New Zealand strategy for primary health care
The underpinning principle for the Australian healthcare services framework is equity to widespread accessibility of most healthcare provisions without the attention to the circumstance or capacity to pay. This is feasible because the income for this social insurance originates from tax collection. The healthcare services are supported through Medicare and pharmaceuticals plans which are profoundly sponsored by the government. Further, the public facilities, as well as the public healthcare services, are halfway subsidized by federation and state financing understandings. The plans are established on the idea of making public health available to every native independent of their budgetary capacity hence the primary health care strategy.
The main objective of primary health care is to increase universal access to health care as well as empowering the general population to manage their health. Australia has one of the best healthcare systems in the world, ranking second among the Organization for Economic Co-operation and Development (OECD) countries (Schneider, 2017). The Australian healthcare sector is implementing various strategies that enhance access to health care and reduce the health inequalities that exist among its customers. Through the formation of a long-lasting relationship between the general practitioners (GP) and the clients, promotion of multidisciplinary healthcare workers and the utilization of better economically possible funding for the sector, the successful advancement of primary health care is to be achieved by the government for its people (Duckett & Willcox, 2015). New Zealand adopts a similar strategy for primary health care that aims at tackling the inequalities in health for the New Zealanders (Mays, 2013). In this article, the New Zealand key strategy for primary health care will be evaluated and a discussion on determinants of primary care health. Also, this key strategy will be compared and contrasted with the Australian approach to primary health care.
The New Zealand primary healthcare strategy was launched in 2001 based on the Alma-Ata declaration principles (Neuwelt & Matheson, 2012). The government seeks to reduce the accessibility inequalities to primary care among particular population groups in conjunction with the health outcome indications as a result of the disparities to provide primary health care for all the New Zealanders (Gauld, 2012).
The strategy incorporates the general population in the local primary health care services and ensures that these services improve the health status of the people rather than individuals (Neuwelt & Matheson, 2012). In this regard, the healthcare providers participate in communities and work with them to improve the community’s health through enhancing the preventive measures for example by health education and counseling. It is worth noting that this strategy for promoting the population primary care necessitates the participation of a range of professionals. The primary care strategy, therefore, entailed grouping of primary care providers, nurses and other professionals, for example, the Maori health providers into what is called Primary Health Organizations (PHOs). These PHOs are subsidized on a capitation basis for giving a predefined set of treatment and preventive administrations to their enlisted population with or without making contact throughout the period (Salmond & Crampton, 2012). Also, the primary care strategy augments the already achieved efforts for equity and universal accessibility to health care services with new mechanisms that will promote the overall wellbeing of the society. These mechanisms included the development of a relationship of the service providers with the communities and the district health board, training and dissemination of best practices, developing and funding of the primary care programs.
Social factors influencing primary health care
Primary health care (PHC) and the social factors influencing health share a solid spotlight on inter-sectoral activity for wellbeing. The PHC acknowledges that the healthcare department isn’t the sole factor for enhancing welfare. The consideration of social determinants demonstrates how most wellbeing disparities are not caused by an absence of access to healthcare provisions, yet by the impact of imbalances in different sectors, for example, housing, occupation, education or revenue. Also, both the PHC and the social determinants perceive that the structuring of healthcare frameworks impacts on health equity. Therefore, these factors require a system that enhances universal coverage of the services to promote PHC (Browne et al., 2012).
Income is directly related to health for the low earning people experience poor health as opposed to the high or middle-income persons. Further, income dictates the quality of life of an individual, for example, people with less income experience inadequate housing, poor diet, illiteracy, and limited capacity to access or pay for healthcare services. These factors contribute to the generally poor health of the low earning groups of people. For example, the Maori have typically high levels of poverty as opposed to the non-Maori, although measures are implemented to reduce the gap (Marriot & Sim, 2015).
Consequently, low income earning people will experience low literacy levels for they have a lesser capacity to cater for their education, unlike the rich people. Illiteracy thwarts the implementation of PHC strategies and incapacitates these group on individuals from managing their health due to inadequate knowledge. Without quality education, an individual will not make sound decisions regarding their health. Insufficient understanding of the available health care services and its benefits to an individual hinders accessibility to these services. For example, the management of chronic illness requires that the patients recognize the symptoms at an early phase and seeks medical attention. However, due to lack of knowledge the individual may not accept such symptoms, therefore, failing to visit a health facility. The number of hospital visitations for illiterate groups is less as compared to the learned people who may attend a healthcare facility for checkup enhancing the preventive measures for PHC. These are some of the social factors that determine either positively or negatively the accessibility of healthcare services hence affecting PHC.
The health of an individual is significantly affected by chemical, physical, biological and external factors such as the quality of the environment. A high-quality climate promotes good health because a good number of diseases are caused or enhanced by the environment (Bircher & Kuruvilla, 2014). PHC entails empowering an individual to manage his or her health appropriately. Poor hygiene standards, poor water quality as well as sanitation may lead to skin maladies, diarrhea diseases, and acute respiratory infections. A clean environment of good quality is vital in the implementation of PHC. In poor settings, it’s difficult to prevent some diseases, therefore, making the efforts for PHC costly or of less impact.
Environmental determinants of primary health care
Therefore, to promote equity and accessibility to primary health care, these key strategy must factor in the provision of an enabling environment for good health. Policies that aim at providing a quality environment for example through good housing and clean water. So, the PHC strategy focuses on eliminating the illness predisposing factors of the surrounding to promote a healthy environment which in turn enhances access to healthy living standards.
The health status of the general population directly influences the health of an individual, especially for communicable diseases. The roles of the public health sector are to perform health surveillance, promoting health, preventing infections as well as injury. All these functions played by the public health department are similar to those that the PHC carries out or requires for successful implementation. For example, PHC promotes population health by enhancing equity and access to healthcare resources.
In case of an outbreak of a disease for instant pandemic diseases, the whole population is at risk of contracting the disease. Such a scenario strains the resources of the health sector and may further heal inequalities among certain groups of people. Therefore, public health directly affects the accessibility of healthcare resources. In times of an outbreak, the healthcare resources may become insufficient due to high demand thwarting equity framework of PHC (Kringos et al., 2013). Moreover, the PHC strategy entails prevention of diseases meaning poor population health negates the efforts of PHC implying poor access to healthcare services.
The Australian PHC services operate within the PHC framework. The healthcare sector targets to create a good relationship between the service providers and its clients. A multidisciplinary group of professionals teams up with primary healthcare workers to enhance service delivery. These efforts aim to improve active participation of all the primary healthcare stakeholders and integrate other departments of the healthcare services. The integration of these sectors enhances the inclusion of the already existing service delivery models with the new ones to facilitate economic feasibility and efficiency of the establishment of the PHC. The successful implementation of these ensures the services are population centered meeting the expectations and needs of the people in general. The support of these frameworks relies on financing and resources allocation that facilitates quality, improvement of prevention for controllable diseases which ultimately reduces health care costs and hospitalization (Macdonald, 2013). The underlying principle is to increase accessibility and enhance equity for primary care.
Impact of income, education, and housing on health equity
New Zealand’s PHC strategy aims at advancing the health of the New Zealanders by the reduction of the health inequalities that exist among its natives (Smith et al., 2013). The PHC strategy incorporates other healthcare services to better the health of the population. The PHC sought to work with the local community and the enlisted people. Eight PHOs were formed which enroll the locals who in turn participate in decision making and the performance of other PHC activities under the guidance of the PHOs. Such registration of the locals and their active participation in the community healthcare are crucial in screening and immunization process to ensure that the community controls the preventable diseases. The enrolled individuals are empowered through education which helps them to make sound judgments about their health. However, these PHOs are geographically defined without overlapping membership which may block some individuals from exercising their choice of PHO. For New Zealand, individuals require PHO enrollment to facilitate PHC as opposed to Australia.
Similar to the Australian approach, New Zealand endeavors to provide comprehensive service to cater to all the needs of its people with the intention of restoring their health as well as reducing health disparities. Through the PHO the customer the range of customer needs will be understood to aid the development of population needs tailored services. There has been increased utilization of PHC services in all the population groups of New Zealand (Mills & Vaithianathan, 2012). Furthermore, the enrollment has reduced the costs of access to primary care. The PHC strategy in Australia has realized the similar results in a more significant way whereby accessibility to primary care has increased over time (Gauld et al., 2012).
The other mechanism for enhancing equity and accessibility to primary care it through the development of primary healthcare workforce. Improper distribution of general practitioners especially to the economically disadvantaged and remote areas promoted the agenda of the PHC strategy. Now they have been allocated in numbers relatively proportionate to the needs of the people (Greenhalgh, 2013).
The significant difference between Australia and the New Zealand strategy is the rate at which the implementation of the reforms is occurring. Australia has achieved greater success due to its health care system as compared to New Zealand hence its good performance among the OECD countries. However, the health disparities still exist among various groups of population in both countries although there is a significant reduction. It is worth noting that the income disparities still prevail among these population groups. Some of the barriers to the success of the strategy include the cultural hindrances and geographical obstacles that reduce the applicability of the PHC establishment.
Nursing practices entail the holistic provision of services to the needy in the most appropriate ways. These practices factor in cultural barriers to enable the delivery of these services to culturally diverse populations. Furthermore, to facilitate holistic service provision the nurses require to form good relationships with their clients. The PHC is dependent on the nurses to a significant degree for they render services to large numbers of people with diverse needs. Therefore, there is a need for better maneuvering team members (Robinsons et al., 2015).
In conclusion, the PHC strategy is fundamental to the wellbeing of the society. The barriers to its successful implementation between the two countries are similar. So far, there is a commendable achievement of both governments in the establishment of the strategy. However, there is a lot more to be done.
References
Bircher, J., & Kuruvilla, S. (2014). Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. Journal of public health policy, 35(3), 363-386.
Browne, A. J., Varcoe, C. M., Wong, S. T., Smye, V. L., Lavoie, J., Littlejohn, D., … & Fridkin, A. (2012). Closing the health equity gap: evidence-based strategies for primary health care organizations. International Journal for Equity in Health, 11(1), 59.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Gauld, R. (2012). New Zealand’s post-2008 health system reforms: Toward re-centralization of organizational arrangements. Health Policy, 106(2), 110-113.
Gauld, R., Blank, R., Burgers, J., Cohen, A. B., Dobrow, M., Ikegami, N., … & Wendt, C. (2012). The World health report 2008–primary healthcare: how wide is the gap between its agenda and implementation in 12 high-income health systems?. Healthcare Policy, 7(3), 38.
Greenhalgh, T. (2013). Primary health care: theory and practice. John Wiley & Sons.
Kringos, D. S., Boerma, W., van der Zee, J., & Groenewegen, P. (2013). Europe’s strong primary care systems are linked to better population health but also to higher health spending. Health affairs, 32(4), 686-694.
Macdonald, J. J. (2013). Primary health care: medicine in its place. Routledge
Marriott, L., & Sim, D. (2015). Indicators of inequality for Maori and Pacific people. Journal of New Zealand Studies, (20), 24.
Mays, N. (2013). Reorienting the New Zealand health care system to meet the challenge of long-term conditions in a fiscally constrained environment. Wellington: New Zealand Treasury.
Mills, C., Reid, P., & Vaithianathan, R. (2012). The cost of child health inequalities in Aotearoa New Zealand: a preliminary scoping study. BMC Public Health, 12(1), 384.
Neuwelt, P., & Matheson, D. (2012). New Zealand’s journey towards people-centred care. International Journal of Person Centered Medicine, 2(1), 73-79.
Robinson, S., Varhol, R., Ramamurthy, V., Denehy, M., Hendrie, D., O’Leary, P., & Selvey, L. (2015). The Australian primary healthcare experiment: a national survey of Medicare Locals. BMJ open, 5(3), e007191
Salmond, C., & Crampton, P. (2012). Measuring socioeconomic position in New Zealand. Journal of primary health care, 4(4), 271-280.
Schneider, E. C. (2017). Mirror Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better US Health Care. Commonwealth Fund.
Smith, J., Holder, H., Edwards, N., Maybin, J., Parker, H., Rosen, R., & Walsh, N. (2013). Securing the future of general practice: new models of primary care. London: Nuffield Trust.
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
