Communities. Primary Care

 

Primary Care

A strong primary health care system is central to improving the health of all New Zealanders and reducing health inequalities between different groups.
Click on the blue panels at the left of this page to find out more.

Health promotion and primary care: finding common ground

In their paper, written for HPF's Keeping Up to Date series, Drs Pat Neuwelt and Matire Harwood speak of the need for a complementary relationship between the traditional individual and psyschological model of primary care and the collective and sociological approach of health promotion.  They see untapped potential for health promotion in primary care settings and suggest some practical steps to help health promoters gain traction in a clinical practice.

Dr Neuwelt is a senior lecturer in public health at The University of Auckland; a public health physican and a GP.  Dr Harwood (NgāPuhi) is a GP and Māori health researcher.

'Better, Sooner, More Convenient Primary Health Care'

Better, Sooner, More Convenient Primary Health Care was the Government's 2011 initiative to deliver a more personalised primary health care system that provides services closer to home and makes Kiwis healthier.

Primary health care was seen to have a part to play in helping reduce acute demand pressure on hospitals by better managing chronic conditions and proactively supporting high need populations.

A package of services was proposed to make significant improvements. This included multiple Integrated Family Health Centres, nurses acting as case managers for patients with chronic conditions, providing a wider range of care and support for patients and shifting some secondary care services to primary care.

Challenges and Opportunities of Primary Care   

Drawing on expert knowledge, key documents within the sector and discussions with a number of Primary Health Organisations (PHOs), Glenn Thomas’ The Challenges and Opportunities of Primary Care in 2010 provided the health promotion workforce with some perspective on where it may fit within the primary care environment and a starting point for identifying where to focus its energy in changing times.  

WHO - Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health

In their paper published in the Journal of Epidemiology and Community Health, four WHO-based authors make the assertion that health services that do not consciously address social determinants will actually make them worse.  "If a revitalised primary health care is to be the key approach to organise society to minimise health inequities, action on social determinants has to be a major constituent strategy," they say.

World Health Report 2008 - Primary Health Care - Now More than Ever

"Globalization is putting the social cohesion of many countries under stress, and health systems, as key constituents of the architecture of contemporary societies, are clearly not performing as well as they could and as they should.
People are increasingly impatient with the inability of health services to deliver levels of national coverage that meet stated demands and changing needs, and with their failure to provide services in ways that correspond to their expectations. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world. PHC can do that."  The 2008 WHO report Now More Than Ever outlines Primary Healthcare (PHC) reforms to mee the health challenges of today's world.

A Guide to Developing Health Promotion Programmes in Primary Health Care Settings

Effective co-ordination of primary care beyond treatment and prevention services to include comprehensive disease prevention and health promotion is central to the success of the Primary Health Care Strategy. To achieve effective health promotion in a PHO, public health and primary care practitioners will need to work together.

The purpose of this guide is to assist PHOs and DHBs develop, assess and deliver health promotion programmes aimed at improving the health status of the population and reducing health inequalities. A Guide to Developing Health Promotion Programmes

Te Uru Kahikatea: the Public Health Workforce Development Plan (2007-2016)

The public health workforce is not confined to public health ‘services’. Public health skills and experience (including the skills to deal with new and re-emerging diseases and mass casualty events) are required across the wider health sector, particularly in areas that have population health responsibilities like Primary Health Organisations (PHOs) and GP practices. 

The most urgent priority is to address the workforce development requirements arising from the Primary Health Care Strategy.  Te Uru Kahikatea: The Public Health Workforce Development Plan (2007-2016) (TUK) is the national strategy to guide public health workforce development in within Aotearoa, New Zealand, over the 10+ years from 2007.  Visit the MoH's Public Health Workforce Development site to read more about the plan and progress against it.

Public Health in a Primary Health Care Setting

Primary health care as described in the Primary Health Care Strategy (PHCS)includes population-based services that are best delivered in a primary care setting. This style of primary health care; outlined in this 2001 document, required new skills and competencies and a degree of co-operation and co-ordination across the health sector not previously achieved.

The MoH's Primary Health Care Strategy website offers information for and about Primary Health Organisations (PHOs).

WHO - Primary health care and the social determinants of health: essential and complementary approaches for reducing inequities in health

In their paper published in the Journal of Epidemiology and Community Health, four WHO-based authors make the assertion that health services that do not consciously address social determinants will actually make them worse.  "If a revitalised primary health care is to be the key approach to organise society to minimise health inequities, action on social determinants has to be a major constituent strategy," they say.

Improving Access to Primary Care for Māori and Pacific Peoples

This literature review, commissioned by the former Health Funding Authority in December 2000, examined the most relevant literature on strategies that improve Māori and Pacific peoples’ access to primary health care services. It may help inform PHOs when planning services to improve access.

Declaration of Alma-Ata

The Alma-Ata Declaration is considered by many to be the founding framework for health promotion internationally.  It came from an International Conference on Primary Health Care, in Alma-Ata, USSR, 1978.
"The International Conference on Primary Health Care, meeting in Alma-Ata this twelfth day of September in the year Nineteen hundred and seventy-eight, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world, ..... "

 

Pat Neuwelt
Chair of HPF Primary Health Care Reference Group

Facebook Pages

Health Promotion Forum