Panelli Ruth, Gallagher Lou, Kearns Robin
Department of Geography, University of Otago, P.O. Box 56, Dunedin, New Zealand.
Soc Sci Med. 2006 Mar;62(5):1103-14. doi: 10.1016/j.socscimed.2005.07.018. Epub 2005 Sep 26.
Although access to rural health services has been an enduring focus for a variety of scholars, little has been recorded about the intersection between health service policy, provision and access experiences. This paper identifies how community action can highlight the gaps between policy rhetoric and access experiences. Taking the case of rural New Zealand, we document how a community organisation Rural Women New Zealand (RWNZ) completed a national survey as a form of community action. This study records rural households' experiences and challenges when accessing both primary and secondary health services. A range of access problems is identified. The study also illustrates how community-based activism concerning health care need not be local or single-service focussed, but can involve a multi-service critique at the national scale. Such work highlights not only the experience but also the complexity and politics of health service access.
尽管农村卫生服务的可及性一直是众多学者长期关注的焦点，但关于卫生服务政策、提供情况与可及性体验之间的交叉点，记录却很少。本文确定了社区行动如何能够凸显政策言辞与可及性体验之间的差距。以新西兰农村为例，我们记录了一个社区组织——新西兰农村妇女组织（RWNZ）如何通过开展全国性调查作为社区行动的一种形式。这项研究记录了农村家庭在获取初级和二级卫生服务时的经历与挑战。识别出了一系列可及性问题。该研究还表明，基于社区的医疗保健行动主义不一定局限于地方或单一服务，而是可以在全国范围内涉及多服务的批判。此类工作不仅凸显了卫生服务可及性的体验，还凸显了其复杂性和政治性。
