Review of a Primary Health Care Evaluation Program - Essay Example

?Review of a Primary Health Care Evaluation Program By [Presented to] of [October 11 Introduction The importance and relevance of primary health care initiatives is no hidden fact that is very much required to contribute in the success of societies across the world. Primary health care is a global initiative that requires participation of the masses and equal attention on wide arrays of issues pertaining to a number of diseases. The ultimate goal of any primary health care initiative is to offer better health to all along with continuous improvement in the present as well as in the future. There is no denying that a number of initiatives have been taken in addressing wide arrays of primary health care issues in the past playing an important role in terms of appropriate findings. This has also helped in identifying health issues along with ways to curtail them in the short as well as in the long run by educating participants (Baum, Fran, 2002 pp-5-14) The primary purpose of the assignment is to evaluate an existing primary health care study using health care principles and evaluation methods developed by World Health Organisation. The report does not aim at analysing the program but reviewing the evaluation of the program in an analytical and critical manner. This would also help in understanding and analysing the impact of the study and evaluation of the report in a significant manner. It needs to be understood that in spite of many primary health care initiatives being introduced; very few resulted in an outstanding piece of work. This assignment would address certain loopholes and objectives not being covered in the evaluation report to analyse the impact and influence of the report. For this purpose, an evaluation report on primary health care initiatives has been selected and detailed information on it has been shared in the next part. This evaluation report is based on identifying the impact and influence of existing evaluation report in terms of findings and contribution in the success of the society. Description of the Primary Health Care Program The primary health care research project has been developed, designed and implemented by the National Primary Health Care Strategy. The report aims at analysing and highlighting the impact of primary health care practices. The assessment is based on views and opinions of stakeholders including consumer group, health professionals, academicians and researchers, and government of Australia. The report analyses whether the primary health care initiatives are good enough to support present and future investments in primary health care system. It gives a profound insight on the health care practices including health care objectives and guidelines prescribed by the World Health Organisation. The evaluation report addresses key issues faced by the Australian primary health care system covering priorities areas and reforms. Research methods included interviews with wide arrays of stakeholders that helped in identifying issues in a logical manner. It also helped in identifying the feasibility and acceptance of findings generated through the research framework. Overall, 260 submissions were received from wide arrays of stakeholders. The discussion paper proposed 10 elements for enhancing primary health care system based on improving access to health care and reducing inequalities, better management of chronic conditions, increasing the focus on prevention, improving the quality safety and overall performance. The research has certain loopholes as the impact was largely evaluated and assessed using feedback and opinions of investigators (Glasgow, Kraus, Brown, 2008) The impact would have been assessed in a logical manner by involving beneficiaries of the research initiatives. There is no denying that researches helped in understanding and analysing health problems but lacked key criteria that would be discussed in the later part of the evaluation. As per the World Health Organisation (2006), primary health care is commonly viewed and assumed as a first level of care or entry level of care for the masses concerned with continuing care, accessibility and community involvement along with empowerment and proper education in the short as well as in the long run. As per the Australian Primary Health Care Research Institute, primary health care is socially acceptable and accessible first level care offered by health services and systems having well trained expert workforce giving priorities to the health needs of communities in a systematic manner. It addresses health inequalities, maximizes communities participation and self reliance at the individual level along with health promotion and illness prevention tools and initiatives It can be stated that the opinion of World Health Organisation and the Australian Primary Health Care Research Institute is on the same line and thus the objectives are quite similar in nature. The Australian Primary Health Care Research Institute also encompasses key elements in its objective to achieve health care goals. The basic principles pertaining to health care developed by the World Health Organisation has also been included in the evaluation report evaluating primary health care initiatives. The next part would explain the purpose of the evaluation along with design and methods used in assessing and evaluating the report. This would further help in understanding the benefits of analysing a report based on findings. Evaluation Purpose, Design and Methods The primary purpose of this evaluation report is to identify and assess the mode of evaluation. It aims at finding how the evaluation was conducted and whether all health care principles based on the Ottawa Charter of WHO 1886 has been incorporated or not. This would further help in understanding the impact and influence of the study conducted. In the report developed and evaluated by the Australian Primary Health Care Research Institute, ten elements have been used having direct relevance with the primary health care practices. These elements include, Accessible, clinically and culturally appropriate, timely and affordable, patient centered and supportive health literacy and self management, more focus on preventive care, well integrated, coordinated continuity of care, safe high quality care, better management of health information, flexibility to respond to local communities needs, good working environment to attract, support and retain workforce, high quality education and training arrangements for the workforce, fiscal sustainability and cost effective measures and tools. The evaluation report designed by the Australian Primary Health Care Research Institute can be considered as quite effective based on garnering views and opinions of health planners, consumers and government. As stated earlier, 260 submissions from these people were garnered based on ten above mentioned elements addressing the impact of primary health care initiatives and programs. The design used for this purpose can be considered as quite effective based on descriptive studies using surveys. This helped in understanding the views and opinions of almost every concerned party. The research design is based on primary and secondary data analysis majorly garnered through surveys like questionnaires, Commonwealth Surveys and Reports on the Audit of Health Workforce. The evaluation is based on responses garnered from respondents based on current studies and facts (Australian Bureau of Statistics, 2008 pp-25-29) In order to evaluate this particular evaluation report, health care principles prescribed by the World Health Organisation would be used to analyse the overall evaluation. It is important to assess whether designs and methods are aligned to the research objectives and the WHO or not along with assessing the impact of findings on the social environment in the present as well as in the future (Hawe, Degeling, Hall, 1990 pp- 35-41). The key criteria to be used for the evaluation purpose include key elements identified by the World Health Organisation (World Health Organisation (2006) Reducing social disparities Organising health services around people’s needs and expectations Integrating health into all sectors Leadership Reforms Increasing stakeholder’s participation Apart from this basic health care principles have also being used to evaluate the impact of the evaluation report and its content. These principles include: Equitable distribution of health care Community Participation Health workforce development Use of appropriate technology Multi-sectional approach The next part of the evaluation study identifies the strengths and weaknesses of the actual evaluation report of the Australian Primary Health Care Research Institute using above mentioned health care principles and elements. This would further help in understanding the impact of this report at the social level. Usually, health care initiatives and programs are community based catering to the needs and demands of particular people on particular diseases by involving them in the discussion. Participants are educated through speeches, learning programs and other initiatives. However, the report developed by the Australian Primary Health Care Research Institute identifies the impact of all these initiatives and thus not restricting it to a particular community. It covers the health care system of Australia in an informative manner. An Assessment of the Evaluation’s Strengths and Weaknesses based on the Criteria It is important to evaluate the evaluated information in the study of the Australian Primary Health Care Research Institute using primary health care principles and elements. The Australian Primary Health Care Research Institute’s evaluation is based on ten elements and to make the evaluation more significant some elements have been assessed individually. Accessible, clinically and culturally appropriate, timely and affordable- as per the information garnered from the audited report of commonwealth surveys, not many have access to primary health care. The data have been analysed using quantitative tools that could have been replaced with qualitative (Patton, Quinn, 2002). It takes into account equitable distribution of health care and reducing social disparities and can be considered as an effective inclusion. The evaluation states that there is a need of reducing social disparities and barriers but effective findings have not been presented and thus can be considered as a loophole that needs answer on ways of reducing social disparities and barriers. Patient-centered and supportive of health literacy, self-management- It needs to be understood that primary health care initiatives are an integral part of Australian Health Care System lacking individual preference and support. The evaluation is again based on quantitative and qualitative data garnered from the commonwealth survey highlighting issues and problem pertaining to health management and self improvement. The opinions and views of respondents offer solutions to a known problem but these solutions have not been implemented yet. It again lacks practical approach as findings are based on theoretical approach. It does talk about stakeholder’s participation and health work force development but does not offer an evidence of solutions being implemented and offering great value and benefits to a number of communities across the country (McDonald, Harris 2005 pp-23-25) More focused on preventive care- the study does talk about the focus on preventive care by educating communities and raising awareness in an effective manner. Again, quantitative analysis has been done using Commonwealth survey and solutions have been offered without highlighting the implications and benefits. It talks about multi-sectional approach and empowerment of the society through education but findings are based on assumptions and hope rather results (The Commonwealth Fund (2008). Well-integrated, coordinated, and providing continuity of care- this element talks about leadership reforms, incorporating health into all sectors and health care workforce development through effective graphs and data garnered from authentic sources like Commonwealth survey, Australia Health Care Survey and opinions of respondents including consumers, health planners and policy makers. There is no denying that the evaluation report evaluates the pros and cons of the current health care initiatives in the country but its presentation is analysis is based on theoretical aspects. It does not offer realistic solution. Assessment of Remaining Elements After assessing and evaluating the report of the Australian Primary Health Care Research Institute. It has been assumed that most elements developed in the report do not offer much explanation on existing loopholes. Even though, the explanation is theoretical in nature, it seems that most of the information has been known from a long period of time. It fails to offer practical implication of the studies by highlighting what would have happened if the findings stated would have been implemented in the current health care practices. There is no denying that the evaluation parameters include primary health care principles like social disparity, empowerment and education and especially the concept of social disparity and empowerment through education. It offers a good insight on the issues faced by the primary health care programs implemented by the Australian Primary Health Care Research Institute in the past as well as in the present. Strengths and Weaknesses of the Evaluation Using PHC and General Principles It is important to discuss strengths and weakness of the evaluation report in a precise manner. Some strength includes: The evaluation is based on qualitative and quantitative analysis backed by highly impressive data collection methods and designs The evaluation report encompasses primary health care principles like empowerment through education, improved participation of communities, equitable treatment and health work force development It involves participation of different stakeholders including health planers, policy makers and consumers Weaknesses of the Evaluation The major weakness of the evaluation report is to evaluate the impact of primary health care initiatives at the macro level. It needs to be understood that 256 submissions cannot offer a descriptive opinion over such a vast subject. The evaluation is based on data and facts garnered from surveys but lacks practical interpretation and understanding. Some of the weaknesses include: Minimum number of respondents to evaluate the impact of primary health care across the country Limited practical approach of evaluating the issues and thus offering a practical and implemented solution The evaluation seems to be a theoretical summary of health care issues and problems and solutions are futuristic and realistic lacking practical approach and implementation Process Evaluation of the Primary Health Care Evaluation Report The process evaluation offered a good amount of insight on the primary health care issues and problems and outcomes were based on the analysis of quantitative underpinning of opinions and views shared by 256 submitters. The analysis was done by the internal and external evaluators comprising senior health care department officers of the Australian Primary Health Care Research Institute and professionals from National Health and Hospitals Reform Commission. Evaluation and Objectives The objective of the evaluation report of the Australian Primary Health Care Research Institute is to assess the impact and influence of primary health care initiatives and programs across the country. It has been successful in meeting its objectives through qualitative and quantitative approach. On the other hand the assignment’s objective was to evaluate the evaluation report of the Australian Primary Health Care Research Institute using health care principles prescribed by the WHO (World Health Organisation (2006). It can be said that health care principles have been incorporated in the evaluation report and makes the study a bit impactful in terms of theoretical approach sans practical interpretation. Assessment Criteria for the Evaluation Report The assessment criteria for the evaluation report are based on health care principles and elements introduced by the WHO. The evaluation report includes: Assessment Criteria End Result Inclusion of key elements of primary health care introduced by the WHO Yes Inclusion of basic primary health care principles Yes Practical Approach Not much mainly theoretical analysis Findings (effective, moderately effective, less effective) Moderately effective Contribution to the society Of course yes but lacks practical interpretation and evidences in terms of implementation of solutions and findings Conclusion The evaluation of the primary health care evaluation report has been carried in an analytical problem by highlighting the purpose and importance of the evaluation in the very beginning. The primary health care program and initiative has not been evaluated but its evaluation has been evaluated in terms of impact and relevance using primary health care key elements and principles prescribed by the WHO (Robson, 2000 pp- 67-69). The evaluation has been done in a critical manner highlighting positive and negative aspects of the evaluation study. The evaluation report’s key findings include: Emphasis on equity and social determinants of health Empowerment of communities of individuals through adequate support, education and training High focus on theoretical aspect of primary health care embedded with primary and secondary information Little information on practical implementation of findings using multi-sectional approach The evaluation clearly states that health principles and elements have been included in the evaluation process conducted by the Australian Primary Health Care Research Institute but individual attention on these principles and elements has not been offered that makes the whole evaluation a bit lengthy and monotonous in terms of findings and understanding. Bibliography Australian Bureau of Statistics, 2008. Health Literacy, Australia, ABS cat. no. 4233.0, Retrieved on October 11, 2011 from: http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/73ED158C6B14BB5ECA2574720011AB83/$File/42330_2006.pdf Baum, Fran (2002). The New Public Health (Second Edition). Melbourne: Oxford University Press. Glasgow N, Jeon Y, Kraus S & Pearce-Brown C, 2008. Chronic disease self-management support: the way forward for Australia, Medical Journal of Australia, vol. 189, no. 10, pp. 14-S16. Hawe, P., Degeling, D. and Hall, J. (1990). Evaluating health promotion: A health workers guide. Sydney: MacLennan and Petty. McDonald J & Harris E, 2005. Conceptual Framework for Primary and Community Health services in NSW, Centre for Health Equity Training Research and Evaluation, University of NSW. Retrieved on October, 11, 2011from: http://www.phcconnect.edu.au/files/Conceptual_framework.pdf Patton, Michael Quinn (2002). Qualitative research and evaluation methods (3rdedition). Newbury Park: Sage Robson, C (2000). Small-Scale Evaluation. London: Sage. The Commonwealth Fund (2008). International Health Policy Survey in Eight Countries, the Commonwealth Fund, New York. Weiss, Carol (1998). Evaluation. Methods for studying programs and policies (2ndedition). New Jersey: Prentice Hall World Health Organisation (2006). Health Systems: principled integrated care, Retrieved on October, 11, 2011 from http://www.who.int/whr/2003/chapter7/en/index8.html Read More