Impact evaluation of a health promotion-focused organisational development strategy on a health service

2015 ◽  
Vol 21 (4) ◽  
pp. 444 ◽  
Author(s):  
Michelle Costello ◽  
Jane Taylor ◽  
Lily O'Hara

A comprehensive primary health care approach is required to address complex health issues and reduce inequities. However, there has been limited uptake of this approach by health services nationally or internationally. Reorienting health services towards becoming more health promoting provides a mechanism to support the delivery of comprehensive primary health care. The aim of this study was to determine the impact of a health promotion-focused organisational development strategy on the capacity of a primary health care service to deliver comprehensive primary health care. A questionnaire and semistructured individual interviews were used to collect quantitative and qualitative impact evaluation data, respectively, from 13 health service staff across three time points with regard to 37 indicators of organisational capacity. There were significant increases in mean scores for 31 indicators, with effect sizes ranging from moderate to nearly perfect. A range of key enablers and barriers to support the delivery of comprehensive primary health care was identified. In conclusion, an organisational development strategy to reorient health services towards becoming more health promoting may increase the capacity to deliver comprehensive primary health care.

2017 ◽  
Vol 23 (3) ◽  
pp. 243 ◽  
Author(s):  
Kathryn McFarlane ◽  
Sue Devine ◽  
Jenni Judd ◽  
Nina Nichols ◽  
Kerrianne Watt

Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.


Curationis ◽  
1981 ◽  
Vol 4 (3) ◽  
Author(s):  
Delene Mcnulty

Article 30 areas are those in which the Department of Health, Welfare and Pensions act as the local authority in terms of health services. The Department has been developing comprehensive primary health care services, provided by registered nurses, in these areas since 1975. These services are challenged by complex problems and methods for primary health care used successfully in other areas are inappropriate. As those served are mostly immigrant farm labourers, village workers cannot be used. A lack of demographic and epidemiological data complicates the setting of objectives and thus planning of services. There are few clinic services and supportive services and sources for referral are inadequate or non-existent. The nurse mostly provides the service from a car at suitable central points. Sophisticated technology cannot be used and equipment, techniques and procedures must be carefully selected or even improvised. The success of the service depends on the nurses’ ability to gain the co-operation and acceptance of the farmer who is the employer; doctors and pharmacists; school principals; magistrates; the nearest hospitals which may be in another country; and of the target group comprising the workers and their families. In this time of fragmentation and specialised care in health services the nurses providing the section 30 services must be able to meet all promotive, preventive, curative and rehabilitative health needs — she is expected to be a model of versatility.


1999 ◽  
Vol 5 (3) ◽  
pp. 6 ◽  
Author(s):  
John Macdonald

Comprehensive Primary Health Care, and Comprehensive Health Promotion, is as relevant today as it ever was. Its approach and philosophy are useful and even necessary tools in all societies where there is still concern to build a rational and humane health care system.


2020 ◽  
Vol 10 (32) ◽  
pp. 367-372
Author(s):  
Fernanda Cristina Santos Rodrigues ◽  
Izabella Cristina Alves de Souza ◽  
Alexandra Paiva Araújo Vieira ◽  
Janice Maria Borba ◽  
Liléia Gonçalves Diotaiuti ◽  
...  

O Sistema Único de Saúde enfrenta desafios em relação à doença de Chagas devido ao elevado número de portadores crônicos no Brasil. Os enfermeiros e auxiliares/técnicos de enfermagem são os profissionais que prestam acolhimento e encaminhamento dos portadores nas Unidades Básicas de Saúde. Objetivou-se analisar a percepção da equipe de enfermagem sobre a doença de Chagas e serviços de saúde relacionados nos municípios da microrregional de saúde de Itaúna, Minas Gerais. Foram aplicados questionários semiestruturados aos profissionais de enfermagem. Os profissionais dominam aspectos relacionados aos vetores, sintomas, exames diagnósticos e fluxo de exames. Há ausência de ações de promoção à saúde voltadas a doença, problemas no rastreamento dos portadores na Atenção Primária à Saúde, e ausência de capacitações para os profissionais abordando o manejo clínico da doença. Sugere-se a realização de capacitações com foco técnico/clínico voltadas à equipe de enfermagem, e implantação de ações de promoção a saúde nos municípios.Descritores: Atenção Primária à Saúde, Estratégia de Saúde da Família, Serviços de Saúde. Nursing team: perception of Chagas diseaseAbstract: The primany health care in Brazil, faces challenges in relation to Chagas disease due to the high number of chronic carriers in Brazil. Nurses and nursing assistants / technicians are professionals who provide care and referrals to patients in Basic Health Units. The objective of this study was to analyze the perception of the nursing team about Chagas disease and related health services in the municipalities of the micro health region. Itaúna, Minas Gerais. Semi-structured questionnaires were applied to nursing professionals. Professionals master aspects related to vectors, symptoms, diagnostic tests and flow of tests. There is an absence of health promotion actions aimed at disease, problems in tracking patients in Primary Health Care, and an absence of training for professionals addressing the clinical management of the disease. It is suggested to carry out training with a technical/clinical focus on the nursing team, and to implement health promotion actions in the municipalities.Descriptors: Chagas Disease, Family Health Team, Primary Health Care, Health Services. Equipo de enfermería: percepción de la enfermedad de ChagasResumen: El Sistema Único de Salud enfrenta desafíos en relación con la enfermedad de Chagas debido a la gran cantidad de portadores crónicos en Brasil. Las enfermeras y los asistentes / técnicos de enfermería son profesionales que brindan atención y derivaciones a pacientes en Unidades Básicas de Salud. El objetivo de este estudio fue analizar la percepción del equipo de enfermería sobre la enfermedad de Chagas y los servicios de salud relacionados en los municipios de la región de micro salud. Itaúna, Minas Gerais. Se aplicaron cuestionarios semiestructurados a profesionales de enfermería. Los profesionales dominan aspectos relacionados con vectores, síntomas, pruebas de diagnóstico y flujo de pruebas. Hay una ausencia de acciones de promoción de la salud dirigidas a la enfermedad, problemas en el seguimiento de pacientes en Atención Primaria de Salud y una falta de capacitación para profesionales que aborden el manejo clínico de la enfermedad. Se sugiere llevar a cabo capacitación con un enfoque técnico / clínico en el equipo de enfermería e implementar acciones de promoción de la salud en los municipios.Descriptores: Atención Primaria de Salud, Estrategia de Salud Familiar, Servicios de Salud.


2020 ◽  
Vol 6 (2) ◽  
pp. I-II
Author(s):  
Tashi Tobgay ◽  
Susan Rifkin

The World Health Organization was created in 1948. It was initially focused on medical and bio-medical issues and on the delivery of health services. The Alma Ata Declaration of 1978 brought the wider context of social determinants based on the principles of equity and community participation into discussions about how health improves1. The Global Conference on Primary Health Care in Astana, Kazakhstan in October 2018, reinforced the critical role of primary health care to ensure that everyone everywhere is able to enjoy the highest possible attainable standard of health2. Primary Health Care (PHC) became the policy of all member nations. Despite this policy, focus has remained on the delivery of health services. This siloed approach proved inadequate to address the COVID pandemic. The result has been the loss of several hundred thousand lives as well as livelihood of millions more people3.


2010 ◽  
Vol 16 (3) ◽  
pp. 211 ◽  
Author(s):  
Helen Keleher ◽  
Rhian Parker ◽  
Karen Francis

Health reform is increasingly targeted towards strengthening and expansion of primary health systems as care is shifted from hospitals to communities. The renewed emphasis on prevention and health promotion is intended to curb the tide of chronic disease and sustain effective chronic disease management, as well as address health inequities and increase affordable access to services. Given the scope of nurses’ practice, the success of Australia’s health system reforms are dependent on a nursing workforce that is appropriately educated and prepared for practice in community settings. This article reports on the results of an Australian national audit of all undergraduate nursing curricula to examine the extent of professional socialisation and educational preparation of nurses for primary health care. The results of the audit are compared with Australian nursing standards associated with competency in primary health care. The findings indicate that Australian nursing competencies are general in their approach to skills and knowledge, not specifying any particular competencies for primary health care, while undergraduate student preparation for practice in primary health and community settings is patchy and not keeping pace with reform agendas that promote expanded roles for nurses in primary health care, prevention and health promotion. The implication for nursing curriculum reform is that attention to achieving nursing graduate capacity for primary health care and health promotion is a priority.


2017 ◽  
Vol 12 (2) ◽  
pp. 431-440 ◽  
Author(s):  
Antônio Augusto Dall’Agnol Modesto ◽  
Marcia Thereza Couto

Erectile dysfunction (ED) is a common sexual problem and has been attracting growing interest from the field of medicine. The pharmaceutical industry works together with medical associations to popularize the theme, emphasizing individual enhancement and medication, besides reinforcing an idea of a male sexuality defined by the ability to have an erection and penetrate. Patients worried about erection problems search for general practitioners (GPs), frequently without a clear complaint, and a comprehensive primary health care (PHC) must be capable of dealing with these issues considering medicalization and disease mongering. This article discusses how PHC physicians take (and might take) care of men with erection problems, and how users perceive it and search for help in two cities in the State of São Paulo, Brazil. The qualitative research, performed in five PHC services, included semistructured interviews with 16 GPs and 15 adult male users. The adult male users were invited by their doctors during consultations where questions about prostate, ED, or other sexual problems arose. Interviews were transcribed and submitted for content analysis. In addition, the five participating services were observed with help of a specific script. Results indicate that ED is frequently a hidden agenda and that doctors have trouble approaching the problem, usually focusing on the biological aspects. Based on empirical data and literature, this work indicates some measures to qualify the care of men with ED in PHC which includes contemplating users’ questions, respecting their autonomy, avoiding an antidrug stance, and considering drug and nondrug approaches as a continuum of resources.


2021 ◽  
Vol 27 (1) ◽  
pp. 57
Author(s):  
Ailsa Munns

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.


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