Larkins Sarah, Sen Gupta Tarun, Evans Rebecca, Murray Richard, Preston Robyn
School of Medicine and Dentistry, James Cook University, Townsville, Qld 4811, Australia.
Aust J Prim Health. 2011;17(4):362-8. doi: 10.1071/PY11040.
Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.
关注初级卫生保健资源的不公平分配以及获取机会有限，是满足农村、偏远和大都市外围地区服务不足人群优先健康需求的关键。关于改善服务不足群体获得优质初级卫生保健服务的机会，尤其是与地理障碍相关的高质量证据很少，并且关于改善获得机会的改革对培训的影响的讨论也很有限。为了推进初级卫生保健服务获取的公平性，卫生专业教育机构需要与卫生部门和政策制定者合作，以解决劳动力构成、招聘和留用以及初级卫生保健提供新模式等问题。这需要这些机构和卫生部门从根本上转变关注点，将自己视为一个以教学、研究和服务为导向的综合卫生系统中的合作伙伴。本文讨论了初级卫生保健专业人员、教育工作者和卫生部门在因改革议程而为越来越多的卫生专业人员提供高质量教学和临床经验方面所面临的挑战和机遇。然后概述了一些基于理论和不断发展的经验的实用策略，以应对其中一些挑战并利用机遇。
