Health needs, community and network in primary care: an action research program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Milani ◽  
G Occhini ◽  
C Francini ◽  
G Orsini ◽  
L Baggiani ◽  
...  
Keyword(s):  
Action Research ◽  
Health Workers ◽  
Participant Observation ◽  
Local Population ◽  
Health Needs ◽  
Local Health ◽  
Structured Interviews ◽  
Health Networks ◽  
Comprehensive Primary Health Care ◽  
Health Related

Abstract Issue According to the Alma Ata Declaration, Comprehensive Primary Health Care (C-PHC) addresses the main health problems in the community, promotes participation and involves all health related sectors. In Italy the so called Case della Salute model aims at realizing these principles. The purpose of the project is to understand how this model should be implemented in order to better answer the community needs. In the outskirts of Florence there is an area mostly made of public housing, devoted to people with housing and economic problems. There it is Casa della Salute (a health center where a PHC multidisciplinary team works), which could represent the key to cope with health inequalities and to create a network with the multiple associations rooted in the community. The implementation of an experimental model of C-PHC needs to involve local population, community actors, health professionals and researchers in a process of action-research. Results • An epidemiological study described a heavily deprived population compared with the rest of the city, with a burden of mortality especially affecting those most deprived and women. Mental health and addictions showed a deep need of care. A map of the neighbourhood was created in order to analyse formal and informal resources.The health needs of the community were deepened using social and ethnographic methodologies (semi-structured interviews, participant observation and focus groups with health workers, associations' representatives and individuals).Standing multi professional briefings were launched in order to facilitate the process of taking care of complex situations as a team. Lessons Preliminary results show the need for stronger collaborations with the actors in the community; further exploration of health related topics; community participation in the process of informing and transforming health practices; involvement of health workers in interprofessional practices to create a shared knowledge. Key messages Local health networks need a methodology to expand knowledge of peoples’ needs. Complexity in health and inequalities require a paradigm based on social determinants of health such as PHC.

scholarly journals Sustainable electricity for sustainable health? A case study in North-western Zambia

2020 ◽  
Vol 31 (4) ◽  
pp. 72-82
Author(s):  
Lizzie Caperon ◽  
Lina Brand-Correa
Keyword(s):  
Health Outcomes ◽  
Health Workers ◽  
Clean Energy ◽  
Hydropower Plant ◽  
Structured Interviews ◽  
Community Members ◽  
Trade Offs ◽  
Health Related ◽  
Development Goals ◽  
The Impact

This study explores the under-researched link between clean energy and public health outcomes, and offers new insights into the link between wider access to clean energy and progress towards health outcomes, in particular the prevention and treatment of non-communicable diseases such as diabetes. This is the first study to consider the impact of a run-of-river hydropower plant (RORHP) in a remote rural community in Zambia in relation to health outcomes. Exploring this relationship establishes how the health benefits which renewable energy can bring can be capitalised upon to meet the health-related objectives of the United Nations sustainable development goals. Workshops and semi-structured interviews were conducted with a range of stakeholders including community members, health workers, business owners, and key people involved with the plant, to establish health and social impacts of the introduction of electricity in the community of Ikelenge. Findings are used to establish both synergies and trade-offs of the RORHP on the health of the community, and recommendations are made for the continued improvement of health following the introduction of the RORHP, to achieve further progress towards meeting SDG targets.

scholarly journals Community Needs Assessments in a Student-Run Clinic serving a West Philadelphia Neighborhood

2020 ◽  
Author(s):  
Daniel J. Arenas ◽  
Dania D. Hallak ◽  
Rommell Noche ◽  
Gilberto Vila-Arroyo ◽  
Swathi Raman ◽  
...  
Keyword(s):  
Pap Smear ◽  
Health Needs ◽  
Local Health ◽  
Community Members ◽  
Community Needs ◽  
Needs Assessments ◽  
Healthcare Needs ◽  
Health Related ◽  
Healthcare Interventions ◽  
Local Healthcare

ABSTRACTBackgroundWhile Community Needs Assessments (CNAs) are an important tool for Student-Run Clinics (SRCs) to understand local communities’ healthcare needs, few studies have evaluated CNAs and their impact on care provided at SRCs.ObjectiveEvaluate results from two CNAs of an SRC in East Parkside, Philadelphia to better comprehend (1) community awareness and opinions regarding the SRC and (2) local healthcare concerns and access.Methods58 and 105 East Parkside residents were surveyed in 2011 and 2015 respectively. The results were analyzed to quantify various health-related measures in the community.ResultsResults showed high rates of hypertension, asthma, and diabetes. Rates of pap-smear and hypertension screening matched national averages while mammograms and colonoscopies were below national rates. Both CNAs showed that less than 40% of community members were aware of the clinic’s existence.ConclusionsCNAs can provide valuable insights regarding local health needs which can inform future healthcare interventions.

scholarly journals Asylum seekers’ healthcare in Italy: policies and practices among different regions

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Milani ◽  
J Bianchi ◽  
P Bordin ◽  
S Bortoluzzi ◽  
V Gianfredi ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Asylum Seekers ◽  
Health Workers ◽  
Health Needs ◽  
Local Health ◽  
Refugee Status ◽  
The Real ◽  
Italian Law ◽  
Computerized System ◽  
Policies And Practices

Abstract Background The Italian law provides for international protection and universal health-care coverage for asylum seekers (AS). Indeed, they are entitled to be regularly registered at the National Healthcare Service. Before submitting the application for refugee status, medical assistance to migrants is up to local administration. Our aim was to describe and compare policies and protocols regulating AS healthcare from their arrival to their application for refugee status, at national and regional level. Moreover, we investigated the daily healthcare practice addressing potential gaps between policies and practice. Methods The research team is a subgroup of the Inequality working group of the Italian hygiene society and it is composed of public health residents. The research involved also local health workers and other professionals belonging to regional groups of Italian migrant medicine society (SIMM). We collected national, regional and local policies and protocols and we compared them using a specific framework. Furthermore, we achieved a mapping of daily practice implementation at local health organization (LHO) level using a checklist. Results The most relevant findings were that regional policies themselves vary notably from each other and, as regard practices, LHO implement differently the same regional legislation. Furthermore, we found some critical issues: the delayed inclusion in primary care assistance and lack of continuity of care and of a computerized system of recording information. Conclusions The lack of uniformity concerning policies and practices of AS healthcare might also result in unawareness and uncertainty about how to access to healthcare services by migrants. An enhanced cooperation between groups dealing with migrants’ issues may lead to avoid variability at the implementation. Finally, a computerized system for data collection might facilitate the continuity of care and the assessment of the real health needs of the AS population. Key messages It is a priority challenge for health systems to strengthen the interventions aimed at overcoming the linguistic, economic, cultural and administrative barriers to the health services access. It is crucial to improve the recording information system to detect the real health needs of AS, their change and the inequalities in access and to improve collaboration between groups and university.

The Health Status and Health Needs of Chinese Population in Glasgow

1995 ◽  
Vol 40 (3) ◽  
pp. 77-80 ◽  
Author(s):  
Xiao-Hui Liao ◽  
G. McIlwaine
Keyword(s):  
Health Status ◽  
Health Services ◽  
Chinese Population ◽  
Local Community ◽  
Local Population ◽  
Cross Sectional Study ◽  
Health Needs ◽  
Chinese Community ◽  
Structured Interviews ◽  
Cross Sectional

This cross sectional study explored the health problems and health needs in the local Chinese community in Glasgow. Several data collection methods have been used in this study, including face-to-face and telephone structured interviews, postal and hand delivered questionnaires. A total of 800 questionnaires were processed, and 493 were completed, giving an overall response rate 61.6%. The results from the present survey indicated that the health status of Chinese residents in Glasgow is poorer than that of the local population. The most important findings of the study is that the Chinese community in Glasgow underuse health services, and unmet health needs exist in the community. The main barrier to effective use of present health services and benefit from the health promotion and health education programmes is language difficulties. Following discussion with the local community, options for improving the health services for the Chinese community in Glasgow were obtained. The findings of the study have implications for health service purchaser/providers of health care to the Chinese population generally in Scotland.

Making and measuring “good” HR practice in an SME: the case of a Yorkshire bakery

2013 ◽  
Vol 36 (2) ◽  
pp. 128-147 ◽  
Author(s):  
Liz Doherty ◽  
Ann Norton
Keyword(s):  
Action Research ◽  
Design Methodology ◽  
Participant Observation ◽  
Good Practice ◽  
Original Model ◽  
Structured Interviews ◽  
Action Research Project ◽  
Content Type ◽  
The Impact ◽  
The Relationship

Purpose – The purpose of this paper is to understand how “good” HR practice is characterised in SMEs and what the drivers are for adopting this good practice. The paper also explores methods for measuring the impact of HR practice which are helpful and realistic in the context of an SME. Design/methodology/approach – The research was carried out in one SME, a bakery based in South Yorkshire. It was an action research project which utilised semi-structured interviews, participant observation on the factory floor and analysis of company documentation in the diagnosis phase. In addition, reflections on action interventions have informed the findings, together with post-project, semi-structured interviews with key actors three years after the completion of the project. Findings – The drivers of good HR practice were found to be size, market position, external “coercive networks”, presenting issues, the ideology of the managing director and the energy of an HR champion. The findings demonstrate that the impact of “good” HR practice can be best evaluated in SMEs through one-shot, cost-based metrics or more strategic qualitative measures. Originality/value – The paper develops an original model to show the relationship between the drivers, the HR practices adopted and measurable outcomes. This makes an important contribution to the debate about HRM within SMEs and it has practical value for informing the development of good HR practice in SMEs.

scholarly journals ESTRATÉGIA SAÚDE DA FAMÍLIA MEETINGS: AN INDISPENSABLE TOOL FOR LOCAL PLANNING

2019 ◽  
Vol 28 ◽  
Author(s):  
Bruna Carla Voltolini ◽  
Selma Regina de Andrade ◽  
Talita Piccoli ◽  
Lucas Alexandre Pedebôs ◽  
Vanessa Andrade
Keyword(s):  
Information Exchange ◽  
Participant Observation ◽  
Single Case ◽  
Health Planning ◽  
Health Centre ◽  
Local Health ◽  
Local Planning ◽  
Structured Interviews ◽  
Construction Technique ◽  
Indispensable Tool

ABSTRACT Objective: to demonstrate the structure, functioning and contributions of the Estratégia Saúde da Família work meetings regarding local health planning. Method: a single case study with five integrated units of analysis, represented by the coordinator of the Health Centre and four Estratégia Saúde da Família teams. Data collection was performed through semi-structured interviews, non-participant observation and documentary research from October to December 2014. Data were triangulated, organized with MaxQDA®Plus software, and analyzed according to the explanatory construction technique. Results: three analytical categories were identified: Structure and functioning of the Estratégia Saúde da Família work meetings; Participation of professionals in the Estratégia Saúde da Família work meetings for local planning; Processes that contribute to local health planning. Conclusion: work meetings are essential for the construction of local health planning. They provide professional integration through discussions, and facilitate decision-making and information exchange.

scholarly journals Collaboration with community connectors to improve primary care access for hardly reached people: a case comparison of rural Ireland and Australia

2020 ◽  
Author(s):  
Carolyn Wallace ◽  
Jane Farmer ◽  
Carolynne White ◽  
Anthony McCosker
Keyword(s):  
Health Services ◽  
Boundary Spanning ◽  
Health Staff ◽  
Local Health ◽  
Service Access ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cultural Boundaries ◽  
Case Comparison ◽  
Health Related

Abstract Background: This study presents a way for health services to improve service access for hardly reached people through an exploration of how staff can find and collaborate with citizens (referred to as connectors) who span socio-cultural boundaries in their community. The study explored the local socio-cultural contexts of connectors’ boundary spanning activities and if they are health related; boundary spanning occurring between connectors and health professionals at the interface of health systems and community; and the opportunities and barriers to actively seeking out and collaborating with community connectors to access marginalised and hardly reached people. Methods: We conducted a qualitative case comparison from rural Ireland and Australia. Following purposive snow-ball sampling techniques to recruit participants, semi-structured interviews were conducted with 34 community informants, 21 healthcare staff and 32 connectors. Transcripts were coded and analysed using an inductive approach to ascertain categories and overall themes. Results : We found a diverse sample of connectors relating to heterogenous, small and locally distinct groups of hardly reached people. Overall 26 connectors were active at the interface between health services and the community, with variation in how this occurred between cases. The majority (21) described one or more health related activities with hardly reached people. All connectors expressed a willingness to develop a relationship with local health services on issues they identified as relevant. Barriers to collaborations between connectors and health services related to bureaucracy, workload, and burnout. Conclusions : Collaborating with connectors has potential as one strategy to improve access to health services for hardly reached people. To enact this, health staff need to identify local socio-cultural boundaries and associated connectors, facilitate two-way connections at the boundary between health services and community and enable collaboration by attending to activities in the community, at the interface between health services and community, and within the health system.

scholarly journals IMPLEMENTATION AND SYSTEMATIZATION OF A COMPREHENSIVE MEDICATION MANAGEMENT (CMM) SERVICE DELIVERED TO WOMEN WITH BREAST CANCER

2018 ◽  
Vol 11 (1) ◽  
pp. 228 ◽  
Author(s):  
Maria Angela Ribeiro ◽  
Simone Araújo Medina Mendonça ◽  
Agnes Ribeiro Filardi ◽  
Anna Claudia Yokoyama Dos Anjos ◽  
Djenane Ramalho De Oliveira
Keyword(s):  
Breast Cancer ◽  
Action Research ◽  
Pharmaceutical Care ◽  
Driving Forces ◽  
Participant Observation ◽  
Medication Management ◽  
Research Process ◽  
Innovative Technology ◽  
Care Practice ◽  
Structured Interviews

  Objective: The aim of the present study was to describe the process of implementation and systematization of a comprehensive medication management (CMM) service, from the perspective of the participants involved, in a high complexity service that cares for women with breast cancer in Brazil.Methods: A qualitative study that utilized action research that followed the procedures proposed by Kurt Lewin and the ethical and clinical principles of pharmaceutical care practice. Data collection techniques were participant observation between August 2014 and December 2016, semi-structured interviews with eight pharmacists and pharmacy residents, field notes, and analysis of documents.Results: Six major themes emerged in four cycles of the action research process: (1) Resistance is human; the management of conflict is necessary; (2) insecurity with being a clinician; (3) management of change supported by driving forces; (4) pharmaceutical care fostering professionals’ self-efficacy; (5) documentation as the conducting wire of the practice; and (6) the advantages of a systematized practice.Conclusion: The study offered an understanding of the process of implementation of CMM services from the perspective of pharmacists. It produced knowledge on the experiences of pharmacists as they lived through the process of transformation of their professional practice to offer a patient-centered and systematized service. The framework of Lewin supported the introduction of a new work path for pharmacists, which could be operationalized as an innovative technology for the Brazilian health-care system: CMM services.

Short-Term Medical Missions: Enhancing or Eroding Health?

1993 ◽  
Vol 21 (3) ◽  
pp. 333-341 ◽  
Author(s):  
Laura M. Montgomery
Keyword(s):  
Care Delivery ◽  
Local Population ◽  
Health Needs ◽  
Local Health ◽  
Medical Missions ◽  
Negative Consequences ◽  
Short Term ◽  
Cultural Assumptions ◽  
Design And Implementation ◽  
Health Care Delivery Systems

This paper analyzes two case studies of short-term medical missions to Latin America. Its conclusions suggest that when such projects are evaluated in terms of their impact upon the health status of the local population or health care delivery systems, they are found to have insignificant and even negative consequences. The shortcomings of these short-term efforts reflect the cultural assumptions that inform their design and implementation, rather than local health realities. Recommendations are suggested to increase the effectiveness of these missions in terms of the health needs of local populations.

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