Jones Debra, Ballard Jacqueline, Dyson Robert, Macbeth Peter, Lyle David, Sunny Palatty, Thomas Anu, Sharma Indira
The University of Sydney Director Primary Health Care, Broken Hill University Department of Rural Health, Broken Hill, Australia.
Nursing and Midwifery Directorate, Nurse Manager Policy Practice and Initiatives, Far West Local Health District, Broken Hill, Australia.
Prim Health Care Res Dev. 2019 Mar 20;20:e26. doi: 10.1017/S1463423618000907.
This descriptive paper aims to describe the design and implementation of a community engaged primary healthcare strategy in rural Australia, the Primary Healthcare Registered Nurse: Schools-Based strategy. This strategy seeks to address the health, education and social inequities confronting children and adolescents through community engaged service provision and nursing practice.
There have been increasing calls for primary healthcare approaches to address rural health inequities, including contextualised healthcare, enhanced healthcare access, community engagement in needs and solutions identification and local-level collaborations. However, rural healthcare can be poorly aligned to community contexts and needs and be firmly entrenched in health systems, marginalising community participation.
This strategy has been designed to enhance nursing service and practice responsiveness to the rural context, primary healthcare principles, and community experiences and expectations of healthcare. The strategy is underpinned by a cross-sector collaboration between a local health district, school education and a university department of rural health. A research framework is being developed to explore strategy impacts for service recipients, cross-sector systems, and the establishment and maintenance of a primary healthcare nursing workforce.
Although in the early stages of implementation, key learnings have been acquired and strategic, relationship, resource and workforce gains achieved.
本描述性论文旨在介绍澳大利亚农村地区一项社区参与式初级卫生保健战略——初级卫生保健注册护士：基于学校的战略的设计与实施情况。该战略旨在通过社区参与式服务提供和护理实践，解决儿童和青少年面临的健康、教育和社会不平等问题。
越来越多的人呼吁采用初级卫生保健方法来解决农村地区的健康不平等问题，包括因地制宜的医疗保健、改善医疗服务可及性、让社区参与需求和解决方案的确定以及地方层面的合作。然而，农村医疗保健可能与社区背景和需求不太契合，并且深深植根于卫生系统之中，从而使社区参与边缘化。
该战略旨在提高护理服务和实践对农村环境、初级卫生保健原则以及社区对医疗保健的体验和期望的响应能力。该战略以当地卫生区、学校教育和农村卫生大学部门之间的跨部门合作为基础。目前正在制定一个研究框架，以探讨该战略对服务接受者、跨部门系统以及初级卫生保健护理人员队伍的建立和维持所产生的影响。
尽管该战略仍处于实施初期，但已获得了关键经验教训，并在战略、关系、资源和人员队伍方面取得了进展。
