Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

2011 ◽  
Vol 17 (4) ◽  
pp. 362 ◽  
Author(s):  
Sarah Larkins ◽  
Tarun Sen Gupta ◽  
Rebecca Evans ◽  
Richard Murray ◽  
Robyn Preston

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

Curationis ◽  
2001 ◽  
Vol 24 (4) ◽  
Author(s):  
N Geyer

The South African health system has undergone major changes over the last 5 - 1 0 years. These rapid changes have not only significantly increased the visibility of the nurse practitioner in South Africa, but are also posing challenges to the profession and health care services that need to be addressed. In its Health Policies the Government has indicated that the nursing/midwifery profession, as the biggest group of health care professionals, should be the practitioners to provide primary health care services to the communities. But to do this, they require enabling legislation. The “permit system” has been in place for non-pharmacists and institutions other than hospitals and pharmacies to acquire, possess, use and supply medication for a number of years. This system has been fraught with problems mainly due to a lack of clarity on exactly how the system works and the system has been abused. The purpose of this article is to explore the current situation with the aim to analyze the legal framework that exists within which the primary health care services, and specifically the diagnosing and prescribing of medication, could be performed. The conclusion is made that health legislation has not kept up with the rapid changes in service delivery and are not adequate to empower the nurse to deliver health services. Some recommendations are made for the way forward.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.


1994 ◽  
Vol 9 (2) ◽  
pp. 155-160 ◽  
Author(s):  
W KIPP ◽  
AA KIELMANN ◽  
E KWERED ◽  
G MERK ◽  
T RUBAALE

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