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Goal
To understand the health issues facing the population enrolled with Harbour Health, so that any services that are developed are increasingly effective at reducing health related inequalities and improving the health of the whole community.
Background
Understanding the health of a community is not easy. No country or organisation has ‘the answer’ regarding the best way to do this. Every service provider and community group has some of the answers, but always from their unique perspective. Interpretations of what the words ‘health’ and ‘disease’ mean varies significantly across cultures as well as opinions about how to stay well.
Although still far from perfect, well designed research has made significant progress in discovering more effective ways of reducing our risk of becoming ill and of managing some common conditions. However, there are still significant gaps in knowledge about how to make the most of this knowledge - especially when changing individual and community lifestyle habits.
We do not live in isolation. Role models and messages constantly received from our immediate families, whanau and society (eg work, school, sports and media heroes, TV, advertising) have an enormous influence on all of our behaviours, that can influence health outcomes - for better or worse.
In order to increasingly understand and work closely with its community in the North Shore and Rodney areas, Harbour Health has developed the following three stage process culminating in an annual plan. Each of these processes will give different information regarding actual health needs.
At Harbour Health, we are endeavouring to become increasingly skilled at linking all of this information to create a useful picture of the actual health needs of our communities. This will allow us to shape the way primary health care delivers its services and how it works increasingly closely with specialist and community services.
Stage one: National Health and Demographic Analysis.
Demographic analysis of North Shore and Rodney districts from the 2006 National census and Ministry of Health statistics give us background information about how our enrolled population compares with New Zealand statistics regarding the major causes of death, hospitalisation and prevalence of serious health conditions.
Stage two: Health service utilisation analysis.
Statistical analysis of how often our enrolled population uses health services will give us an indication of where access may be a major problem and also how different patterns of utilisation by age group, ethnicity or location is positively or negatively associated with overall health outcomes.
Stage three: Community engagement.
A new direction was formalised by the publication of the New Zealand Primary Healthcare Strategy (2001) which states that Primary Health Organisations (PHOs) are required to ‘Work with local communities and enrolled populations by organising services around defined populations – rather than just responding to those individuals who actively seek care. Primary Health Care needs to involve participation by people in the communities covered to achieve this. Services will then be more likely to reflect needs and priorities that are set by the population, and not just by providers.
In theory, this is an excellent move as primary care services have enormous potential to positively influence some aspects of the health of over 90% of the population who use primary care annually.
Harbour Health has made community engagement a priority and has developed the following plan to engage with its community in order to develop effective and efficient communication processes between primary providers and their communities.
Objectives:
- To develop formal processes for ongoing engagement with local community groups and populations.
- To use these processes as efficient conduits for regular two way communication regarding health issues, services and service planning.
Harbour Health has an enrolled population of approximately 150,000 people with diverse characteristics and associated needs. Within this community are numerous formal and informal community groupings that associate for a wide range of reasons, eg family and whanau, iwi, age, culture, religion, work, hobbies, education, sport and other mutual interests, social and health related needs.
One of the most efficient ways of engaging with this wide range of people is to identify the major groupings and discuss with each of them the potential for developing a Memorandum of Understanding (MOU) describing how Harbour Health and their organisation can effectively discuss and share information both ways.
During this process, it will be important to understand the extent of the coverage or contact by each group, where there are duplications or gaps. It will be important that gaps where people or groups are isolated from generic community groupings and have potentially high or unique health related needs eg street dwellers, refugees, new immigrants are identified.
Communication options could include one or more of the following processes, nomination of a liaison person to make regular contact and/or provide feedback, access to websites, sharing newsletter content and/or being on mailing lists, surveys, attendance at annual or routine meetings, and arranging one off consultation meetings for specific purposes.
The major purpose of these communications will be to, keep Harbour Health well informed regarding existing non govenment organisations (NGOs) and community services, make this information readily and usefully available to providers eg via IT referral processes and links to websites, identify and inform appropriate (national, regional, district) agencies regarding service gaps and unmet health related needs in the community, consult/survey populations regarding the strengths and weaknesses of PHO services and plans, and receive solicited or unsolicited feedback regarding needs or services.
If you have any questions regarding the health needs analysis, or if you or your organisation or local community would like to be included in the community engagement plan, please contact: info@harbourhealth.org.nz
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