Rural Remote Health
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Rural Remote Health · Oct 2010
Comparative StudyThe influence of loan repayment on rural healthcare provider recruitment and retention in Colorado.
There is an ongoing shortage of rural healthcare providers relative to urban healthcare providers worldwide. Many strategies have been implemented to increase the distribution of rural healthcare providers, and financial incentives such as loan repayment programs have become popular means to both recruit and retain healthcare providers in rural communities. Studies detailing the effects of such programs on rural provider recruitment and retention are limited. The objective of this study was to assess the influence of loan repayment and other factors on the recruitment and retention of healthcare providers in rural Colorado, USA, and to compare the motivations and attitudes of these rural providers with their urban counterparts. ⋯ Loan repayment programs targeting rural Colorado usually enroll providers who would have worked in a rural area regardless of loan repayment opportunities, but are likely to play a role in providers' choice of specific rural community for practice. They also appear to have a limited but important influence on rural provider retention, though financial concerns are generally less influential for non-retained rural providers than are family preferences and professional dissatisfaction.
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Rural Remote Health · Oct 2010
ReviewCulture at the centre of community based aged care in a remote Australian Indigenous setting: a case study of the development of Yuendumu Old People's Programme.
Yuendumu is a Warlpiri Aboriginal community 300 km north west of Alice Springs in Central Australia. Since emerging from the welfare period in the early 1970s, a range of services have evolved with the aim of developing a comprehensive community based aged care service. In 2000 Mampu Maninja-kurlangu Jarlu Patu-ku Aboriginal Corporation (Yuendumu Old Peoples Programme; YOPP) commenced operation to manage the developing services. This case study aims to describe, from the analytic standpoint of community control and cultural comfort, the main features of the 'Family Model of Care', which underpins the operations of the service and YOPP management processes. ⋯ The notions of 'cultural comfort' and 'community control' as operating principles have enabled YOPP to continue under the management of local people, sustain core cultural strengths and values, and meet the needs for increased quality of care for the aged in Yuendumu. This model of care emphasizes and recognizes paradigms of mutual competence between traditional and mainstream human service culture, and offers important lessons for improvement to the quality of aged care in remote Indigenous communities in Australia and elsewhere.
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Rural Remote Health · Oct 2010
Problems measuring community health status at a local level: Papua New Guinea's health information system.
The Papua New Guinea Department of Health monitors the performance of the health system using a computerised national health information system. This article draws on the recent evaluation of a national-wide donor-project community development initiative to highlight the problems of the lack of and disaggregated village health data. This data could be used to monitor health status, health worker performance and intervention impact. ⋯ This article highlights problems in evaluating community interventions or local service performance if reliable village-level data is absent. The health information system does not allow reporting of villages separately or the tracking of changes in health status over time according to identifiable villages. Assessing changes in physical health status is not possible without village-level baseline data to measure illness trends and improvements in health in identifiable villages. There is a need for policy changes to occur at national level to prevent loss of aid-post data from the system. Future planning for community health intervention strategies need to include disaggregated village-level baseline data against which to measure changes in community health status over time.