Service providers' views of community participation at six Australian primary healthcare services: scope for empowerment and challenges to implementation.

Abstract

Community participation is a key principle of comprehensive primary health care (PHC). There is little literature on how community participation is implemented at Australian PHC services. As part of a wider study conducted in partnership with five South Australian PHC services, and one Aboriginal community controlled health service in the Northern Territory, 68 staff, manager, regional health executives, and departmental funders were interviewed about community participation, perceived benefits, and factors that influenced implementation. Additional data were collected through analysis of policy documents, service reports on activity, and a web-based survey completed by 130 staff. A variety of community participation strategies was reported, ranging from consultation and participation as a means to improve service quality and acceptability, to substantive and structural participation strategies with an emphasis on empowerment. The Aboriginal community controlled health service in our study reported the most comprehensive community participation. Respondents from all services were positive about the benefits of participation but reported that efforts to involve service users had to compete with a centrally directed model of care emphasising individual treatment services, particularly at state-managed services. More empowering substantive and structural participation strategies were less common than consultation or participation used to achieve prescribed goals. The most commonly reported barriers to community participation were budget and lack of flexibility in service delivery. The current central control of the state-managed services needs to be replaced with more local management decision making if empowering community participation is to be strengthened and embedded more effectively in the culture of services.

DOI: 10.1002/hpm.2253

Cite this paper

@article{Freeman2016ServicePV, title={Service providers' views of community participation at six Australian primary healthcare services: scope for empowerment and challenges to implementation.}, author={Toby Freeman and Fran Baum and Gwyneth M Jolley and Angela Lawless and Tahnia Edwards and Sara Javanparast and Anna Ziersch}, journal={The International journal of health planning and management}, year={2016}, volume={31 1}, pages={E1-21} }