In Australia, self-management predominantly refers to education programmes that, theoretically, equip people with chronic disease with the necessary information and skills to manage their own healthcare, maintain optimal health, and minimize the consequences of their condition. These programmes are designed, and often delivered, by practitioners. Our research has demonstrated that for consumers, self-management involves navigating and responding to a myriad of information sources and experiences, many of which originate in their own lived bodily experiences and personal knowledge. In contrast to this organic and dynamic version of self-managing that is naturally practised by consumers, common practitioner and policy representations of self-management tend to discount consumer agency and overlook the daily ways in which people manage their own body, experiences and health choices. We argue that if the self-management movement is to tackle health inequalities (rather than creating new ones), health professionals and policy-makers must examine the potentially damaging assumptions that are inherent in contemporary self-management discourse.
Evidence-based approaches to health care have been difficult to achieve in Indigenous populations across the world, a situation which has contributed to the significant health disparities found in this group. One reason for the inadequacy of evidence-based health interventions is that empirical knowledge tends to be organized around professional disciplines that are grounded in Western ways of knowing. In this article we describe events that have led to more appropriate research methods in Australia, and the resulting changes in the research community. The principles that have guided Australian research policy development might not yet be fully matured, but the improvements we have experienced over the last several decades have gone a long way toward acknowledging the significant disparities that affect Indigenous people and the role of researchers in addressing this issue.
BackgroundAlthough attainment of the health-related Millennium Development Goals relies on countries having adequate numbers of human resources for health (HRH) and their appropriate distribution, global understanding of the systems used to generate information for monitoring HRH stock and flows, known as human resources information systems (HRIS), is minimal. While HRIS are increasingly recognized as integral to health system performance assessment, baseline information regarding their scope and capability around the world has been limited. We conducted a review of the available literature on HRIS implementation processes in order to draw this baseline.MethodsOur systematic search initially retrieved 11 923 articles in four languages published in peer-reviewed and grey literature. Following the selection of those articles which detailed HRIS implementation processes, reviews of their contents were conducted using two-person teams, each assigned to a national system. A data abstraction tool was developed and used to facilitate objective assessment.ResultsNinety-five articles with relevant HRIS information were reviewed, mostly from the grey literature, which comprised 84 % of all documents. The articles represented 63 national HRIS and two regionally integrated systems. Whereas a high percentage of countries reported the capability to generate workforce supply and deployment data, few systems were documented as being used for HRH planning and decision-making. Of the systems examined, only 23 % explicitly stated they collect data on workforce attrition. The majority of countries experiencing crisis levels of HRH shortages (56 %) did not report data on health worker qualifications or professional credentialing as part of their HRIS.ConclusionAlthough HRIS are critical for evidence-based human resource policy and practice, there is a dearth of information about these systems, including their current capabilities. The absence of standardized HRIS profiles (including documented processes for data collection, management, and use) limits understanding of the availability and quality of information that can be used to support effective and efficient HRH strategies and investments at the national, regional, and global levels.
Partnerships among multiple organizations across a range of sectors that bring together multiple perspectives are a common way of addressing community health and building capacity. To function successfully, partnerships depend on the careful orchestration of a collaborative culture and the facilitation of collective action. Using a systematic method, we developed a synthesis of evidence about collaborative capacity building, integrating this diverse knowledge base into a usable framework. Seventeen published models of collaborative capacity building met the inclusion criteria and were combined to derive a matrix that could guide the actions of those responsible for partnership management. This matrix may make the process of developing partnerships less complicated in future.
Although the value of service-learning opportunities has long been aligned to student engagement, global citizenship, and employability, the rhetoric can be far removed from the reality of coordinating such activities within higher education. This article stems from arts-based service-learning initiatives with Indigenous communities in Australia. It highlights challenges encountered by the projects and the tactics used to overcome them. These are considered in relation to Young, Shinnar, Ackerman, Carruthers, and Young’s four tactics for starting and sustaining service-learning initiatives. The article explores the realities of service-learning initiatives that exist at the edge of institutional funding and rely on the commitment of key individuals. The research revises Young et al.’s four tactics and adds the fifth tactic of organizational commitment, which emerged as a distinct strategy used to prompt new commitment, enact existing commitment, and extend limited commitment at the organizational level.
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