Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service
Carole Reeve A G , John Humphreys B , John Wakerman A , Vicki Carroll C , Maureen Carter D , Tim O’Brien C , Carol Erlank E , Rafik Mansour E and Bec Smith FA Centre for Remote Health, Flinders University and Charles Darwin University, PO Box 4066, Alice Springs, NT 0871, Australia.
B Centre of Research Excellence in Rural and Remote Primary Care, Monash University School of Rural Health, Bendigo, Vic. 3552, Australia.
C Western Australian Country Health Services, Kimberley Population Health Unit, Locked Bag 4011, Broome, WA 6725, Australia.
D Nindilingarri Cultural Health Services, PO Box 59, Fitzroy Crossing, WA 6765, Australia.
E Western Australian Country Health Services, Fitzroy Crossing Hospital, PO Box 5, Fitzroy Crossing, WA 6765, Australia.
F Derby Hospital, PMB 938, Derby, WA 6728, Australia.
G Corresponding author. Email: carole.reeve@flinders.edu.au
Australian Journal of Primary Health 21(4) 409-416 https://doi.org/10.1071/PY14073
Submitted: 17 December 2013 Accepted: 26 September 2014 Published: 29 January 2015
Journal Compilation © La Trobe University 2015
Abstract
The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.
Additional keywords: change management, equity, remote health, sustainable.
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