CHCI and EHSDI Planning and Evaluation - Essay Example

CHCI and EHSDI Planning and Evaluation Name of Student Student Number Institution Course Code Name of Instructor Date of Submission Introduction Public health is a key feature within the community, and every individual has a contribution to make towards effective realisation of good health and well-being. The aspect of health promotion is a process that enables individuals to raise standards of controlling and improving their health. According to Baum (2008: 203), public health involves community-based initiatives focussing on social, policy organisational and individual change; as well as, the fact that community-based settings pose particular challenges for planning and evaluation. The Northern Territory’s Child Health Check Initiative (CHCI) and Expanding Health Services delivery Initiative (EHSDI) are two programs that well depict this statement, and this essay looks into their background and key features. Further, an identification of the various approaches to planning and evaluation of CHCI and EHSDI will be done with reference to Summary Evaluation Report of 2011. Finally, a critical assessment of given challenges and responses involved in planning and evaluating the initiatives will be carried out. Background and Key Features of CHCI and EHSDI The Child Health Check Initiative (CHCI) and the expanding Health Service Delivery Initiative (EHDI) came into being to address the health needs of the indigenous people in the Northern Territory (Allen and Clarke 2011). CHCI was initiated with the aim of providing health checks upon children of the Aboriginal communities within the remote areas. EHSDI was initiated with the major goal of expanding delivery of primary health care services within indigenous people, create regional approaches crucial for planning and service delivery (Allen and Clarke 2011), as well as enhance the control and participation of health services planning and delivery by the community. The said needs are still critically high with a significant necessity to enhance in the health systems to realise the needs in question. CHCI have been developed to realise credible achievements in areas of dental care, as well as hearing, nose and throat health. This is in respect to ensuring effective health and well-being of the community and specifically looking into the young children who are at the vulnerable stages of acquiring manageable infections through hygiene (Glanz, Rimer and Viswanath 2008). The evaluations looks into the implementation of the two initiatives carried out upon the indigenous people, where in this context, it refers to the Aboriginals and Torres Strait Islanders found in the NT region. The features of CHCI as outlined in the Summary Report by Allen and Clarke (2011) illustrate various items laid down to identify the program. First, the initiative ensured the development of rigorous policies incorporating programs already in place, and then commenced the development and implementation of child health screening programs. The screening programs ensured identification of prevailing health issues and thus, coming up with effective measures to attend to them (Department of Health 2012). The reason behind basing the initiative upon existing programs was due to the fact that initiating new programs is an expensive venture. The program was able to establish gaps that were hindering effective delivery of health care services and consequently target these areas for development (Allen and Clarke 2011). Having been initiated in 2007 and 2008 respectively, CHCI and EHSDI were effectively managed amid the major setbacks. Continuous resourcing was done to ensure initiatives favourable to overcome barriers in the workforce were put in place and this was crucial in sustaining and extension of CHCI achievements (Allen and Clarke 2011). This was in respect to efficiency in service delivery models for dental, ear, nose and throat hygiene and care. One critical aspect of the CHCI was in respect to incorporating given measures looking into the fundamental social determinants of health which incorporated education, housing and level of poverty (Kickbusch and Buckett 2010). The main feature of achievement of this initiative is that it brought to perspective to the political and administrative bodies, the health needs of the indigenous children living in the remote areas of Northern Territory. Thus, further policy, planning and delivery of child health was boosted by the availability of access to regular and comprehensive data on what is needed among the Aboriginal children, as well as the capacity of the systems to respond to these needs (Department of Health 2012). The EHSDI was based on engaging with the already in place processes within Northern Territory, as well as coming up with effective partnerships between the Australian Government, NT Government and Aboriginal Community controlled sectors (Allen and Clarke 2011). This approach contrasts the CHCI approach. The two initiatives were initiated as part of suite of actions scheduled by the Australian Government looking into health aspects (Department of health 2012. Nevertheless, its overall impact has been overshadowed by lack of precision in respect to interactions with communities and prevailing heath care systems. Children of Aboriginal decent living in NT are still significantly high and there is great need for improvement in the health care system to achieve the needs (Baum, Ziersch, Bentley and Gallaher 2009). Thus, with the level of improvement in place, there is need for continued support among existing partnerships, as well as the sharing of aspirations, expertise and resources derived from the Aboriginal Community, the regional NT Government and the Australian Government to control the sector. Basically, the health systems require continued expansion of the comprehensive PHC services on the ground to connecting impeccably with diverse and specialised services (Kickbusch and Buckett 2010). Approaches towards Planning and Evaluation of CHCI and EHSDI The Government of Australia commissioned a project for evaluation to understand and assess the entire process of development, as well as the implementation of initiatives and outcomes that are associated with them. On the same note, the probable impacts to be made and achieved in the future among the Indigenous persons in the Northern Territory were evaluated (Allen and Clarke 2011). The evaluation process is critical in examining the performance and implementation progress of the two initiatives in respect to their effectiveness, efficiency and appropriateness. The effectiveness aspect relates to improvement of health of the remote indigenous persons in the Northern Territory (Department of Health 2012). Efficiency regards to the delivery of services in a cheap and cost-effective way. While the appropriateness regards to ensuring the proper services are availed to target population appropriately and timely as per the set out policy and priority of the Government of Australia (Allen and Clarke 2011). The evaluation process of the CHCI component was a critical step in the monitoring of the implementation, as well as the follow up services carried out on various case scenarios within the communities (Department of Health 2012). In regard to EHSDI, the focus of evaluation was done to assess whether the program was still on track towards ensuring effective and sufficient service delivery in the health sector (Allen and Clarke 2011). Consequently, it was aimed at looking into the extent of health outcomes improvement, as well as come up with effective utilisation of the scarce resources. The realisation of a state of total physical, mental and social well-being, a person or group ought to be in a position to establish and realise aspirations necessary to satisfy needs and change or survive in the environment (Baum 2008). Thus, health is a resource necessary daily and not the objective of living. It is a positive concept that highlights on social and individual resources coupled with physical capacities (Glanz, Rimer and Viswanath 2008). In context, realisation of effective public health is the responsibility of not only the health sector, but also extends beyond the healthy lifestyles to well-being. Planning and evaluation were commenced on the basis of the extent and implementation process of the programme at hand. The CHCI programme was covered extensively by the time of evaluation and thus a summative approach was utilised (Allen and Clarke 2011). In context, the approach was expected to highlight the overall projection of the outcome on full implementation of the initiative was over. This is in respect to the fact that tangible evaluation was viable. Conversely, EHSDI was at its early stages of implementation thus, a formative approach was utilised in respect to the emergent nature of the programme (Allen and Clarke 2011). In respect to this initiative, evaluation aimed at assessing the initial work of programme commencement and implementation. Thus, supporting its continuity was a major goal of the initiative. The work was carried out closely in corroboration with the three partner agencies to ensure continuity of the implementation process of the two initiatives (Department of Health 2012). Challenges and Responses involved in Planning and Evaluation of the Initiatives. Planning and evaluation of the two programs had its share of challenges slowing down the pace of the implementation process, as well as leading to failure of achieving the set targets (Allen and Clarke 2011). The complexity of the two initiatives and the context of their implementation were challenging undertaking. There had been critical measures to come up with ways of improving the ability of health services to meet the high needs of Indigenous people residing in the remote areas (Baum, et al. 2009). However, the challenge has been rewarding and offered the privilege to collectively put together the efforts of partner agencies, as well as other participants in the process of evaluation. Amid the fact that there significant achievements on the programs, there were continuing problems being faced in respect to recruitment, accommodation of staff shortage, training of Aboriginal Health Worker and high staff turnover (Department of Health 2012). In respect to this, comprehensive workforce strategy was necessary to address the issues a system standard. Long-term funding strategy was crucial to ensure continued expansion and reform of the remote NT primary health care (Allen and Clarke 2011). Thus, an accurate costing model was initiated to ensure PHC critical services in the region were available. Although follow-up services were a priority, there was lack of efficient physical infrastructure to ensure full implementation of the initiatives (Baum, et al. 2009). This prompted the venture of creating measures to overcome the lack infrastructure providing a big challenge. On the same note, there was no enough labour among the Indigenous communities prompting workforce recruitment which was equally challenging (Department of health 2012). In order to overcome the shortage of workforce, a service delivery model was created with the approach of recruiting staff from interstate in duration of three weeks placement to provide mobile dental services, secondary clinical services and outreach medical services (Department of Health 2012). These were critical measures to overcome lack of personnel and thus, access far and wide populations in the Northern Territory. Once staff were recruited, more challenges pertaining to their work and well-being arose which called for critical attention. Staff accommodation was another challenged that required further attention, as well as health centre space and dental facilities posing great challenges in the full implementation of the initiatives (Allen and Clarke 2011). The reality was that challenges were coming up amid the fact that the programmes were being rolled out on already existing policies. Nevertheless, the realisation of effective running of the implementation process proved quite challenging. According to Department of Health (2012), the challenge was handled by the initiation of a joint working resolution by DoHA (Department of Health and Ageing) and DHF (Department of Health and Family) to create workable solutions to be financed by the government of Australia to overcome the challenges. Conclusion In conclusion, the two initiatives came into focus aimed at ensuring effective health care among all with the inclusion of the community and the authorities to ensure the set goals are realised. Generally, the aspect of ensuring health care delivery is determined by various determinants; and thus, the realisation of effective care involves concerted efforts from various sectors. The NT’s CHCI and EHSDI have been evaluated to set out the concepts of planning and evaluation. Basically, the development of health care is affected by social conditions in respect to the lives of individuals to promote well-being. It is imperative to note health care programs implementation face diverse challenges but, persistent support and critical evaluation ensures effective achievement of set out goals. This is realised with inclusion of the community and provision of necessary resources by the regional and national authorities to promote health and well-being. Reference List Allen and Clarke, 2011. Evaluation of the Child Health Check initiative and the Expanding Health Service Delivery Initiative: Summary Report, Department of Health and Ageing. Canberra: Commonwealth of Australia. Baum, F., 2008. The New Public Health, 3rd ed. Melbourne: Oxford University Press. ISBN 978-0-19-555046-7. Baum, F., Ziersch, A., Bentley, M. and Gallaher, G., 2009. Increasing the Likelihood that Aboriginal Health Research Influences Policy: Insights from an Adelaide Study. In Making a Difference: Intervening to Improve Health Outcomes. PHAA 39th Annual Conference, Canberra. Department of Health, 2012. Evaluation of the Child Health Check Initiative and the Expanding health Service Delivery initiative –Final report. Sydney: Commonwealth of Australia. . Glanz, K., Rimer, B. and Viswanath, K. (Eds.), 2008. Health Behaviour and Health Education: Theory, Research and Practice, 4th ed. San Francisco: John Willey & Sons. Kickbusch, I. and Buckett, K., 2010. Implementing Health in all Policies: Adelaide 2010. Department of Health, Government of South Australia. Read More