scholarly journals Theory and Practice in Digital Behaviour Change: A Matrix Framework for the Co-Production of Digital Services That Engage, Empower and Emancipate Marginalised People Living with Complex and Chronic Conditions

Informatics ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 41 ◽  
Author(s):  
Lars Kayser ◽  
Christian Nøhr ◽  
Pernille Bertelsen ◽  
Lars Botin ◽  
Sidsel Villumsen ◽  
...  
Keyword(s):  
Health Service ◽  
Service Provision ◽  
Chronic Conditions ◽  
Digital Technologies ◽  
Care Model ◽  
Health Service Provision ◽  
Step Process ◽  
Digital Services ◽  
The Matrix

Background: The WHO framework on integrated people-centred health services promotes a focus on the needs of people and their communities to empower them to have a more active role in their own health. It has advocated five strategies including: Engaging and empowering people and communities; co-ordinating services within and across sectors; and, creating an enabling environment. Any implementation of these strategies needs to occur at individual, community, and health service levels. Useful steps to reorganising health service provision are already being guided by existing models of care linked to increased adoption and use of digital technologies with examples including: Wagner’s Chronic Care Model (CCM); Valentijn’s Rainbow Model of Integrated Care (RMIC); and Phanareth’s et al.’s Epital Care Model (ECM). However, what about individuals and the communities they live in? How will strategies be implemented to address known inequities in: the social determinants of health; access to, and use of digital technologies, and individual textual, technical, and health literacies? Proposal of a matrix framework: This paper argues that people with complex and chronic conditions (PwCCC) living in communities that are at risk of being under-served or marginalised in health service provision require particular attention. It articulates a step-by-step process to identify these individuals and co-produce mechanisms to engage, empower and ultimately emancipate these individuals to become activated in living with their conditions and in their interactions with the health system and community. This step-by-step process focuses on key issues related to the design and role of digital services in mitigating the effects of the health service inequity and avoiding the creation of an e-health divide amongst users when advocating digital behaviour change initiatives. This paper presents a matrix framework providing a scaffold across three inter-related levels of the individual; the provider, and the health and care system. The matrix framework supports examination of and reflection on the design and role of digital technologies in conjunction with pre-existing motivational instruments. This matrix framework is illustrated with examples from practice. Conclusion: It is anticipated that the matrix framework will evolve and can be used to map and reflect on approaches and practices aiming to enrich and stimulate co-production activities supported by digital technology focused on enhancing people-centred health services for the marginalised.

scholarly journals The Role of Health Extension Workers in Primary Health Care in AsgedeTsi'mbla District: A Case of Lim'at T'abya Health Post

2017 ◽  
Vol 4 (4) ◽  
pp. 248-266 ◽  
Author(s):  
Seare Hadush Desta ◽  
Shaik Yousuf Basha
Keyword(s):  
Family Planning ◽  
Health Service ◽  
Service Provision ◽  
Service Providers ◽  
Cultural Beliefs ◽  
Health Post ◽  
Health Extension Workers ◽  
Health Service Provision ◽  
Qualitative Approaches

Health Extension Workers are the health service providers to the community in delivering integrated preventive, promotive and basic curative health services. Hitherto no studies have been carried out in Lim ‘at T’abya health post focusing on the role of health extension workers. Thus the researcher has randomly selected 263 participants in order to achieve the intended objectives of the study. The researcher used both quantitative and qualitative approaches. The result of the study identified the major Health Extension Program services which are delivered by Health Extension Workers in the health post to seek malaria treatment, child immunization and Antenatal Care followed by Postnatal Care, family planning, referral for delivery, diarrhea treatment and health education. The challenges of Health Extension Workers hindering their performance for the unsuccessful health service provision identified as strong societal cultural beliefs, remoteness, poor relation with supervisors, communication system and road construction, low remuneration, lack of refresher courses and improper attention by Qebelle administrators to health agendas. Attitude of community towards Health Extension Workers communication skill, quality of service provision and social behaviors is over all positive but the following up of referred patients and the skill to diagnosing community health problems that Health Extension Workers need to work sensitively which are answered negatively by the respondents. To increase community’s health post utilization, health posts should be equipped with minimum essential medical equipment with particular focus on malaria treatments, family planning, deliver, treatment of common illnesses and immunization services in the study area.Int. J. Soc. Sc. Manage. Vol. 4, Issue-4: 248-266

Health Service Restructuring: Changes in the Roles of General Practitioners

1996 ◽  
Vol 2 (2) ◽  
pp. 12
Author(s):  
Chris Peterson
Keyword(s):  
Health Service ◽  
Health System ◽  
Federal Government ◽  
Health Professionals ◽  
Service Provision ◽  
Case Managers ◽  
Payment Systems ◽  
Health Service Provision ◽  
Maximum Effort

As part of the general restructuring of the health system in Australia, the role of the general practitioner (GP) is undergoing some changes. Experience in a number of countries has been to broaden the GP role and for some GP skills to be performed by other health professionals, and for GPs to subsume some specialist tasks. Some time ago the Federal government undertook initiatives to strengthen the position of GPs and to upgrade their status in the health system. This has had an impact in their role in co-ordinating care, as gatekeepers and case managers, and in potentially taking over some skills areas which specialists have performed for some time. Here it is proposed that the GP role needs to become more flexible to be able to account for changes in payment systems and moves towards fundholding arrangements. Some specialist skills can be subsumed into the GP role and maximum effort needs to be directed towards integrating the GP into the wider field of health service provision.

scholarly journals Health needs and challenges of women and children in Uganda’s refugee settlements: Conceptualising a role for social work

2019 ◽  
Vol 62 (6) ◽  
pp. 1535-1547 ◽  
Author(s):  
Hadijah Mwenyango ◽  
George Palattiyil
Keyword(s):  
Social Work ◽  
Health Service ◽  
Service Provision ◽  
Health Needs ◽  
Refugee Crisis ◽  
Health Service Provision ◽  
Women And Children ◽  
The Government ◽  
Health Situation

With 1.36 million refugees, Uganda has witnessed Africa’s highest refugee crisis and is confronted with subsequent protection and assistance demands. The Government of Uganda and its partners are trying to support refugees to overcome the associated debilitating health conditions, and it recently shot to prominence in refuge management. Despite this, there are still gaps in health service provision for refugees. This article discusses the health situation of refugee women and children living in Uganda’s refugee settlements, explores the existing health service gaps, and argues that there is a need to extend the role of social work in health services for refugees.

scholarly journals The Role of Commissioners in Health Service Provision: Lessons Learned from Primary Care Trusts (PCTs) England

2018 ◽  
Vol 22 (1) ◽  
pp. 49
Author(s):  
Pradhikna Yunik Nurhayati ◽  
Barbara Allen
Keyword(s):  
Primary Care ◽  
Health Service ◽  
Service Provision ◽  
Central Government ◽  
Early Stage ◽  
Lessons Learned ◽  
Policy Outcomes ◽  
Health Service Provision ◽  
The Government

It is the government’s responsibility to reach policy outcomes. Since the needs of citizen vary, the government needs to improve the way it delivers public services. Monopolistic provision of public service by government becomes inadequate to fulfill the needs of the community. One of the ways pursued by the government is working with the third sector, through procurement and commissioning. National Health Services (NHS) in the UK is one of the examples of commissioning in the healthcare service. The role of commissioning has been done by Primary Care Trusts (PCTs) from 2002 until 2014. Since commissioning became the center of public health provision, the role of commissioners has become pivotal. Using systematic review, this study aims to examine the role of commissioners in health service provision in England. It can be concluded that commissioners (PCT) play an essential role in identifying the needs of the community. This early stage of planning relied on the knowledge, skills, and capacity of commissioners. Unfortunately, not every commissioner has the capability to perform the commissioning process. Therefore, a partnership with other stakeholders is critical to overcoming the limitations of resources, including the capacity, time, and funding. The other findings suggest that national policy by the central government has contributed to the success of commissioning. Results revealed that national targets often prevented commissioners from reaching the local targets, especially when resources were insufficient.

School Settings

2018 ◽  
Author(s):  
Melissa K. Holt ◽  
Jennifer Greif Green ◽  
Javier Guzman
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Provision ◽  
Community Mental Health Service ◽  
Health Service Provision ◽  
School Settings ◽  
Mental Health Service Provision

Schools are a primary setting for mental health service provision to youth and are also main sources of referral to community mental health service providers. This chapter examines the school context and its key role in the child and adolescent mental health services system. The chapter first provides information about the association of emotional and behavioral disorders with school experiences, including academic performance. Next, the chapter presents a framework for mental health service provision and assessment in schools, including describing methods for identifying students who might need mental health services and tracking their progress. Further, several evidence-based interventions are highlighted as examples of effective practices in schools. The chapter concludes with recommendations for clinical practice in school settings.

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