Responding to rural health needs through community participation: addressing the concerns of children and young adults Vivienne Jeffery A,C and Kaye Ervin B A Numurkah District Health Service, PO Box 128, Numurkah, Vic. 3636, Australia. B University of Melbourne, PO Box 252, Cobram, Vic. 3644, Australia. C Corresponding author. Email: jefferyv@humehealth.org.au Abstract. A small rural health service undertook a major needs analysis in 2008 to identify gaps in service delivery and duplication of services. This exercise was intended to inform strategic direction but the result was consumer and community consultation and outcomes that far exceeded everyone’s expectations. Organisations often pay lip service to the concept of community participation and consultation and the importance of consumer involvement. Turning this rhetoric into action is challenging and requires dedicated staff, organisational support and momentum for it to occur. The project described resulted in targeted, purposeful action regarding community engagement, and the findings and outcomes are reflective of this. The unexpected findings required an organisational shift, which was embraced by the health service and resulted in collaborative partnerships with consumers and organisations that are proving beneficial to the entire community and outlying areas. Few organisations would demonstrate the willingness to accommodate such change, or undertake a needs analysis that is chiefly community driven. Background Discussion and collaboration at a community level is essential to inform pathways for effective health service delivery and local government policy. Needs analysis within organisations is a widely accepted concept, with benefits ranging from data provision, need identification, evidence-base contribution, improved patient outcomes, developing and improving links with local community and team building opportunities (Pallant 2002). Many needs assessment methods used by health services are reported to reinforce the status quo in service delivery rather than challenge it (Hawe 1996). Hawe proposes that data collection is often ritualistic and self-justifying without a view to changing service delivery based on consumer needs. For the project described, the organisation’s decision for community collaboration inferred that where possible the health service would act to make necessary changes. There was true commitment to the principles of community participation and continuous improvement through this process. The findings would provide local level data and identify community opinions and ideas, relevant and current at that point in time. Criticism of such processes (Fuller et al. 2001) include instilling false hope for those members who have participated, where inaction is likely to result in a status quo of ongoing, ad hoc evaluated historical processes. The project described used a conceptual approach to community engagement via a process of consultation of needs assessment as described by Billings and Cowley (1995) with ensuing collaboration to achieve desired changes and community development. The literature confirms the role of health care professionals in facilitating situations whereby consumers can learn to articulate their needs clearly (Chalmers 1993; Wainwright 1994). Previous studies (Hawe 1996; Allan et al. 2007) identify community development as a strategy to develop new models of health service provision and drive change of service delivery. Optimal health promotion includes advocacy, often via a larger group or organisation on behalf of consumers, provision of a supportive environment to enable individuals to achieve their full health potential and a mediating role to represent the different interests in society in the pursuit of health (World Health Organization 1986). Community participation is acknowledged as enabling constituents of a community to feel empowered and valuable in projects that concern their well-being. Health care organisations should have a strong consumer focus as participation is an ethical and democratic right (Department of Health 2006b). There is evidence that participation improves service quality and safety and improves health outcomes, while also increasing responsiveness to the needs of consumers (Consumer Focus Collaboration 2001). The process of community engagement explores concepts of social and support networks, social participation and community engagement by providing a forum where interaction between residents enables them to subjectively identify issues within their own community (Vinson 2004). Without accurate feedback concerning specific problems confronted by individual communities, service provision often fails to respond to the specific needs of the community (Department of Human Services 2005). Ó La Trobe University 2011 10.1071/PY10050 1448-7527/11/020125 CSIRO PUBLISHING Practice & Innovation www.publish.csiro.au/journals/py Australian Journal of Primary Health, 2011, 17, 125–130