improving the factors that positively influence the population health.

scholarly journals Desafios dos processos educativos em nutrição na atenção primária à saúde

2020 ◽  
Vol 10 (2) ◽  
pp. 177
Author(s):  
Renan Soares Araújo ◽  
Ana Claudia Cavalcanti Peixoto Vasconcelos ◽  
Pedro José Santos Carneiro Cruz
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Professional Training ◽  
Healthy Diet ◽  
Current Debate ◽  
Primary Health ◽  
Educational Processes ◽  
Food And Nutrition

O presente artigo objetiva apresentar e discutir os desafios dos processos educativos em alimentação e nutrição no âmbito da Atenção Primária à Saúde (APS), tendo como base de sua análise, as publicações institucionais do Governo Federal brasileiro. Para tanto, efetuou-se uma pesquisa documental, com enfoque qualitativo, do tipo exploratória e descritiva. Constituíram como fontes documentais, as publicações sobre alimentação e nutrição promulgadas de 2006 a 2016 − período marcado pela expansão e fortalecimento das políticas públicas de saúde e nutrição, com centralidade para o combate à fome e à miséria, e para a promoção da alimentação saudável. Como resultado, elencou-se três desafios para os processos educativos em alimentação e nutrição na APS: i) desenvolver a concepção de Promoção da Saúde no contexto dos processos educativos em alimentação e nutrição; ii) a construção de práticas de educação alimentar e nutricional com perspectiva pedagógica crítica, ênfase intersetorial e abordagem interdisciplinar e; iii) constituir abordagens de formação profissional coerentes com um olhar ampliado sobre a alimentação, a nutrição e suas interfaces sociais. Ademais, sublinhou-se alguns referenciais significativos em apoio à implementação de ações nesse horizonte. Finalmente, evidencia-se a APS como espaço promissor no enfrentamento do contexto de saúde contemporâneo, baseando-se em teorias pedagógicas críticas, dialógicas e problematizadoras, com vistas à promoção da alimentação adequada e saudável. Para além do papel do nutricionista, se sobressai a necessidade de engajamento de outros profissionais na constituição de processos interdisciplinares e intersetoriais, alinhando-se com o atual debate sobre Promoção da Saúde e Segurança Alimentar e Nutricional.Palavras-chave: Educação alimentar e nutricional; Atenção Primária à Saúde; Saúde pública; Promoção da saúde; Segurança alimentar e nutricional. ABSTRACT: This article aims to present and discuss the challenges of educational processes in food and nutrition within the scope of Primary Health Care (PHC), based on the analysis of the institutional publications of the Federal Government. Methodologically, was development a documentary research, with a qualitative approach, of an exploratory and descriptive type. Were constituted as documentary sources the publications on food and nutrition promulgated from 2006 to 2016 − due to the expansion and strengthening of public health and nutrition policies, with a focus on combating hunger, poverty and promoting healthy diet. As a result, three challenges were identified for the educational processes in food and nutrition in PHC: i) to develop the concept of Health Promotion in the context of educational processes in food and nutrition; ii) the construction of food and nutrition education practices with a critical pedagogical perspective, intersectoral emphasis and interdisciplinary approach; iii) to constitute professional training approaches that are coherent with a broader perspective on food, nutrition and their social interfaces. In addition, some significant references were highlighted in support of the implementation of actions within this horizon. Finally, PHC is highlighted as a promising space in facing the contemporary health context, based on critical, dialogical and problematizing pedagogical theories, with a view to promoting healthy diet. For more, the need to engage other professionals in the establishment of interdisciplinary and intersectoral processes is highlighted, in line with the current debate on Health Promotion and Food and Nutritional Security.Keywords: Food and nutritional education; Primary Health Care; Public health; Health promotion; Food and nutrition security.

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