Rural midwifery practice in Aotearoa/New Zealand: Strengths, vulnerabilities, opportunities and challenges

2020 ◽  
Vol 56 ◽  
pp. 17-25
Author(s):  
Rea Daellenbach ◽  
Lorna Davies ◽  
Mary Kensington ◽  
Susan Crowther ◽  
Andrea Gilkison ◽  
...  
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
Social Services ◽  
Health Professionals ◽  
Rural Women ◽  
Rural Areas ◽  
Service Providers ◽  
Rural Practice ◽  
Midwifery Practice ◽  
Adverse Weather

Background: The sustainability of rural maternity services is threatened by underfunding, insufficient resourcing and challenges with recruitment and retention of midwives. Aims: The broader aim of this study was to gain knowledge to inform the optimisation of equitable and sustainable maternity care for rural communities within New Zealand and Scotland, through eliciting the views of rural midwives about their working conditions and practice. This article focuses on the New Zealand midwives’ responses. Method: Invitations to participate in an online questionnaire were sent out to midwives working in rural areas. Subsequently, themes from the survey results were followed up for more in-depth discussion in confidential, online group forums. 145 New Zealand midwives responded to the survey and 12 took part in the forums. Findings: The New Zealand rural midwives who participated in this study outlined that they are attracted to, and sustained in, rural practice by their sense of connectedness to the countryside and rural communities, and that they need to be uniquely skilled for rural practice. Rural midwives, and the women they provide care to, frequently experience long travel times and distances which are economically costly. Adverse weather conditions, occasional lack of cell phone coverage and variable access to emergency transport are other factors that need to be taken into account in rural midwifery practice. Additionally, many participants noted challenges at the rural/urban interface in relation to referral or transfer of care of a woman and/or a baby. Strategies identified that support rural midwives in New Zealand include: locum and mentoring services, networking with other health professionals, support from social services and community service providers, developing supportive relationships with other rural midwives and providing rural placements for student midwives. Conclusion: Midwives face economic, topographic, meteorological and workforce challenges in providing a service for rural women. However, midwives draw strength through their respect of the women, and the support of their midwifery colleagues and other health professionals in their community.

scholarly journals Recruiting and Retaining Allied Health Professionals in Rural Australia: Why is it so Difficult?

2004 ◽  
Author(s):  
Janet Struber
Keyword(s):  
Rural Communities ◽  
Health Professionals ◽  
Rural Areas ◽  
Allied Health ◽  
Health Service Delivery ◽  
Rural Practice ◽  
Allied Health Professionals ◽  
Attrition Rates ◽  
Recruitment And Retention ◽  
Health Related

Rural communities in Australia have particular health needs, and the recruitment and retention of Allied Health Professionals (AHPs) is a significant concern. Despite the increasing number of AHPs being trained, vacancy and attrition rates in rural areas continue to rise. Professional and social isolation combined with rapidly changing health service delivery structures are identified as major deterrents to long-term rural practice. While strategies are now being implemented, endeavours to resolve the issues lag well behind initiates offered to Medical and Nursing staff. Given the wealth of political, professional and health related issues underlying the recruitment and retention of AHPs to rural areas, total resolution of this issue may not be possible. A unified approach by AHPs combined with concerted effort and collaboration on the part of all the stakeholders may, however, allow management at a level required to sustain a viable rural AHP workforce.

Pathways ahead for New Zealand hill country farming

2016 ◽  
Vol 78 ◽  
pp. 73-82 ◽  
Author(s):  
F.G. Scrimgeour
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
New Technologies ◽  
Service Providers ◽  
Farming Systems ◽  
Hill Country ◽  
The Status ◽  
And Performance ◽  
Hill Farming ◽  
The Hill

This paper provides a stocktake of the status of hill country farming in New Zealand and addresses the challenges which will determine its future state and performance. It arises out of the Hill Country Symposium, held in Rotorua, New Zealand, 12-13 April 2016. This paper surveys people, policy, business and change, farming systems for hill country, soil nutrients and the environment, plants for hill country, animals, animal feeding and productivity, and strategies for achieving sustainable outcomes in the hill country. This paper concludes by identifying approaches to: support current and future hill country farmers and service providers, to effectively and efficiently deal with change; link hill farming businesses to effective value chains and new markets to achieve sufficient and stable profitability; reward farmers for the careful management of natural resources on their farm; ensure that new technologies which improve the efficient use of input resources are developed; and strategies to achieve vibrant rural communities which strengthen hill country farming businesses and their service providers. Keywords: farming systems, hill country, people, policy, productivity, profitability, sustainability

The Interplay of Agents in Improvising Telecommunication Infrastructures' Services to Rural Community of South Africa

2015 ◽  
pp. 208-225
Author(s):  
Sharol Mkhomazi
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
South African ◽  
Service Provider ◽  
Rural Areas ◽  
Service Providers ◽  
Telecommunication Network ◽  
Structuration Theory ◽  
Telecommunication Service ◽  
Network Service Provider

The deployment of telecommunication infrastructures is a challenge in many parts of South Africa particularly in the rural areas. The challenge has impact of communities' members as they do not have network coverage for Internet in some areas. The challenge gets worse with individual telecommunication service provider. Hence there is technological proposal for sharing of infrastructure by the service providers. However, the sharing of infrastructure is not as easy as notion by many individuals and groups institutions included. The article presents findings from a study on how a South African telecommunication network service provider could deploy shared infrastructures in the country's rural communities. The sharing of infrastructure is described by the structure and actions of agents within the infrastructure sharing process. Structuration theory was employed as a lens in the data analysis. The key findings include insufficient distribution of infrastructure, ownership responsibility, competitiveness, infrastructure deployment cost, and signification of regulation.

Rural Practice

2013 ◽  
Author(s):  
H. Stephen Cooper ◽  
Freddie L. Avant
Keyword(s):  
Social Work ◽  
Rural Communities ◽  
Social Workers ◽  
Rural Areas ◽  
Social Issues ◽  
Work Practice ◽  
Social Work Practice ◽  
Rural Practice ◽  
Direct Result ◽  
Rural Social Work

Rural social work, the history of which stretches back more than a century, has been revitalized since the mid-1970s. The renewed interest in rural social work has led to an increase in scholarship on rural social work practice, much of which is a direct result of the efforts of the Rural Social Work Caucus and its annual National Institute on Social Work and Human Services in Rural Areas. Recent research endeavors have moved our understanding of the differences between rural and urban communities beyond the common definitions, which are limited to population and population density. We have also come to realize that there are many different types of rural communities, all of which have different characteristics, needs, etc. Specifically, the concept of rural is not monolithic. Rural practitioners and researchers have also reached a better understanding of the following: rural culture and lifestyles, the importance of approaching rural communities from a strengths perspective rather than a deficit or problem focus, and the challenges to rural practice presented by the characteristics that are common across rural communities (e.g., lack of anonymity, dual relationships). Not surprisingly, the increase in research on rural social work practice has been accompanied by an interest in preparing social workers for rural practice and growth in the number of graduate programs focused on such. The importance of these programs lies in the unique nature of the challenges faced by rural communities. For example, many rural communities are experiencing sharp population declines while at the same time seeing substantial increases in adults who are 65 years of age and older. Other common trends include: economic decline and subsequent increase in social issues; substantial issues with substance abuse, especially methamphetamine and opioids; lack of technology infrastructure; concerns related to the environment and/or conversation of natural resources; and lack of services for veterans. The key to successfully addressing these issues in rural communities is involvement from social workers who are prepared to practice in the rural context.

scholarly journals Non-starch polysaccharide intakes in Mexican villagers and residents of Mexico City

1997 ◽  
Vol 77 (3) ◽  
pp. 345-357 ◽  
Author(s):  
Claudia P. Sanchez-Castillo ◽  
David Grubb ◽  
Maria De Lourdes Solano ◽  
Michael F. Franklin ◽  
W. Philip T. James
Keyword(s):  
Rural Communities ◽  
Mexico City ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Density Ratio ◽  
Food Composition ◽  
World Health ◽  
Men And Women ◽  
Food Composition Tables

A study was performed in a rural Mexican community and in Mexico City to investigate possible differences in non-starch polysaccharide (NSP) intakes. One hundred and fourteen women (fifty-five rural and fitty-nine urban) and forty-three men (twenty-four rural and nineteen urban) completed 24 h recall questionnaires for three consecutive days with NSP intakes being estimated from a specially prepared set of new food composition tables. Potential underestimation of intakes was assessed by estimating individual BMR and dividing the estimated energy intakes by BMR to give a ratio. Excluding severe underrecording (ratio < 1·01) suggested NSP intakes of 21·8 and 17·3 g/d in rural men and women and 17·7 and 15·6 g/d in urban men and women respectively. NSP sources differed, with a marked fall in intake from pulses in the urban areas but a compensatory increase of tortilla intakes and a rise in NSP-rich fruit consumption. Both soluble- and insoluble-NSP intakes were higher in rural areas. NSP intakes scaled by probable energy intakes of moderately active adults in developing countries suggest that NSP intakes in Mexico are similar to adjusted values in Africa, i.e. 26·9 g/d in Mexico v. 28·5 g/d in Africa in rural men and 22·9 v. 21·0 g/d respectively in rural women. The NSP: energy density ratio (g/MJ) of the rural diet conformed with the World Health Organization (1990) goal. Data available on urban and rural communities for three countries showed that in each case the intake of NSP was lowest in the urban community.

Social Networks and Psychiatric Morbidity in New Zealand Women

1992 ◽  
Vol 26 (3) ◽  
pp. 485-492 ◽  
Author(s):  
S. E. Romans ◽  
V. A. Walton ◽  
G. P. Herbison ◽  
P. E. Mullen
Keyword(s):  
Social Networks ◽  
New Zealand ◽  
Rural Communities ◽  
Social Relationships ◽  
Rural Women ◽  
Psychiatric Morbidity ◽  
Normative Values ◽  
Part Time ◽  
Demographic Subgroup ◽  
Demographic Subgroups

A random community survey of urban and rural New Zealand women revealed higher rates of psychiatric morbidity in subjects who reported poorer social support. Substantial differences in social networks were found between demographic subgroups. Rural women described better than expected social relationships, giving some support to the pastoral ideal of well integrated rural communities. Women in part-time employment also described better social networks. Elderly, low socio-economic, and widowed, separated and divorced women had poorer social relationships. It is suggested that normative values for social network measures for each demographic subgroup will need to be established before the clinical significance of deviations from the norm can be meaningfully evaluated. Also, the mechanisms linking social networks to health may vary in different subgroups.

scholarly journals Accountability for refugee resettlement in New Zealand

2021 ◽  
Author(s):  
◽  
Thuy Tran
Keyword(s):  
New Zealand ◽  
Social Services ◽  
Public Services ◽  
Service Providers ◽  
Refugee Resettlement ◽  
Public Governance ◽  
Accountability System ◽  
New Public ◽  
The Government

<p><b>Public governance in many countries has been moving toward a model called New Public Governance (NPG) to deal with the increasing complexity in the provision of public services. NPG adopts a new perspective that emphasises the importance of managing the interaction between and among organisations within and outside the government to achieve efficiency and effectiveness of public policy and service delivery. The interdependent relationships of these cross-working organisations are reflected in their accountability processes. Thus, a robust accountability system is central to managing public governance. However, accountability is complicated, and its definition is regularly debated. Accountability is even more intricate in network relationships where it is challenging to identify who has contributed in what way. However, research on accountability in networks is limited.</b></p> <p>To contribute to the understanding of the problems of accountability in public governance, this study examines the nature of accountability and evaluates the discharge of accountability in the provision of public services in practice, using a case study of refugee resettlement in New Zealand. The following research question is addressed, “What is the nature of the accountability relationships between different parties involved in, or affected by, the provision of social services to former refugees in New Zealand?”. In answering this question, the study developed a research framework that was built on insights from prior literature and stakeholder theories and employed a case study approach that analysed 32 semi-structured interviews and a range of documents related to refugee resettlement in New Zealand.</p> <p>The study finds that the current accountability system has not reflected the broader conception of multiple and interrelated accountability relationships identified in the literature on NPG. Upward accountability to powerful stakeholders is mostly prioritised, downward accountability to beneficiaries has not significantly improved, and horizontal accountability to cross-working partners is limited. The tensions between a bureaucratic need for control and a more devolved governance model that allows for the recognition of multiple contributions to both policy formation and implementation are still strong. Moving from the New Public Management (NPM) perspective involving control over public money, still codified in the Public Finance Act 1989, to something closer to NPG is evidently not easy.</p> <p>iiThe key academic contribution of this study is in adding an important piece to the nearly “empty land” of horizontal accountability research, providing an understanding of how accountability mechanisms are used in practice, and raising the voices of less powerful stakeholders about the discharge of accountability by social service providers. Regarding its practical contributions, the study provides a typical case study for research on accountability of non-government organisations (NGOs) in an NPG context, which can be valuable for policymakers wishing to develop policies that lead to an improvement in the appropriate expectations in NPG and accountability relationships between different parties in the delivery of social services. It also provides recommendations for the government, NGOs, and refugee communities for achieving greater accountability.</p>

scholarly journals THE ROLE OF PUNJAB RURAL SUPPORT PROGRAMME IN PROVIDING HEALTH FACILITIES TO RURAL WOMEN;

2018 ◽  
Vol 21 (05) ◽  
pp. 1033-1038
Author(s):  
Ayesha Riaz ◽  
Sher Muhammad ◽  
Ijaz Ashraf ◽  
Aisha Siddique ◽  
Khalid Mahmood Ch
Keyword(s):  
Social Services ◽  
Rural Women ◽  
Rural Areas ◽  
Health Workers ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Total Sample ◽  
Health Facilities ◽  
Poor People

Despite the fact that women account for more than half of the total worldpopulation, they are still not considered equal to men. The health of rural women in Pakistanis very poor because of the lack of health services and competent health workers. Besidesgovernment health centres, hospitals and many Non-Governmental Organizations (NGOs)are also working in the rural areas for providing social services to rural women. Punjab RuralSupport Programme is also working for socio-economic empowerment of rural women. PRSPbegan to provide health facilities to the poor people in villages through Basic Health Units(BHUs). Objectives: To analyze the role of PRSP in providing health facilities to women in ruralarea. Design: A multistage simple random sampling technique was used for the study. Setting:District Faisalabad. Material & Methods: The population for the study consisted of rural womenonly who were members of the Community Organizations (COs) of PRSP. Out of the eight townsof district Faisalabad, four towns which cover rural areas (Samundri, Iqbal town, Jaranwala,and Chak Jhumra) were selected. Four field units of PRSP are working in these four towns i.e.Salarwala in Chak Jhumra, Satiana in Jaranwala, Khidarwala in Samundri, and Dijkot in IqbalTown. These field units had 214, 203, 170 and 238 female COs, respectively. A sample of 10%COs was selected from each field unit randomly. Thus the total selected COs were 82. Fivemembers from each CO were selected at random. In this way the total sample size for the studywas 410 respondents. A reliable and validated data collection instrument consisting of openand close ended questions was used. The data were analyzed using SPSS. It was concludedthat respondents were satisfied with certain facilities like availability of female doctors in BHUs,availability of medicines and availability of competent and qualified paramedics. Provision ofbasic tests (blood, sugar, pregnancy and haemoglobin etc.) was very weak area which neededmuch improvement. Conclusions: It was also concluded that respondents were satisfied withthe behaviour of staff at BHUs. However, provision of basic medical equipment needed attentionfrom the authorities.

Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia

2015 ◽  
Vol 39 (3) ◽  
pp. 351
Author(s):  
Amy CW Tan ◽  
Lynne M Emmerton ◽  
H Laetitia Hattingh ◽  
Adam La Caze
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Local Community ◽  
Service Providers ◽  
Medication Management ◽  
Community Pharmacists ◽  
Rural Hospitals ◽  
Service Needs ◽  
Provision Of Services ◽  
Medication Reviews

Objective Many of Australia’s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Methods Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n = 8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40–55 min each, recorded and analysed descriptively. Results A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Conclusion Participants were unaware of each other’s models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models. What is known about the topic? Many rural hospitals lack an optimal workforce to provide comprehensive health services, including pharmaceutical services. One solution to address medication management shortfalls is employment of a local community pharmacist or consultant pharmacist on a sessional basis in the hospital. There is no known research into remuneration options for pharmacists providing sessional hospital services. What does this paper add? Viability of services and financial sustainability are paramount in rural healthcare. This paper describes and compares the mechanisms initiated independently by hospitals or pharmacists to meet the medication needs of rural hospital patients. Awareness of the funding arrangements provides options for health service providers to extend services to other rural communities. What are the implications for practitioners? Rural practitioners who identify unmet service needs may be inspired to explore funding arrangements successfully implemented by our participants. Innovative use of existing funding schemes has potential to create employment options for rural practitioners and increase provision of services in rural areas.

scholarly journals Understanding Broadband Infrastructure Development in Remote and Rural Communities – a Staged and Reflexive Approach

2014 ◽  
Vol 10 (2) ◽  
Author(s):  
Ingjerd Skogseid ◽  
Ivar Petter Grøtte ◽  
Geir Liavåg Strand
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Service Providers ◽  
Infrastructure Development ◽  
Rural And Remote ◽  
Remote Areas ◽  
Rural And Remote Areas ◽  
Local Actors ◽  
Staged Model

Access to broadband telecommunication infrastructure is important for both urban and rural areas. In urban areas market forces ensures access to service providers. In many rural and remote areas this is not the case. Local actors need to initiate the development of the infrastructure. This paper contributes to the development of a staged model for infrastructure development. We explore how local stakeholders have initiated and sustained the development of broadband access in rural and remote areas of Norway. Our conclusion is that the model is relevant in a Norwegian context. However we see the need to extend and strengthen it with elements of local reflexive processes taking context, feedback, learning, and global change forces into account. In initiating a timely development to meet local needs it is important to have a staged reflexive approach.  Such a model provides a path of development that allows local and regional initiatives to aggregate and grow.

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