CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Australian Journal of Primary Health   
Australian Journal of Primary Health
http://www.latrobe.edu.au/aipc/
  The issues influencing community health services and primary health care
 
blank image Search
 
blank image blank image
blank image
 
  Advanced Search
   

Journal Home
About the Journal
Editorial Board
Contacts
Content
Online Early
Current Issue
Just Accepted
All Issues
Special Issues
Sample Issue
For Authors
General Information
Instructions to Authors
Submit Article
For Referees
Referee Guidelines
Review Article
Annual Referee Index
For Subscribers
Subscription Prices
Customer Service
Print Publication Dates

blue arrow e-Alerts
blank image
Subscribe to our email Early Alert or RSS feeds for the latest journal papers.

red arrow Connect with us
blank image
facebook   youtube

 

Article << Previous     |     Next >>   Contents Vol 17(4)

Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

Sarah Larkins A B, Tarun Sen Gupta A, Rebecca Evans A, Richard Murray A and Robyn Preston A

A School of Medicine and Dentistry, James Cook University, Townsville, Qld 4811, Australia.
B Corresponding author. Email: sarah.larkins@jcu.edu.au

Australian Journal of Primary Health 17(4) 362-368 http://dx.doi.org/10.1071/PY11040
Submitted: 31 March 2011  Accepted: 30 August 2011   Published: 15 November 2011


 
PDF (644 KB) $25
 Export Citation
 Print
  
Abstract

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

Additional keywords: health equity, health professional education, health workforce, medical educator, socially accountable, underserved.


References

Australian Government Department of Health and Ageing (2008) Report on the audit of health workforce in rural and regional Australia, April 2008. (Commonwealth of Australia: Canberra). Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/4F3A981914316A11CA257434008189EC/$File/ruraud.pdf [Verified 5 October 2011]

Australian Government Department of Health and Ageing (2010a) Building a 21st century primary health care system: Australia’s first national primary health care strategy. (Commonwealth of Australia: Canberra)

Australian Government Department of Health and Ageing (2010b) Medical training review panel thirteenth report. (Commonwealth of Australia: Canberra)

Blue AV, Chessman AW, Geesey ME, Garr DR, Kern DH, White AW (2004) Medical students’ perceptions of rural practice following a rural clerkship. Family Medicine 36, 336–340.

Boelen C (2008) Social accountability: medical education’s boldest challenge. MEDICC Review 10, 52

Boelen C, Woollard B (2009) Social accountability and accreditation: a new frontier for educational institutions. Medical Education 43, 887–894.
CrossRef | PubMed |

Chen L, Evans T, Anand S, Boufford JI, Brown H, Chowdhury M, Cueto M, Dare L, Dussault G, Elzinga G, Fee E, Habte D, Hanvoravongchai P, Jacobs M, Kurowski C, Michael S, Pablos-Mendez A, Sewankambo N, Solimano G, Stilwell B, de Waal A, Wibulpolprasert S (2004) Human resources for health: overcoming the crisis. Lancet 364, 1984–1990.
CrossRef | PubMed |

Comino E, Harris M, Haas M, Furler J, Powell Davies G, Raymont A, Hall J, Krastev Y, Christl B (2010) Optimising access to best practice primary health care: a systematic review. (Australian Primary Health Care Research Institute: Canberra)

Dunbabin JS, Levitt L (2003) Rural origin and rural medical exposure: their impact on the rural and remote medical workforce in Australia. Rural and Remote Health 3, 212

Eley D, Young L, Shrapnel M, Wilkinson D, Baker P, Hegney D (2007) Medical students and rural general practitioners: congruent views on the reality of recruitment into rural medicine. The Australian Journal of Rural Health 15, 12–20.
CrossRef | PubMed |

Fox GJ, Arnold SJ (2008) The rising tide of medical graduates: how will postgraduate training be affected? The Medical Journal of Australia 189, 515–518.

Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, Fineberg H, Garcia P, Ke Y, Kelley P, Kistnasamy B, Meleis A, Naylor D, Pablos-Mendez A, Reddy S, Scrimshaw S, Sepulveda J, Serwadda D, Zurayk H (2010) Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 376, 1923–1958.
CrossRef | PubMed |

Gray JD, Steeves LC, Blackburn JW (1994) The Dalhousie University experience of training residents in many small communities. Academic Medicine 69, 847–851.
CrossRef | CAS | PubMed |

Grobler L, Marais B, Mabunda S, Marindi P, Reuter H, Volmink J (2009) ‘Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. Issue 1.’ (Cochrane Library of Systematic Reviews: Oxford)

Hays R, Stokes J, Veitch J (2003) A new socially responsible medical school for regional Australia. Education for Health 16, 14–21.
CrossRef | PubMed |

HealthLandscape Australia (2011) Location of medical schools plotted against composite score of deprivation. Available at http://www.anu.edu.au/aphcri/healthlandscapeaustralia/index.html [Verified 24 March 2011]

Hsueh W, Wilkinson T, Bills J (2004) What evidence-based undergraduate interventions promote rural health? The New Zealand Medical Journal 117,

James Cook University (2010) Faculty of Medicine, Health and Molecular Sciences self reflection portfolio: faculty review.

Jones GI, Alford K, Russell U, Simmons D (2003) Removing the roadblocks to medical and health student training in rural hospitals in Victoria. The Australian Journal of Rural Health 11, 218–223.
CrossRef | PubMed |

Mullan F (2005) The metrics of the physician brain drain. The New England Journal of Medicine 353, 1810–1818.
CrossRef | CAS | PubMed |

Murray RB, Wronski I (2006) When the tide goes out: health workforce in rural, remote and Indigenous communities. The Medical Journal of Australia 185, 37–38.

Neusy A-J, Pálsdóttir B (2008) A round table with innovative leaders in medical education. MEDICC Review 10, 20–24.

Neusy A-J, Pálsdóttir B (2011) Roundtable: revisiting innovative leaders in medical education. MEDICC Review 13, 6–11.

Northern Clinical Training Network (2011) Northern Clinical Training Network homepage. Available at http://www.nctn.net.au/ [Verified 8 August 2011]

Pálsdóttir B, Neusy A-J, Reed G (2008) Building the evidence base: networking innovative socially accountable medical educational programs. Education for Health Available at http://www.educationforhealth.net/publishedarticles/article_print_177.pdf [Verified 5 October 2011] 21, 1–6.

Queensland Health (2010) Rural generalist pathway. Available at http://www.health.qld.gov.au/ruralgeneralist/ [Verified 24 March 2011]

Rourke JTB (2000) Postgraduate medical education for family practice in Canada. The Journal of Rural Health 16, 280–287.
CrossRef | CAS |

Seifer SD (2002) From placement site to partnership: the promise of service-learning. The Journal of Nursing Education 41, 431–432.

Sen Gupta T, Hays RB, Murray RB (2007) Intern choices for James Cook University graduates. The Medical Journal of Australia 187, 197

Sen Gupta TK, Murray RB, McDonell A, Murphy B, Underhill A (2008) Rural internships for final year students: clinical experience, education and workforce. Rural and Remote Health 8, 827

Sen Gupta TK, Murray RB, Beaton N, Farlow D, Jukka C, Coventry N (2009) A tale of three hospitals: solving learning and workforce needs together. The Medical Journal of Australia 191, 105–109.

Strasser R, Neusy A-J (2010) Context counts: training health workers in and for rural and remote areas. WHO Bulletin 88, 717–782.
CrossRef |

Suárez IRM, Sacasas JAF, García FD (2008) Cuban medical education: aiming for the six star doctor. MEDICC Review 10, 5–9.

THEnet (2010) The Training for Health Equity Network. Available at http://www.thenetcommunity.org/ [Verified 8 August 2011]

Thompson LG, Davis PM (2008) Best medical practices in social accountability and continuing professional development: a survey and literature review. Journal of Interprofessional Care 22, 30–39.
CrossRef | PubMed |

Veitch C, Battye K (2008) Rural health workforce: planning and development for recruitment and retention. In ‘A textbook of Australian rural health’. (Eds S-T Liaw, S Kilpatrick) pp. 113–127. (ARHEN: Adelaide)

Veitch C, Underhill A, Hays R (2006) The career aspirations and location intentions of James Cook University’s first cohort of medical students: a longitudinal study at course entry and graduation. Rural and Remote Health 6, 537

Wilkinson D, Laven G, Pratt N, Beilby J (2003) Impact of undergraduate and postgraduate rural training, and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors. Medical Education 37, 809–814.
CrossRef | PubMed |

Wilson N, Couper I, De Vries E, Reid S, Fish T, Marais B (2009) A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural and Remote Health, 9, 1060. Available at http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=1060 [Verified 5 October 2011]

Woollard RF (2006) Caring for a common future: medical schools social accountability. Medical Education 40, 301–313.

World Health Organization (2006) The 2006 World Health Report: working together for health. (World Health Organization: Geneva)

World Health Organization (2010) Increasing access to health workers in remote and rural areas through improved retention. (World Health Organization: Geneva)

Worley P, Murray R (2011) Social accountability in medical education – an Australian rural and remote perspective. Medical Teacher 33, 654–658.
CrossRef | PubMed |

Worley P, Martin A, Prideaux D, Woodman R, Worley E, Lowe M (2008) Vocational career paths of graduate entry medical students at Flinders University: a comparison of rural, remote and tertiary tracks. The Medical Journal of Australia 188, 177–178.

Wronski I (2001) Vertical integration and its role in workforce education and support: ACRRM’s academic role. The Australian Journal of Rural Health 9, 1
CrossRef |


   
Subscriber Login
Username:
Password:  

 
    
Legal & Privacy | Contact Us | Help

CSIRO

© CSIRO 1996-2013