Journal: Rural and remote health
There is little knowledge about the use of point-of-care (POC) tests among general practitioners (GPs). The aim of this study was to determine which POC tests are known and used by GPs and how they estimate the usefulness of those tests. The use of POC tests among GPs and university-associated general practitioners who teach undergraduates (GPTUs) was elucidated. Differences between GPs working in urban and rural areas were also investigated.
Evidence shows that the government of Papua New Guinea is failing to provide basic services in health to the majority of its people. Local non-government organisations (NGOs), partnered with international NGOs, are attempting to fill this gap. With limited resources, these small Indigenous organisations must focus much of their effort on training that supports self-reliance as the main strategy for communities to improve their quality of life. This project explored the training content and methodology of Touching The Untouchables (TTU), a small Indigenous NGO based in Goroka, Eastern Highlands Province, that has trained a network of village volunteers in health promotion and safe motherhood.
Village life imposes multiple demands, from self-sufficiency in food to maintaining law and order. There are established attitudes about power and dependence, referred to as ‘cargo thinking’. Cargo thinking stands as a barrier to the necessity of self-reliance, and requires training strategies that seek to empower participants to create change from their own initiative. Empowerment is understood as oriented towards individual people taking collective action to improve their circumstances by rectifying disparities in social power and control. To achieve self-reliance, empowerment is necessarily operational on the levels of person, community and society.
In addition to being operational on all three levels of empowerment, the training content and methodology adopted and developed by TTU demonstrate that empowering practice in training employs approaches to knowledge that are evidence-based, reflexive, contextual and skill-based. Creating knowledge that is reflexive and exploring knowledge about the broader context uses special kinds of communicative tools that facilitate discussion on history, society and political economy. Furthermore, training methodologies that are oriented to empowerment create settings that require the use of all three types of communication required for cooperative action: dramaturgical, normative and teleological communication.
The success of TTU’s training content and methodology demonstrates that creating the conditions for achieving collective self-reliance through empowerment is a necessary part of primary health promotion in Papua New Guinea, and that underlying the success of empowerment oriented training are definable types of knowledge and communication.
Rural healthcare resource limitations can affect the choices people make and their quality of life during its end stages. In rural regions of Australia, district nurses (DNs) working in generalist community roles provide access to care by visiting people in their homes. They may be well positioned to improve the quality of the end-of-life experience by advocating for choice and person-centred end-of-life goals; however, knowledge about care in this context is limited. Initial findings from an exploratory qualitative study describing how rural DNs are able to successfully advocate for the end-of-life choices and goals of people living at home need to be confirmed and further developed to inform clinical practice. This survey aimed to test and complement the findings from a narrative exploration of how DNs advocate successfully for the end-of-life goals of rural Australians.
For the past 50 years paramedic services and paramedic roles in high-income nations have evolved in response to changes in community needs and expectations. The aim of this article is to review paramedic models of service delivery, with an emphasis on models that have the potential to improve the health and wellbeing of frontier and remote populations.
The intersecting vulnerabilities of migrant agricultural workers (MAWs) impact both their health and their access to health care in rural areas, yet rural clinicians' voices are rarely documented. The purpose of this study was to explore health professionals' perspectives on health care for MAWs in sending countries and rural Ontario, Canada.
Indigenous patients with life-limiting conditions have complex needs, experience reduced access to and uptake of treatment, and have lower utilisation of palliative care services than the general population. Lack of understanding of the role of palliative care and poor availability of culturally safe specialist palliative care services impact on Indigenous people’s end-of-life decision-making.
In 2008, the Medical Council of New Zealand recognised rural hospital medicine as a vocational scope of practice. The aim was to provide training and professional development standards for medical practitioners working in New Zealand’s rural hospitals and to encourage quality systems to become established in rural hospitals. Hokianga Health in New Zealand’s far north is an established integrated health service that includes a rural hospital and serves a largely Māori community. The aim of this study was to explore how the new scope had affected health practitioners and the health service at Hokianga Health.
Lifelong health behaviour habits are often consolidated in adolescence, with primary health care an important element of current and future health and wellbeing. Barriers to adolescent primary healthcare access are complex and include social, behavioural and geographical issues as well as organisational and systemic barriers.
Evaluation expertise to assist with identifying improvements, sourcing relevant literature and facilitating learning from project implementation is not routinely available or accessible to not-for-profit organisations. The right information, at the right time and in an appropriate format, is not routinely available to program managers. Program management team members who were implementing The Fred Hollows Foundation’s Indigenous Australia Program’s Trachoma Elimination Program required information about what was working well and what required improvement. This article describes a way of working where the program management team and an external evaluation consultancy collaboratively designed and implemented an utilisation-focused evaluation, informed by a developmental evaluation approach. Additionally, principles of knowledge translation were embedded in this process, thereby supporting the evaluation to translate knowledge into practice. The lessons learned were that combining external information and practice-based knowledge with local knowledge and experience is invaluable; it is useful to incorporate evaluative information from inception and for the duration of a program; a collaborative working relationship can result in higher quality information being produced and it is important to communicate findings to different audiences in different formats.
Respiratory syncytial virus (RSV) is the leading viral cause of acute lower respiratory infections globally, accounting for high morbidity and mortality burden among children aged less than 5 years. As candidate RSV vaccine trials in pregnant women and infants are underway a greater understanding of RSV epidemiology is now needed, especially in paediatric populations with high rates of acute and chronic respiratory disease. The objective was to identify RSV prevalence in children living in northern Australia, a region with a high respiratory disease burden.