Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Nothern Territory
Date
2013Author
Baum, Fran
Freeman, Toby
Sanders, David
Jolley, Gwyn
Lawless, Angela
Bentley, Michael
Värttö, Kaisu
Boffa, John
Labonte, Ronald
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This paper reports on the health promotion and disease
prevention conducted at Australian multi-disciplinary
primary health care (PHC) services and considers the ways
in which the organizational environment affects the extent
and type of health promotion and disease prevention activity.
The study involves five PHC services in Adelaide and
one in Alice Springs. Four are managed by a state health
department and two by boards of governance. The study is
based on an audit of activities and on 68 interviews conducted
with staff. All the sites undertake health promotion
and recognize its importance but all report that this activity
is under constant pressure resulting from the need to
provide services to people who have health problems. We
also found an increased focus on chronic disease management
and prevention which prioritized individuals and
behavioural change strategies rather than addressing social
determinants affecting whole communities. There was little
health promotion work that reflected a salutogenic approach
to the creation of health. Most activity falls under
three types: parenting and child development, chronic
disease prevention and mental health. Only the non-government
organizations reported advocacy on broader
policy issues. Health reform and consequent reorganizations
were seen to reduce the ability of some services to
undertake health promotion. The paper concludes that
PHC in Australia plays an important role in disease prevention,
but that there is considerable scope to increase the
amount of community-based health promotion which
focuses on a salutogenic view of health and which engages
in community partnerships.
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