Which types of organizations provide community health programs? select three options.

Community health services provide state-funded primary healthcare in Victoria, focusing on people with, or at risk of, poorer health, under a social model of health.

Community health services directory

CHSs work alongside general practice, privately funded services and other health and support services in Victoria. They primarily deliver:

• allied health services
• child health services
• chronic disease management (including support for self-management)
• dental health services
• disability services
• drug and alcohol services
• family planning
• health promotion
• home and community care services
• medical services
• mental health services
• post-acute care services
• refugee health.

The delivery of these supports and services is flexible and responsive to the needs of people and local communities. In this way, the CHSs focus on person-centred, coordinated care.

Community health services also have a key role in early intervention and management of people with chronic and complex conditions.

How community health services operate

Delivery guidelines

The Community Health Integrated Program (CHIP) guidelines describe what funded CHSs are expected to deliver. Their aim is to improve consistency across the state in organisations’ planning, program design and service delivery. They also clarify expectations for coordinated service provision.

Budget

Community health services receive Community Health Program funding from the Department of Health. 

Departmental funding accounts for approximately 60 per cent of CHS revenue. In 2013-14 the department contributed $138 million for the Community Health Program with funding for general counselling, allied health (audiology, dietetics, physiotherapy, occupational therapy, podiatry, speech pathology), community health nursing and health promotion.

The department also funds CHSs to deliver a range of other services, including aged care, dental health, Home and Community Care and a range of other community-based health.

Governance

Victorian CHSs operate under two distinct legal and governance arrangements: 55 CHSs operate as part of public health services and 26 are independent registered CHCs.

The independent registered services are companies limited by guarantee, and registered under the Health Services Act 1988.

Victoria's registered community health centres comply with performance standards and report regularly to the department.

Eligibility

CHSs provide universal access to services. The Community Health Program prioritises access to people with particular health needs. The program’s eligibility and priority criteria target disadvantaged populations with the poorest health and the greatest economic and social needs.

Fees

CHSs use a schedule of fees and income ranges when assessing clients. Fees for CHS are applied in line with the Home and Community Care (HACC) fees policy and program manual which provide a consistent framework for how service providers are to operate. 

Philosophy

CHSs operate from a social model of health. They acknowledge the social, environmental and economic factors that affect health, as well as the biological and medical factors.

For this reason, CHSs are active participants in and contributors to their communities. This strong community connection means they can better respond to their local communities and better address the factors that influence health.

for medical practitioners

By CHARLES PETER TARIMO Community health refers to simple health services that are delivered by laymen outside hospitals and clinics. Community health volunteers and community health workers are the main practitioners and they work with Primary Care Providers to facilitate entry into, exit from and utilization of the formal health system by community members.

Community health volunteers are members of the local community who have considerable knowledge of the health services available to the community and are used to identify and link beneficiaries or those in need and the registered providers. Community health workers (Community health assistants and Community health officers) are employees who do not necessarily come from the local community but have vocational, professional or academic qualifications which enable them to provide training, supervisory, administrative, teaching and research services in community health departments.

Community health services are classified into:

1. Preventive health services such as chemoprophylaxis for Tuberculosis, cancer screening and treatment of diabetes and hypertension.
2. Promotive health services such as Health education, family planning, vaccination and nutritional supplementation
3. Curative health services such as treatment of jiggers, lice infestation, Malaria and Pneumonia.
4. Rehabilitative health services such as provision of prosthetics, Social work, Occupational therapy, Physical therapy, Counselling and other Mental health services.

Community health volunteers are members of the local community who have considerable knowledge of the health services available to the community and are used to identify and link those in need and the registered providers. The community Health Volunteers report directly to Community Health Assistants or Community Health officers (CHAs/CHOs) popularly known as the Community Health Extension Workers. Community health Assistants/Officers do not necessarily come from the local community but have professional training and academic qualifications which enable them to provide supervisory, administrative, teaching and research services in community health departments.

CHAs/CHOs are formal County Government employees.

The community Health Volunteers title changes to Community Health Worker immediately if they are on monthly stipend program or salary.

Community health services are classified into:

1. Preventive health services
2. Promotive health services such as Health education, family planning
3. Curative health services such as treatment of minor illnesses.
4. Rehabilitative health services

Community health volunteers provide the most basic services such as distribution of Water chlorination tablets, mosquito nets and Health education material but will normally involve or work with registered clinicians when they encounter sick or recovering patients or those with complex or on-going needs.

It is a major field of study within the medical and clinical sciences which focuses on the maintenance, protection, and improvement of the health status of population groups and communities. It is a distinct field of study that may be taught within a separate school of public health or Preventive Healthcare. The WHO defines community health as:

Environmental, Social, and Economic resources to sustain emotional and physical well being among people in ways that advance their aspirations and satisfy their needs in their unique environment.[1]

Medical interventions that occur in communities can be classified as three categories: Primary care, Secondary care, and Tertiary care. Each category focuses on a different level and approach towards the community or population group. In the United States, Community health is rooted within Primary healthcare achievements.[2] Primary healthcare programs aim to reduce risk factors and increase health promotion and prevention. Secondary healthcare is related to "hospital care" where acute care is administered in a hospital department setting. Tertiary healthcare refers to highly specialized care usually involving disease or disability management.

The success of community health programs relies upon the transfer of information from health professionals to the general public using one-to-one or one-to-many communication (mass communication). The latest shift is towards health marketing.

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Community health is generally measured by Geographical Information Systems and Demographic data. Geographic Information Systems can be used to define sub-communities when neighborhood location data is not enough.[3] Traditionally Community health has been measured using sampling data which was then compared to well-known data sets, like the National Health Interview Survey or National Health and Nutrition Examination Survey.[4] With technological development, information systems could store more data for small-scale communities, cities, and towns; as opposed to census data that only generalize information about small populations based on the overall population. Geographical Information Systems (GIS) can give more precise information about community resources, even at neighborhood levels.[5] The ease of use of Geographic Information Systems (GIS), advances in multilevel statistics, and spatial analysis methods make it easier for researchers to procure and generate data related to the built environment.[6]

Social media can also play a big role in health information analytics.[7] Studies have found social media being capable of influencing people to change their unhealthy behaviors and encourage interventions capable of improving health status.[7] Social media statistics combined with Geographical Information Systems (GIS) may provide researchers with a more complete image of community standards for health and well being.[8][9]

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Primary Healthcare and Primary Prevention[edit]

Community-based health promotion emphasizes Primary Prevention and population-based perspective (traditional prevention).[10] It is the goal of Community Health to have individuals in a certain community improve their lifestyle or seek medical attention. Primary Healthcare is provided by health professionals, specifically the ones a patient sees first that may refer them to Secondary or Tertiary care.

Primary prevention refers to the early avoidance and identification of risk factors that may lead to certain diseases and disabilities. Community-focused efforts including immunizations, classroom teaching, and awareness campaigns are all good examples of how primary prevention techniques are utilized by communities to change certain health behaviors. Prevention programs, if carefully designed and drafted, can effectively prevent problems that children and adolescents face as they grow up.[11] This finding also applies to all groups and classes of people. Prevention programs are one of the most effective tools health professionals can use to significantly impact individual, population, and community health.[11]

Secondary Healthcare and Secondary Prevention[edit]

Community health can also be improved with improvements in individuals' environments. Community health status is determined by the environmental characteristics, behavioral characteristics, social cohesion in the environment of that community.[12] Appropriate modifications in the environment can help to prevent unhealthy behaviors and negative health outcomes.

Secondary prevention refers to improvements made in a patient's lifestyle or environment after the onset of disease or disability. This sort of prevention works to make life easier for the patient since it's too late to prevent them from their current disease or disability. An example of secondary prevention is when those with occupational low back pain are provided with strategies to stop their health status from worsening; the prospects of secondary prevention may even hold more promise than primary prevention in this case.[13]

Tertiary Healthcare[edit]

In Tertiary healthcare, community health can only be affected with professional medical care involving the entire population. Patients need to be referred to specialists and undergo advanced medical treatment. In some countries, there are more sub-specialties of medical professions than there are primary care specialists.[12] Health inequalities are directly related to social advantage and social resources.[12]

Challenges and Difficulties With Community Health[edit]

The complexity of community health and its various problems can make it difficult for researchers to assess and identify solutions. Community-Based Participatory Research (CBPR) is a unique alternative that combines community participation, inquiry, and action.[15] Community-Based Participatory Research (CBPR) helps researchers address community issues with a broader lens and also works with the people in the community to find culturally sensitive, valid, and reliable methods and approaches.[15]

Other issues involve access and cost of medical care. A great majority of the world does not have adequate health insurance.[16] In low-income countries, less than 40% of total health expenditures are paid for by the public/government.[16] Community health, even Population health, is not encouraged as health sectors in developing countries are not able to link the national authorities with the local government and community action.[16]

In the United States, the Affordable Care Act (ACA) changed the way community health centers operate and the policies that were in place, greatly influencing community health.[17] The ACA directly affected community health centers by increasing funding, expanding insurance coverage for Medicaid, reforming the Medicaid payment system, appropriating $1.5 billion to increase the workforce and promote training.[17] The impact, importance, and success of the Affordable Care Act is still being studied and will have a large impact on how ensuring health can affect community standards on health and also individual health.

Ethnic disparities in health statuses among different communities are also a cause of concern. Community coalition-driven interventions may bring benefits to this segment of society.[18] This also relates to language usage, where results from a 2019 systematic review found that patients with limited English proficiency who received care from physicians who communicate in the patient's own preferred language generally had improved health outcomes.[19]

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Each community is different and should create its own Community Health Improvement Process also known as CHIP.[20] A CHIP consists of problem identification and prioritization cycle along with an analysis and implementation cycle. Five strategies that assist the CHIP process are improving community health and well-being; community involvement, political commitment; healthy public policy; multi-sectoral collaboration; and asset-based community development. An asset-based approach involves empowering individuals and communities by focusing on community strengths along with the skills of the individuals.[20][21]

The CDC makes states that Individuals who are in good physical shape, have proper vaccination, have access to clinical services and medications, and know where to get critical health and emergency alert information create a better community than those who have poor health and don't understand where to get proper treatment and medicine.[22]

The Problem identification and prioritization cycle have three phases that help benefit the community which is forming a health coalition, collecting and analyzing data for health profile, and identifying critical health issues. The information that is gathered is also distributed to the community to help with important decision-making.[20]

Following this cycle is the Analysis and Implementation Cycle which helps resolve community health problems by analyzing the health issue, establishing resources, creating a health improvement strategy with the resources, and allocating responsibility throughout the community.[20] Multiple issues are analyzed in conjunction to determine which is most important. Lastly, the authority to act is implemented, sufficient funds are allocated and access to data is released in order for the members of the community to review and move accordingly.[20]

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Access to community health in the Global South is influenced by geographic accessibility (physical distance from the service delivery point to the user), availability (proper type of care, service provider, and materials), financial accessibility (willingness and ability of users to purchase services), and acceptability (responsiveness of providers to social and cultural norms of users and their communities).[23] While the Epidemiological transition is shifting the disease burden from communicable to noncommunicable conditions in developing countries, this transition is still in an early stage in parts of the Global South such as South Asia, the Middle East, and Sub-Saharan Africa.[24] Two phenomena in developing countries have created a "medical poverty trap" for underserved communities in the Global South — the introduction of user fees for public healthcare services and the growth of out-of-pocket expenses for private services.[25] The private healthcare sector is being increasingly utilized by low and middle income communities in the Global South for conditions such as malaria, tuberculosis, and sexually transmitted infections.[26] Private care is characterized by more flexible access, shorter waiting times, and greater choice. Private providers that serve low-income communities are often unqualified and untrained. Some policymakers recommend that governments in developing countries harness private providers to remove state responsibility from service provision.[26]

Community development is frequently used as a public health intervention to empower communities to obtain self-reliance and control over the factors that affect their health.[27] Community health workers are able to draw on their firsthand experience, or local knowledge, to complement the information that scientists and policy makers use when designing health interventions.[28] Interventions with community health workers have been shown to improve access to primary healthcare and quality of care in developing countries through reduced malnutrition rates, improved maternal and child health and prevention and management of HIV/AIDS.[29] Community health workers have also been shown to promote chronic disease management by improving the clinical outcomes of patients with diabetes, hypertension, and cardiovascular diseases.[29]

Slum-dwellers in the Global South face threats of infectious disease, non-communicable conditions, and injuries due to violence and road traffic accidents.[30] Participatory, multi-objective slum upgrading in the urban sphere significantly improves social determinants that shape health outcomes such as safe housing, food access, political and gender rights, education, and employment status. Efforts have been made to involve the urban poor in project and policy design and implementation. Through slum upgrading, states recognize and acknowledge the rights of the urban poor and the need to deliver basic services. Upgrading can vary from small-scale sector-specific projects (i.e. water taps, paved roads) to comprehensive housing and infrastructure projects (i.e. piped water, sewers). Other projects combine environmental interactions with social programs and political empowerment. Recently, slum upgrading projects have been incremental to prevent the displacement of residents during improvements and attentive to emerging concerns regarding climate change adaptation. By legitimizing slum-dwellers and their right to remain, slum upgrading is an alternative to slum removal and a process that in itself may address the structural determinants of population health.[30]

Kenya[edit]

Community health refers to the first level of health services provision in Kenya that comprises;

1. Interventions focusing on building demand for existing health and related services, by improving community awareness and health seeking behavior and 2. Taking defined interventions and services as defined in (Kenya Health Sector Strategic and investment plan KHSSP) close to the community and households.

The current registered association for community Health professionals in Kenya is The Society of Community Health Caregivers.[31] It was registered in the year 2020 to act as an umbrella body for the community health professionals.

Academic resources[edit]

• Journal of Urban Health, Springer. ISSN 1468-2869 (electronic) ISSN 1099-3460 (paper).
• International Quarterly of Community Health Education, Sage Publications. ISSN 1541-3519 (electronic), ISSN 0272-684X (paper).
• Global Public Health, Informa Healthcare. ISSN 1744-1692 (paper).
• Journal of Community Health, Springer. ISSN 1573-3610.
• Family and Community Health, Lippincott Williams & Wilkins. ISSN 0160-6379 (electronic).
• Health Promotion Practice, Sage Publications. ISSN 1552-6372 (electronic) ISSN 1524-8399 (paper).
• Journal of Health Services Research and Policy, Sage Publications. ISSN 1758-1060 (electronic) ISSN 1355-8196 (paper).
• BMC Health Sciences Research, Biomed Central. ISSN 1472-6963 (electronic).
• Health Services Research, Wiley-Blackwell. ISSN 1475-6773 (electronic).
• Health Communication and Literacy: An Annotated Bibliography, Centre for Literacy of Quebec. ISBN 0968103456.

See also[edit]

• Community health agent
• Community health center
• Community mental health service
• Online health communities
• Prison reform
• University of Community Health, Magway

References[edit]

1. ^ "A discussion document on the concept and principles of health promotion". Health Promotion. 1 (1): 73–6. May 1986. doi:10.1093/heapro/1.1.73. PMID 10286854.
2. ^ Goodman RA, Bunnell R, Posner SF (October 2014). "What is "community health"? Examining the meaning of an evolving field in public health". Preventive Medicine. 67 Suppl 1: S58–61. doi:10.1016/j.ypmed.2014.07.028. PMC 5771402. PMID 25069043.
3. ^ Elias Mpofu, PhD (2014-12-08). Community-oriented health services : practices across disciplines. Mpofu, Elias. New York, NY. ISBN 9780826198181. OCLC 897378689.
4. ^ "Chapter 36. Introduction to Evaluation | Community Tool Box". ctb.ku.edu. Retrieved 2018-03-05.
5. ^ Pearce J, Witten K, Bartie P (May 2006). "Neighbourhoods and health: a GIS approach to measuring community resource accessibility". Journal of Epidemiology and Community Health. 60 (5): 389–95. doi:10.1136/jech.2005.043281. PMC 2563982. PMID 16614327.
6. ^ Thornton LE, Pearce JR, Kavanagh AM (July 2011). "Using Geographic Information Systems (GIS) to assess the role of the built environment in influencing obesity: a glossary". The International Journal of Behavioral Nutrition and Physical Activity. 8: 71. doi:10.1186/1479-5868-8-71. PMC 3141619. PMID 21722367.
7. ^ a b Korda H, Itani Z (January 2013). "Harnessing social media for health promotion and behavior change". Health Promotion Practice. 14 (1): 15–23. doi:10.1177/1524839911405850. PMID 21558472. S2CID 510123.
8. ^ Stefanidis A, Crooks A, Radzikowski J (2013-04-01). "Harvesting ambient geospatial information from social media feeds". GeoJournal. 78 (2): 319–338. CiteSeerX 10.1.1.452.3726. doi:10.1007/s10708-011-9438-2. ISSN 0343-2521. S2CID 154991480.
9. ^ Ghosh DD, Guha R (2013). "What are we 'tweeting' about obesity? Mapping tweets with Topic Modeling and Geographic Information System". Cartography and Geographic Information Science. 40 (2): 90–102. doi:10.1080/15230406.2013.776210. PMC 4128420. PMID 25126022.
10. ^ Merzel C, D'Afflitti J (April 2003). "Reconsidering community-based health promotion: promise, performance, and potential". American Journal of Public Health. 93 (4): 557–74. doi:10.2105/AJPH.93.4.557. PMC 1447790. PMID 12660197.
11. ^ a b Nation M, Crusto C, Wandersman A, Kumpfer KL, Seybolt D, Morrissey-Kane E, Davino K (2003). "What works in prevention. Principles of effective prevention programs". The American Psychologist. 58 (6–7): 449–56. CiteSeerX 10.1.1.468.7226. doi:10.1037/0003-066x.58.6-7.449. PMID 12971191.
12. ^ a b c Barbara S (1998). Primary care : balancing health needs, services, and technology (Rev. ed.). New York: Oxford University Press. ISBN 9780195125436. OCLC 38216563.
13. ^ Frank JW, Brooker AS, DeMaio SE, Kerr MS, Maetzel A, Shannon HS, Sullivan TJ, Norman RW, Wells RP (December 1996). "Disability resulting from occupational low back pain. Part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins". Spine. 21 (24): 2918–29. doi:10.1097/00007632-199612150-00025. PMID 9112717.
14. ^ "Chapter 3: Primary care: putting people first". www.who.int. Archived from the original on October 19, 2014. Retrieved 2018-03-05.
15. ^ a b Minkler M (June 2005). "Community-based research partnerships: challenges and opportunities". Journal of Urban Health. 82 (2 Suppl 2): ii3-12. doi:10.1093/jurban/jti034. PMC 3456439. PMID 15888635.
16. ^ a b c Organization, World Health (2016-06-08). World health statistics. 2016, Monitoring health for the SDGs, Sustainable Development Goals. World Health Organization. Geneva, Switzerland. ISBN 978-9241565264. OCLC 968482612.
17. ^ a b Rosenbaum SJ, Shin P, Jones E, Tolbert J (2010). "Community Health Centers: Opportunities and Challenges of Health Reform". Health Sciences Research Commons.
18. ^ Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner-Brown J, Krause LK (15 June 2015). "Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations". Cochrane Database of Systematic Reviews (6): CD009905. doi:10.1002/14651858.CD009905.pub2. PMID 26075988.{{cite journal}}: CS1 maint: multiple names: authors list (link)
19. ^ Diamond, Lisa; Izquierdo, Karen; Canfield, Dana; Matsoukas, Konstantina; Gany, Francesca (2019). "A Systematic Review of the Impact of Patient–Physician Non-English Language Concordance on Quality of Care and Outcomes". Journal of General Internal Medicine. 34 (8): 1591–1606. doi:10.1007/s11606-019-04847-5. ISSN 0884-8734. PMC 6667611. PMID 31147980.
20. ^ a b c d e Health, Institute of Medicine (US) Committee on Using Performance Monitoring to Improve Community; Durch, Jane S.; Bailey, Linda A.; Stoto, Michael A. (1997). A Community Health Improvement Process. National Academies Press (US).
21. ^ "How to build healthy communities? | PlanH". planh.ca. Retrieved 2022-05-17.
22. ^ "A Healthy Community is a Prepared Community | Blogs | CDC". Retrieved 2022-05-17.
23. ^ Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH (2008-07-25). "Poverty and access to health care in developing countries". Annals of the New York Academy of Sciences. 1136 (1): 161–71. Bibcode:2008NYASA1136..161P. doi:10.1196/annals.1425.011. PMID 17954679. S2CID 24649523.
24. ^ Orach, Christopher (October 2009). "Health equity: challenges in low income countries". African Health Sciences. 9: 549–551. PMC 2877288. PMID 20589106.
25. ^ Whitehead M, Dahlgren G, Evans T (September 2001). "Equity and health sector reforms: can low-income countries escape the medical poverty trap?". Lancet. 358 (9284): 833–6. doi:10.1016/S0140-6736(01)05975-X. PMID 11564510. S2CID 263382.
26. ^ a b Zwi AB, Brugha R, Smith E (September 2001). "Private health care in developing countries". BMJ. 323 (7311): 463–4. doi:10.1136/bmj.323.7311.463. PMC 1121065. PMID 11532823.
27. ^ Hossain SM, Bhuiya A, Khan AR, Uhaa I (April 2004). "Community development and its impact on health: South Asian experience". BMJ. 328 (7443): 830–3. doi:10.1136/bmj.328.7443.830. PMC 383386. PMID 15070644.
28. ^ Corburn, Jason. (2005). Street science : community knowledge and environmental health justice. Cambridge, MA: MIT Press. ISBN 9780262270809. OCLC 62896609.
29. ^ a b Javanparast S, Windle A, Freeman T, Baum F (July 2018). "Community Health Worker Programs to Improve Healthcare Access and Equity: Are They Only Relevant to Low- and Middle-Income Countries?". International Journal of Health Policy and Management. 7 (10): 943–954. doi:10.15171/ijhpm.2018.53. PMC 6186464. PMID 30316247.
30. ^ a b Corburn J, Sverdlik A (March 2017). "Slum Upgrading and Health Equity". International Journal of Environmental Research and Public Health. 14 (4): 342. doi:10.3390/ijerph24040342. PMC 5409543. PMID 28338613.
31. ^ "Society of Community Health Care Givers". www.societyofcommunityhealth.org. Retrieved 2022-10-05.

Further reading[edit]

• Agafonow, Alejandro (2018). "Setting the bar of social enterprise research high. Learning from medical science". Social Science & Medicine. 214: 49–56. doi:10.1016/j.socscimed.2018.08.020. PMID 30149199.
• John Sanbourne Bockoven (1963). Moral Treatment in American Psychiatry, New York: Springer Publishing Co.[ISBN missing]

External links[edit]

• Health marketing- CDC

What are the 3 types of community health?

Which types of organizations provide community?

What are some community health programs?

What is community healthcare organization?