Social and political factors influencing the functioning of regional health boards in British Columbia (Canada)

Frankish, C. James; Kwan, Brenda; Ratner, Pamela A.; Higgins, Joan; Larsen, Craig

doi:10.1016/s0168-8510(01)00220-2

Cited by 11 publications

(6 citation statements)

References 50 publications

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“…It is generally acknowledged that regionalization has brought changes in public health governance, leadership, power dynamics, system infrastructure, and visibility, as well as new opportunities for service integration and reorientation to a population focus (Braunstein et al, 2000;Kothari and Edwards, 2003). Various reports have highlighted the challenges and negative impact of regionalization on the Canadian public health system (Sutcliffe et al, 1997;Kluge, 1999;Braunstein et al, 2000;Casebeer et al, 2000;Lewis et al, 2001;Frankish et al, 2002;Kothari and Edwards, 2003;Moloughney, 2005;Jensen and Kisely, 2005), and the need for systematic evaluation of the impact of regionalization (Moloughney, 2006). The public health management participants in this study found themselves caught in the power struggle between provincial and regional systems and within the DHA structure itself, constantly justifying their existence.…”

Section: Discussionmentioning

confidence: 99%

Managements' perspective on Canadian public health nurses' primary health care practice

Meagher‐Stewart

Aston

Edwards

et al. 2007

PHC

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An interpretive qualitative study was conducted to examine public health nurses' (PHNs') practice in fostering citizen participation and collaborative practice and the impact of a decade (1992-2002) of health care restructuring. This article presents the perspectives of public health management and a public policy analysis as they relate to PHNs' primary health care practice in Nova Scotia, a province in Eastern Canada. Seven face-to-face interviews were conducted with public health management from across Nova Scotia and 26 relevant public policy documents were analyzed. Three major themes emerged from the coded transcripts and the document analysis: (1) opportunistic shifts in values: constraining structures, operations, and governance; (2) insufficient funding and infrastructure support; (3) opportunities and challenges to PHN capacity and competency. The emergent themes illustrate the unique population health perspective and day-today contested realities of public health and PHN practice. The study provides preliminary understanding of PHNs' primary health care practice in Nova Scotia that may resonate with other national and international settings. This knowledge can form a basis for more research to explore the PHNs' practice in the organizational context in which it is embedded. This study was undertaken at a pivotal time in Nova Scotia as the provincial government embarked on primary health care renewal to improve the health of Nova Scotians. The success of this study is in large part attributable to the collaborative effort of university researchers and public health decision makers.

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Section: Discussionmentioning

confidence: 99%

Managements' perspective on Canadian public health nurses' primary health care practice

Meagher‐Stewart

Aston

Edwards

et al. 2007

PHC

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“…In the WKB, the establishment of a regional health authority governance framework provides a platform by which the resolution of various competing interests can be achieved through greater attention to local input and conditions, but in no way mollifies the potential for conflict. [52][53][54] Lines of accountability, funding flows, program development, and organizational structures must ultimately work within the confines of finite resources, but with the goal of maximizing support within a given jurisdiction for those in need of care, their families, and informal support networks. At the level of practice, there is likewise a need for recognition of, and respect for, the talents and capacities of others in the field.…”

Section: Implications For Palliative Care Practice and Deliverymentioning

confidence: 99%

‘Heated political dynamics exist …’: examining the politics of palliative care in rural British Columbia, Canada

et al. 2010

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Palliative care is delivered by a number of professional groups and informal providers across a range of settings. This arrangement works well in that it maximizes avenues for providing care, but may also bring about complicated 'politics' due to struggles over control and decision-making power. Thirty-one interviews conducted with formal and informal palliative care providers in a rural region of British Columbia, Canada, are drawn upon as a case study. Three types of politics impacting on palliative care provision are identified: inter-community, inter-site, and inter-professional. Three themes crosscut these politics: ownership, entitlement, and administration. The politics revealed by the interviews, and heretofore underexplored in the palliative literature, have implications for the delivery of palliative care. For example, the outcomes of the politics simultaneously facilitate (e.g. by promoting advocacy for local services) and serve as a barrier to (e.g. by privileging certain communities/care sites/provider) palliative care provision.

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“…Problemas nos resultados da descentralização têm sido relacionados com fatores sociais e políticos 3 , particularmente quanto à estratégia 4 e aos conflitos decisórios 5 . Embora haja um consenso sobre os benefícios potenciais do processo de descentralização, os resultados diferenciados e mesmo negativos da sua operacionalização mostram que essa política não é uma panacéia, dependendo da mediação de um conjunto de fatores políticos, sociais e relacionais 6,7 .…”

Section: Introductionunclassified

Análise da implantação da gestão descentralizada em saúde: estudo comparado de cinco casos na Bahia, Brasil

et al. 2007

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A compreensão das repercussões do processo de des-centralização da saúde no Brasil requer a realização de investigações com enfoques diferenciados, visando a captar a complexidade do objeto a partir de distintos ângulos. Assim, o presente estudo teve por objetivo estimar o grau de implantação da gestão descentralizada da saúde, discutir a influência das características de governo e da gestão em relação ao grau de reorganização das práticas e seus efeitos na saúde da população, por meio de cinco estudos de caso em municípios selecionados da Bahia, Brasil. Foi elaborado um mode-lo teórico-lógico, correspondente à definição de uma "imagem-objetivo" da descentralização da saúde que orientou a elaboração de matriz de indicadores. O estudo revelou que a descentralização sozinha não explica o estágio de organização do sistema municipal de saúde e que características do governo revelaram-se importantes para a reorganização das práticas. Os principais problemas encontrados localizavam-se na gestão do sistema e nas práticas assistenciais, revelando serem estas áreas críticas para futuras intervenções, principalmente no que diz respeito à institucionalização do planejamento e da avaliação, bem como em relação aos projetos intersetoriais.

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Social and political factors influencing the functioning of regional health boards in British Columbia (Canada)

Cited by 11 publications

References 50 publications

Managements' perspective on Canadian public health nurses' primary health care practice

Managements' perspective on Canadian public health nurses' primary health care practice

‘Heated political dynamics exist …’: examining the politics of palliative care in rural British Columbia, Canada

Análise da implantação da gestão descentralizada em saúde: estudo comparado de cinco casos na Bahia, Brasil

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