scholarly journals Community health alliances as social enterprises that digitally engage citizens and integrate services: A case study in Southwestern Sydney (protocol)

2020 ◽  
Vol 6 ◽  
pp. 205520762093011
Author(s):  
Myron Anthony Godinho ◽  
Md Mahfuz Ashraf ◽  
Padmanesan Narasimhan ◽  
Siaw-Teng Liaw
Keyword(s):  
Health Services ◽  
Community Health ◽  
Digital Health ◽  
The State ◽  
Social Enterprises ◽  
Local Health ◽  
Citizen Engagement ◽  
Primary Health ◽  
Age Related ◽  
Health Need

South Western Sydney (SWS) is one of the fastest growing regions in the state of New South Wales (Australia). Much of the population live in local government areas (LGAs) with levels of disadvantage higher than the state average, with a predominance of non-communicable and chronic diseases that are typically associated with age-related and behavioural factors. This necessitates the management of social determinants of health through the integrated provision of primary and social care. The SWS Local Health District and Primary Health Network is exploring the potential of community health alliances (CHAs) as an innovative approach to support the provision of integrated health services. CHAs are a population health approach for addressing health challenges faced by people who share a common area of residence, sociocultural characteristic or health need, and are characterised by a shared mission, shared resource needs and acquiring/developing necessary organisational knowledge and skills. We explore how CHAs operate as social enterprises that utilise digital health and citizen engagement to deliver integrated people-centred health services (IPCHS) by conducting two case studies of CHAs operating in SWS: in Wollondilly and Fairfield LGAs. Using this approach, we aim to unpack the conceptual convergence that enables social enterprises to utilise digital health interventions and citizen engagement strategies to co-produce IPCHS with a view to developing theory and a framework for engaging digital citizens in integrated primary health care via social enterprise.

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

scholarly journals Multimodal Accessibility to Primary Health Services for the Elderly: A Case Study of Naples, Italy

2020 ◽  
Vol 12 (3) ◽  
pp. 781 ◽  
Author(s):  
Gerardo Carpentieri ◽  
Carmen Guida ◽  
Houshmand E. Masoumi
Keyword(s):  
Health Services ◽  
Health Agency ◽  
Social Equity ◽  
The Elderly ◽  
Healthcare Services ◽  
Local Health ◽  
Primary Health ◽  
Primary Health Services ◽  
The City ◽  
Accessibility Measure

In Europe, the share of people aged 65 years and above is expected to increase exponentially, and in 2050, for the first time in human history, the number of older people will be larger than the number of children under the age of 15. Aging is associated with increased vulnerability and dependence on medical care services. For these reasons, providing access to health services to people aged 65 years and over is crucial. From the perspective of social equity, everyone should have the opportunity to access healthcare services equally, but due to economic and geographical issues, achieving this level of equity is challenging. The aim of this study was to fill the gap between scientific and actual practices using an accessibility measure to evaluate urban accessibility to primary healthcare services and to support decision-makers to better allocate resources in local restructuring of welfare policies. The accessibility measure was designed considering both the land use and the transportation components, the local healthcare supply system, and a multimodal transportation network. The methodology was applied to the city of Naples considering Local Health Agency (ASL) healthcare services to the elderly. The ASL is the largest health agency in Europe, consisting of 17 buildings serving nearly 200,000 elderly. The results show that the entire elderly neighborhood population suffers from poor accessibility to primary health services, especially in the city suburbs, and that the methodology could be effectively applied to urban planning strategies to achieve a high quality of life for elderly people. Due to poor dialogue between the authorities, this could help to improve the decision-making process through the lens of social equity.

NGO Contributions to Community Health and Primary Health Care: Case Studies on BRAC (Bangladesh) and the Comprehensive Rural Health Project, Jamkhed (India)

2020 ◽  
Author(s):  
A. Mushtaque R. Chowdhury ◽  
Henry B. Perry
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Health ◽  
Rural Health ◽  
Well Being ◽  
Social Enterprises ◽  
Major Influence ◽  
Primary Health ◽  
The World ◽  
Health Project

Non-governmental organizations (NGOs) working in developing countries are chiefly a post-World War II phenomenon. Though they have made important contributions to health and development among impoverished people throughout the world, the documentation of these contributions has been limited. Even though BRAC and the Jamkhed Comprehensive Rural Health Project (CRHP) are but two of 9.7 million NGOs registered around the world, they are unique. Established in 1972 in Bangladesh, BRAC is now the largest NGO in the world in terms of population served—now reaching 130 million people in 11 different countries. Its programs are multi-sectoral but focus on empowering women and improving the health of mothers and children. Through its unique scheme of generating income through its own social enterprises, BRAC is able to cover 85% of its $1 billion budget from self-generated funds. This innovative approach to funding has enabled BRAC to grow and to sustain that growth as its social enterprises have also prospered. The Jamkhed CRHP, founded in 1970 and located in the Indian state of Maharashtra, is notable for its remarkable national and global influence. It is one of the world’s early examples of empowering communities to address their health problems and the social determinants of those problems, in part by training illiterate women to serve as community health workers. The Jamkhed CRHP served as a major influence on the vision of primary health care that emerged at the 1978 International Conference on Primary Health Care at Alma-Ata, Kazakhstan. Its Institute for Training and Research in Community Health and Population has provided on-site training in community health for 45,000 people from 100 different countries. The book written by the founders entitled Jamkhed: A Comprehensive Rural Health Project, describing its pioneering approach, has been translated into five languages beyond English and is one of the most widely read books on global health. These two exemplary NGOs provide a glimpse of the breadth and depth of NGO contributions to improving the health and well-being of impoverished people throughout the world.

scholarly journals Development of community health services for the arab village population in Israel

Curationis ◽  
1983 ◽  
Vol 6 (3) ◽  
Author(s):  
R.A. Stockler
Keyword(s):  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
The State ◽  
Entire Population ◽  
Arab Population ◽  
The North ◽  
State Of Israel ◽  
Point Of Departure ◽  
Village Population

With the proclamation of the State of Israel in 1948 the war began between Israel and her neighbours and the health services for the entire population were at a minimum. Among the Arab population where such services did exist, the personnel - doctors, nurses, teachers - fled; those in Jerusalem went to Jordan and in the North, Haifa was the point of departure for Lebanon and other countries (Mizrahi 1981, Ron 1981).

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Spain

2020 ◽  
Vol 18 (2) ◽  
pp. 1999 ◽  
Author(s):  
Miguel A. Gastelurrutia ◽  
Maria J. Faus ◽  
Fernando Martinez-Martinez
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Community Pharmacy ◽  
The State ◽  
Community Pharmacies ◽  
State Health ◽  
Primary Health

From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a governmental structure similar to a federal state. The various state regional health services organizational and management structures are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body for intercommunication and cooperation between the state health care services and national government, there is a move to improve health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and 52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position of community pharmacy in Spain as a primary health care partner with government would then be enhanced.

scholarly journals A GDPR-compliant information system to improve community primary care in a middle income country

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V A Oliveira ◽  
R B David ◽  
L G Mota ◽  
M Barral-Netto ◽  
R P Carreiro ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Information System ◽  
Primary Health Care ◽  
Health System ◽  
Community Health ◽  
Digital Health ◽  
Family Health ◽  
Health Interventions ◽  
Primary Health

Abstract Background A strong primary health care (PHC) is associated to better overall health system results. Brazil has good results in PHC in the last decades, integrating 260,000 community health workers (CHW) in 43,000 family health teams (FHT), assisting 90 million people and delivering 500 million health activities yearly, such as home visits, consultations, colposcopy, etc. We address the challenges of incorporating CHA-produced data to official electronic health records, automate its analysis and promote information use by FHT to plan activities & prioritize individuals considering social determinants of health, clinical data and treatment plans. Our study developed a general data protection regulation (GDPR) compliant information system to improve community health agents and family health teams coordination of care in order to address this challenge. Methods The intervention was developed using UX techniques and combines Apps and Web dashboards, issuing digital alerts to the FHT and municipal health manager, regarding individual health status and pending care for each covered individual. The research used the “Monitoring and Evaluating Digital Health Interventions” toolbox by World Health Organization (WHO), and GDPR compliance was attained by terms of use acceptance, pseudonymisation and anonymization procedures. Results Stage 1 and Stage 2 Maturity tests with doctors, nurses and CHA showed good feasibility, usability and user satisfaction of the solution. UX and Qualitative Assessment are reported separately. Conclusions Results so far point that the solution is viable and acknowledged as useful by health professionals. Stage 3 (Pilot) will run in September 2020 in two different cities to test efficacy and health system adherence in real world setting. Digital health interventions are powerful tool to improve health care system performance, particularly in Primary Health Care. Key messages Digital Health Intervention are viable in Primary Care as long as they reduce health profesisonal burden and increase service quality. Brazil is a promising environment for Digital Health. Careful planning, development and deployment are essential in the process.

scholarly journals Gaining knowledge of Ontario’s community mental health and addictions system: linking community-based health services data with administrative health data in Toronto, Ontario, Canada

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Paul Kurdyak ◽  
Abigail Amartey ◽  
Julie Yang ◽  
Daniel Liadsky ◽  
Rachel Solomon ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Service ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Health Data ◽  
Local Health ◽  
Community Based ◽  
Administrative Health Data

IntroductionIn most developed countries, a significant amount of mental health and addictions care occurs in community settings. Data reflecting populations served by community-based mental health and addictions providers and the types of services provided are not available, resulting in an incomplete reflection of the entire mental health and addictions system within existing administrative data. Objectives and ApproachThe Community Business Intelligence (CBI) initiative is a data collection project that captures information on adults receiving community-based mental health, addictions, and support services in Toronto Central Local Health Integration Network (LHIN), located in Ontario, Canada. Leveraging administrative health data and data linkage capacity at the Institute for Clinical Evaluative Sciences (ICES), along with engagement of external stakeholders knowledgeable of CBI and the community health sector, we linked the 2015/16 CBI dataset to administrative health data. Demographic characteristics, health-service utilization, primary care attachment, and 30-day emergency department (ED) revisits were calculated for individuals accessing community health services. ResultsThere was an 80.8% linkage rate, of which 36.9% linked deterministically via health card number, while 43.9% linked probabilistically. After study exclusions, 37,688 individuals in the CBI dataset used community health services between April 2015 and March 2016. Compared to Toronto Central LHIN, a greater proportion in the CBI dataset were female, older than 65 years of age, and living in a low income neighbourhood. Furthermore, 95.5%of individuals had at least one outpatient physician visit, 51.3%had at least one ED visit, and 21.7%had at least one hospitalization in the past year. Few individuals in the CBI dataset were without primary care attachment (4.5%); however, a larger proportion had a 30-day ED revisit, particularly those receiving community addictions services (19%). Conclusion/ImplicationsThe availability of community health services data in the CBI dataset and its successful linkage to the administrative health data held at ICES identified health service intersections and outcomes that were previously unknown. This linkage project demonstrates a successful framework for sector-wide performance measurement to address a critical infrastructure gap.

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