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PubMed1988

Evaluation of governmental dental health services in rural health centers in Egypt.

The aim of the study was to identify and evaluate the existing utility of rural oral health services after 20 yr of implementing the compulsory law of rural health services in Egypt. Six out of 26 governorates present in Egypt were selected. Ten rural health centers from each governorate were visited. A review from each center was performed about the demographic features of the village, the dental manpower and type and condition of dental equipment. The existing records of the dental treatment performed per year from July 1980 to June 1981 were recorded. The general findings revealed that only 31% of rural health centers of the selected governorates had dental facilities. The demand for dental treatments in these centers varied between the six governorates and ranged between 12% in Alexandria to 1% in Dakahlia of the population. Most of the treatments performed were extractions (52.52%), while conservative treatments were minimal (0.85%). Prosthetic treatments were not available in these centers.

Adolescent↗
PubMed2004

Competencies for rural health administrators.

Rural healthcare and rural health administration have been changing rapidly. An evolution in policies, regulations and reimbursement practices combine to make the skills required of the new health service administration graduate significantly different from those required even a few years ago. This paper forms an initial articulation of core competencies required for rural health administrators. It focuses on health administration education programs that focus on or offer learning experiences in rural health administration. To competently address the unique characteristics of rural populations and facilities, administrators should demonstrate capability in multiple areas. These include unique applications of health management tools to rural environments, understanding designated reimbursement mechanisms for financing rural facilities, and development of leadership skills for dealing with multi-disciplinary management teams and evaluation of small organizations.

Curriculum↗
PubMed2003

Transforming the delivery of rural health care in Georgia: state partnership strategy for developing rural health networks.

Since 1996, 19 networks covering 74 of the 117 rural counties in Georgia have emerged. This grassroots transformation of rural health care occurred through a series of partnerships launched by state government officials. These partnerships brought together national and state organizations to pool resources for investment in an evolving long-term strategy to develop rural health care networks. The strategy leveraged resources from partners, resulting in greater impact. Change was triggered and accelerated using an intensive, flexible technical assistance effort amplified by developmental grants to communities. These grants were made available for structural and organizational change in the community that would eventually lead to improved access and health status. Georgia's strategy for developing rural health networks consisted of 3 elements: a clear state vision and mission; investment partnerships; and proactive, flexible technical assistance. Retrospectively, it seems that the transformation occurred as a result of 5 phases of investment by state government and its partners. The first 2 phases involved data gathering as well as the provision of technical assistance to individual communities. The next 3 phases moved network development to a larger scale by working with multiple counties to create regional networks. The 5 phases represent increasing knowledge about and commitment to the vision of access to care and improved health status for rural populations.

Community Health Planning↗
PubMed1999

The adoption of provider-based rural health clinics by rural hospitals: a study of market and institutional forces.

OBJECTIVE: To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). DATA SOURCES/STUDY SETTING: Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. STUDY DESIGN: A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). PRINCIPAL FINDINGS: Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. CONCLUSIONS: Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.

Community Health Centers↗
PubMed2002

Behavioral health: setting the rural health research agenda.

This article seeks to identify current research priorities in the area of rural behavioral health. The method for accomplishing this task begins by identifying several domains where policy has a potential to effect improvements in access or quality but has been hampered by lack of empirical knowledge. In each domain a synthesis of current research summarizes what is known and draws attention to knowledge gaps. Research questions in each domain are proposed. The policy domains are theoretically based, using a conceptual model of access to health care, with a focus on illness level (prevalence), enabling factors (the delivery system, organization and financing, the promise of telemedicine), and predisposing factors (special populations, beliefs, values, stigma).

Behavioral Medicine↗
PubMed2005

Factors that influence the recruitment and retention of graduate nurses in rural health care facilities.

Rural nursing is a distinct practice and rural nurses in Australia constitute the largest group in the rural health workforce. However, the rural workforce is ageing and the turnover of nurses in rural areas is high. In addition, rural health services are experiencing recruitment and retention difficulties; very little is known about the recruitment and retention of new graduates nurses in rural health areas and the potential long-term investment they could offer to rural health services. A qualitative study explored the journey of transition for new graduate nurses employed in graduate nurse transition programs in northern New South Wales. This paper presents two major themes from the study that describe the factors that influenced the new graduate nurse to seek and accept a graduate nurse position within a rural health setting and the factors that influenced their retention. Findings indicate that previous connection with a rural area and positive experiences in a rural health care facility during undergraduate preparation were significant factors influencing the graduate nurses' decision to pursue a rural graduate nurse position. No guarantee of a permanent appointment upon completion of the graduate program, and graduates' disappointment with graduate nurse programs, were important factors influencing their retention within rural health care facilities.

Attitude of Health Personnel↗
PubMedDate not supplied

[Extended main family and mental disease in a rural health area].

OBJECTIVE: To check the association between souche family and the incidence of mental illness. DESIGN: A case-control study. SETTING: Health Rural Zone (Tineo-Asturias-Spain). PATIENTS CASE: every person with a new diagnosis of mental illness who has been compiled (CIE-9-CM) the clinical records of the Mental Health Centre. Field-work from 1-1-1996 until 31-12-1997; they could be dead or alive and of fourteen or more years of age, including suicide and suicide attempts without clinical records in the mental health centre and excluding organic psychosis, mental illness caused by organic damage lesion and mentally handicapped (n = 162). CONTROL: living people of fourteen or more years of age, with diagnosis of current mental illness, after more than one year since their discharge from a mental illness. They will mark five or less than five in the GHQ-28 scale. A systematic random sample was done among all patients registered by computer from the health centre (n = 378). We compiled information about: age, sex, family and personal backgrounds of mental illness, rural or urban context, marital status, education level, family structure and GHQ-28. We carried out univariant and bivariant analysis also we adjusted a logistic regression model (SPSSW7.1). MAIN RESULTS: In the souche family we obtained a odds ratio equal 3.29 (95% CI, 1.69-6.43). CONCLUSIONS: The souche family is a risk of mental illness. Research into dynamics and performance should be done.

Adolescent↗
PubMed1980

Rural health care looks to the future. Issues in the institutionalization and management of rural health care: making technology appropriate.

Experimental projects have demonstrated the technical feasibility of systems of accessible, affordable health care. These projects have relied extensively on non-professional community health workers. However, large-scale implementation of these schemes will require new management procedures that are both responsive to rural health needs and congruent with national institutions. This paper identifies the need to establish institutional mechanisms to mobilize essential inputs, promote acceptance by beneficiaries, maintain quality standards, recruit and retain field staff, and achieve accountability for resources. It then outlines methods for developing these institutions. It stresses the need for both formal, bureaucratic organizations and informal organizations of clients. It also identifies the need to consider administrative and institutional resources in determining the appropriateness of a health care technology.

Developing Countries↗
PubMed2003

The Southern Rural Access Program and Alabama's Rural Health Leaders Pipeline: a partnership to develop needed minority health care professionals.

Rural Health Leaders Pipeline programs are intended to increase the number of youth interested in and pursuing health professions in rural communities. This paper presents 2 complementary approaches to Rural Health Leaders Pipeline programs. Two different organizations in Alabama recruit students from 18 specified counties. One organization is a rural, community-based program with college freshmen and upperclassmen from rural communities. Students shadow health professionals for 6 weeks, attend classes, visit medical schools, complete and present health projects, and receive support from online tutors. The second organization is a university-based program that supplements an existing 11th grade-medical school rural medicine pipeline with 10 minority students from rural communities who have graduated from high school and plan to enter college as premedical students in the following academic year. Students participate in classes, tutorials, seminars, and other activities. Students earn college credits during the 7-week program, maintain contact with program staff during the school year, and by performance and interest can continue in this pipeline program for a total of 4 consecutive summers, culminating in application to medical school. Each organization provides stipends for students. Early experiences have been positive, although Rural Health Leaders Pipeline programs are expensive and require long-term commitments.

Adolescent↗
PubMed2000

New approaches to sexual health services in a rural health board area: involving service users and primary care professionals.

Research was undertaken to inform the future development of sexual health services for the population of a rural health board. Three separate surveys were carried out: (i) users of local and regional genitourinary medicine (GUM) services, (ii) users of local family planning clinics, and (iii) all local general practitioners (GPs) and practice nurses-to obtain views on current sexual health services and the optimum future configuration of services. Respondents to the GUM survey (n=137) attended GUM service for a range of sexual health reasons; confidentiality was the most important factor affecting choice of service provider and almost half (44%) would have been happy to receive the service from their GP. Family planning clinic respondents (n=298) attended clinics for a range of reasons; confidentiality was the most important factor affecting choice of service provider and less than one-third (29%) would attend their GP for a similar service. Both GUM and family planning clinic survey respondents supported the development of clinics providing a broad range of sexual health services. Almost all (97%) GP respondents in the primary care professionals survey saw patients for sexual health-related consultations; over half (54%) treated sexually transmitted infections (STIs). Significant training needs in sexual health were identified for primary care professionals. New models for the provision of sexual health services are proposed for this health board area.

Adult↗