Community Based Healthcare

A majority of people living in rural areas and urban slums worldwide have minimal access to healthcare. Without information about what to give a child with stomach flu, how to relieve the pain of a broken bone, and how to work against increased substance abuse in a village, the whole community suffers. Children, adolescents, adults, and older people are all affected by the lack of what many of us view as basic healthcare, such as vaccination, pain killers, and contraceptives. To improve living conditions and life expectancy, the people in urban slums and rural areas need access to a trained health care worker, and a functioning clinic. Setting up Community Health and Development Programmes in Low and Middle Income Settings illustrates how to start, develop, and maintain a health care programme in poor areas across the world. The focus is on the community, and how people can work together to improve health through sanitation, storage of food, fresh water, and more. Currently, there is a lack of 17 million trained health care workers worldwide. Bridging the gap between medical professionals and people in low income areas, the aim of this book is for a member of the community to receive training and become the health care worker in their village. They will then in turn spread information and set up groups working to improve health. The book also explains in detail how communities can work alongside experts to ensure that practices and processes work effectively to bring the greatest impact. Copiously illustrated and written in easy-to-read English, this practical guide is designed to be extremely user friendly. Ideal for academics, students, programme managers, and health care practitioners in low and middle income settings worldwide, it is an evidence based source full of examples from the field. Setting up Community Health and Development Programmes in Low and Middle Income Settings shows how a community can both identify and solve its own problems, and in that way own its future. This is an open access title available under the terms of a CC BY-NC 4.0 International licence.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

This salient reference grounds readers in the theoretical basis and day-to-day practice of community-based health care programs, and their potential as a transformative force in public health. Centering around concepts of self-determination, empowerment, and inclusiveness, the book details the roles of physicians, research, and residents in the transition to self-directed initiatives and greater community control. Community-focused interventions and methods, starting with genuine dialogue between practitioners and residents, are discussed as keys to understanding local voice and worldview, and recognizing residents as active participants and not simply targets of service delivery. And coverage pays careful attention to training issues, including how clinicians can become involved in community-based care without neglecting individual patient needs. Among the topics covered are: Narrative medicine in the context of community-based practice. Qualitative and participatory action research. Health committees as a community-based strategy. Dialogue, world entry, and community-based intervention. Politics of knowledge in community-based work. Training physicians with communities. Dimensions of Community-Based Projects in Health Care challenges sociologists, social workers, and public health administrators to look beyond traditional biomedical concepts of care and naturalistic methods of research, and toward more democratic programs, planning, and policy. The partnerships described in these pages reflect a deep commitment to patients’ lives, and to the future of public health.p>

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

Developed within the context of the expansion of the Canadian welfare state in the years following the Great Depression, the present organization of Canadian health care delivery is now in serious need of reform. This book documents the causes and effects of changes made in this century to Canada's health care policy. Particular emphasis is placed on the decades following 1940, the years in which Canada moved away from an individualistic entrepreneurial medical care system, first toward a collectivist biomedical model and then to a social model for health care.