Best Practice in Primary Health Care

Legge, David; Wilson, Gerard J.; Butler, Paul; Wright, Maria da Glória Miotto; McBride, Tony; Attewell, Robyn

doi:10.1071/py96004

Cited by 26 publications

(21 citation statements)

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“…Baum, Fry and Lennie [39] described the Australian community health movement and Baum [40] details the experience of PHC in South Australia. Both highlighted very similar elements for best practice to those identified by Legge et al [38]. A strong community health sector working on principles of comprehensive PHC operates in some provinces in Canada (see http://www.cachc.ca/) and Lefkowitz [41] describes the community health movement in the United States highlighting its roots in the civil rights and social justice movements.…”

Section: Introductionmentioning

confidence: 88%

“…Broom [37] explores the contradictions between feminist ideology and the operation of state funded women’s health centres and demonstrates the very significant dilemmas that were posed for services trying to reconcile the contradictions in their practices. Legge et al’s [38] analysis of 185 published accounts of PHC practice stressed the importance of community involvement, collaborative local networking, vertical networking, integrating a concern for the local (“micro”) level and longer term, macro issues and the importance of change consciousness. Baum, Fry and Lennie [39] described the Australian community health movement and Baum [40] details the experience of PHC in South Australia.…”

Section: Introductionmentioning

confidence: 99%

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The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

et al. 2013

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BackgroundThe Commission on the Social Determinants of Health and the World Health Organization have called for action to address the social determinants of health. This paper considers the extent to which primary health care services in Australia are able to respond to this call. We report on interview data from an empirical study of primary health care centres in Adelaide and Alice Springs, Australia.MethodsSixty-eight interviews were held with staff and managers at six case study primary health care services, regional health executives, and departmental funders to explore how their work responded to the social determinants of health and the dilemmas in doing so. The six case study sites included an Aboriginal Community Controlled Organisation, a sexual health non-government organisation, and four services funded and managed by the South Australian government.ResultsWhile respondents varied in the extent to which they exhibited an understanding of social determinants most were reflexive about the constraints on their ability to take action. Services’ responses to social determinants included delivering services in a way that takes account of the limitations individuals face from their life circumstances, and physical spaces in the primary health care services being designed to do more than simply deliver services to individuals. The services also undertake advocacy for policies that create healthier communities but note barriers to them doing this work. Our findings suggest that primary health care workers are required to transverse “dilemmatic space” in their work.ConclusionsThe absence of systematic supportive policy, frameworks and structure means that it is hard for PHC services to act on the Commission on the Social Determinants of Health’s recommendations. Our study does, however, provide evidence of the potential for PHC services to be more responsive to social determinants given more support and by building alliances with communities and social movements. Further research on the value of community control of PHC services and the types of policy, resource and managerial environments that support action on social determinants is warranted by this study’s findings.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints

et al. 2013

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“…Overall this research reveals unanimous endorsement of IAH, 29,32 citing a range of outcomes supporting PHC aims. It reiterates how important partner relationships and getting 'runs on the board' are to sustaining commitment to IAH from a PHC lens.…”

Section: Discussionmentioning

confidence: 99%

“…29 This paper sets out to augment the literature and answer the research question: What factors facilitate and constrain IAH in PHC services?…”

Section: Objectivesmentioning

confidence: 99%

Factors shaping intersectoral action in primary health care services

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Baum

Freeman

et al. 2014

Australian and New Zealand Journal of Public Health

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Objective: To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory. Methods:Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners. Results:The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care. Conclusions:While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Implications:Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action.

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“…Significant issues have an impact on the effectiveness of the nurses’ role in discharge planning. In part this relates to philosophical interests that divide acute and community‐based health care providers (Kearney, 1994; Legge et al. , 1996; Fine et al.…”

Section: Introductionmentioning

confidence: 99%