Veterans, Part of the Net: Trends in Community Health Programs

1996 ◽  
Vol 2 (4) ◽  
pp. 25
Author(s):  
Felicity Barr

The Department of Veterans' Affairs (DVA) has moved from being a provider of primary health care, through ownership of Repatriation General Hospitals in each state, to being a major purchaser of community-based health care services. Departmental programs are more outwardly focussed than in the past and are more stringently evaluated to ensure the effective delivery of best practice standard services. DVA is committed to recognising the nation's special debt to the veteran community through appropriate compensation and health care programs. In this paper, the range of Departmental community health care programs, including those which focus on the innovative delivery of services through joint initiatives with community self help organisations, are discussed.

2020 ◽  
Vol 14 (2) ◽  
pp. 125-130
Author(s):  
Lawal A ◽  
◽  
Gobir AA ◽  

Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.


2008 ◽  
Vol 188 (6) ◽  
pp. 344-348 ◽  
Author(s):  
Ignacio Correa‐Velez ◽  
Vanessa Johnston ◽  
Joanne Kirk ◽  
Angeline Ferdinand

2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.


2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.


Author(s):  
Guey-Shin Shyu ◽  
Shinn-Jou Lin ◽  
Wei-Ta Fang ◽  
Bai-You Cheng

Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences to construct a postmodern education research scheme by using the method of collaborative ethnography. This study selected and performed the following services: filming a community documentary, administering community health dance classes, and archiving community cultural artifacts in databases. Interviews were also administered to facilitate implementation of the actual services. Community health services commonly seen in Taiwan and abroad were compiled, and the resources required for each service were examined. Subsequently, factor analysis was performed to explore the characteristic of these services in order to recommend feasible services for university students to undertake. The results indicated that the eight resources required for the 59 common community health services were (1) a designated space or venue, (2) materials, (3) monetary resources, (4) human resources, (5) expertise, (6) professional equipment, (7) patience, and (8) empathy. The results revealed three principal components, namely labor services, high-resource services, and professional services, for a total explanatory power of 67.99%; the individual explanatory power of these components accounted for 25.04%, 21.81%, and 21.15%, respectively. Next, community health care services suitable for university students to perform were selected and implemented, and these services were well received. The study results indicated that community and environmental justice can be realized by identifying with the value of community health services and promoting postmodern education theories and social norms. The research results are suitable for implementation after the COVID-19 pandemic.


2020 ◽  
pp. 1-25
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Nils Henriksen ◽  
Torunn Hamran ◽  
Bodil H. Blix

Abstract Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were multifaceted and complex, and were related to attributes of the person with dementia and/or the family care-giver (e.g. reluctance to use services) and/or the health-care services (e.g. low quality). Although services were unused, several family care-givers indicated substantial needs for the services. Strategies aimed at addressing the non-use of services should emphasise individuals’ and families’ needs and the adaptation of information about available services and their benefits for both care recipients and family care-givers. A relationship-centred care approach is thus recommended in dementia care.


2019 ◽  
Vol 26 (1) ◽  
pp. 354-375
Author(s):  
Ryan Palmer ◽  
Martin Utley ◽  
Naomi J Fulop ◽  
Stephen O’Connor

Community health care services are considered integral to overcoming future problems in health care. However, this sector faces its own challenges, such as how to organise services to provide coordinated care given: their physical distribution, patients using multiple services, increased patient use and differing patient needs. The aim of this work was to explore, analyse and understand patterns in community referrals for patients aged 65 years and over, and their use of multiple services through data visualisation. Working with a large community provider, these methods helped researchers and service managers to investigate questions that were otherwise difficult to answer from raw data. Each map focuses on a different characteristic of community referrals: patients reusing services, concurrent uses of different services and patterns of subsequent referrals. We apply these methods to routine patient data and discuss their implications in designing of a single point of access – a service for streamlining referrals.


2010 ◽  
Vol 2010 ◽  
pp. 1-12 ◽  
Author(s):  
XinQi Dong ◽  
E-Shien Chang ◽  
Esther Wong ◽  
Bernarda Wong ◽  
Kimberly A. Skarupski ◽  
...  

The objective of this study is to examine the cultural views of healthy aging, knowledge and barriers to services, and perception of health sciences research among community-dwelling Chinese older adults in Chicago's Chinatown. This qualitative study is guided by the Precede-Proceed conceptual model with community-based participatory research design. Data analysis is based on eight focus group interviews with Chinese older (age60+) adults (n=78). We used a grounded theory framework to systematically guide the thematic structure of our data. Findings show participants described cultural conception of health in terms of physical function, psychological well-being, social support, and cognitive function. The availability, affordability, and cultural barriers towards health care services were major negative enabling factors that inhibit participants from fulfilling health needs. Perception and knowledge of health sciences research were also discussed. This study has implications for the delivery of culturally appropriate health care services to the Chinese aging population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Contu ◽  
E Breton

Abstract Background There is a growing recognition of the limitations of a linear cause-and-effect rationality in planning and evaluating public health interventions. Although this perspective is amenable to programme planning and evaluation, it leaves aside a whole array of mechanisms of change triggered by interactions taking place in complex social systems. Generative causality is one and recognized under a number of works referring to the complexity paradigm. Here we review the state of knowledge on what is often referred to as the complexity theory (CT), and present the results of a review of the literature on its application in public health. Methods We searched PubMed for articles, commentaries, editorials published in English, French and Italian, using the keywords 'Complexity Theory' (also plural). We categorized the fields of application of the CT according to the three core WHO's Essential Public Health Operations, i.e., Health Promotion, Prevention and Protection. All papers addressing issues related to health care services (but not prevention) were included in the category “health care services” while others were tagged as “others”. Results We found 203 papers meeting our inclusion criteria. The largest share of the research output applying the CT was in health care services (n = 167), followed by Health Promotion (5), Prevention (3) and Protection (2). 26 papers were labelled others. In health promotion/ prevention, applications of the CT have yet to integrate most of its concepts. Most authors tap into both the linear and generative rationality perspectives. Conclusions Although regularly deemed as promising in uncovering mechanisms for change triggered by public health intervention, applications of the complexity theory remain uncommon and has made little inroads in the public health domain. This is particularly the case for health promotion where one would assume that participatory community-based interventions would be an incentive to integrate this perspective. Key messages Although deemed promising the complexity theory has made little inroads in public health. Health promotion with its participatory community-based interventions can benefit from its application.


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