What does inclusion look like in primary health?

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Acknowledging diversity means being community-driven.

When we talk about diversity and inclusion in primary health care, we are really talking about a better approach to meeting needs. While we need to recognise and value all forms of difference in individuals such as race and ethnicity, culture and belief, gender and sexuality, age, social status, and ability, we also need to better understand and acknowledge how these factors interact with people’s use of primary health services. This need for understanding can sometimes be more acute for those people whose diversity may not always be obvious or visible.

When we operate from a social model of health, we need to acknowledge the social, environmental and economic factors that affect people’s health on top of the biological and medical factors. Diversity can often intersect with vulnerability through social determinants such as discrimination, which can reduce access to appropriate health care and ultimately lead to poorer care outcomes. We know that the way services include or exclude people can have significant ramifications for their health and wellbeing.

Inclusion and inclusive practice then requires  health care providers to more deliberate and considered action to create environments that more effectively respond to its patient population – environments where everyone feels respected and able to participate in meeting their health care needs.

Beyond improving access: better meeting needs.

How do we make the difference for patients between surviving and thriving? More than simply encouraging people, it is about ensuring that we have adequate policies and practices in place to be truly responsive.

Being cognisant about equality of opportunity is a first step towards inclusion, which means that we need to remain vigilant about ensuring that a full range of people and groups have similar access to our health care service. This requires identifying and eliminating barriers to participation. Health services also need to become more responsive to specific health and wellbeing needs of population subgroups. To deliver truly person-centred care, health service providers require new levels of competency, understanding and sensitivity to the diverse populations they serve.

All of these approaches are underpinned by an appreciation of health need assessments – some kind of systematic method of identifying unmet health and healthcare needs of a population and making changes to meet these unmet needs. This involves the identification and analysis of key data and other forms of information. Undertaking a needs assessment offers a health care provider with the opportunity to engage with local community and service groups which support specific population subgroups, and in doing so, explore pathways, collaboration and integration.

Given that the needs of many groups, and particularly those more vulnerable and/or complex, may not be adequately captured or represented in routine statistical collections, a needs assessment is an opportunity to consult with various communities to better understand the factors which affect their health and quality of life. Opportunities for community empowerment can often emerge from this.

Next steps.

There are different ways that services can approach driving more inclusive practice:

1 – Make mainstream/universal services more responsive to specific needs can include but not limited to:

  • Conduct a needs assessment, using combination of available data and community engagement and consultation
  • Review practical actions that can be taken to improve the responsiveness of services, which might include review of intake & assessment; language; policy, process and documentation
  • Review cultural competence of service and staff confidence and capacity; provide educational experiences to workforce
  • Ensure models of care are sufficiently flexible to be responsive to various needs
  • Use whole-of-organisation approaches to ensure inclusion in a systematic way

2 – Creating pathways and partnerships with targeted local services for population groups that may face barriers to accessing appropriate health and community based care

Larter works with clients to identify and respond to health needs. Our technical skills and primary care expertise assists agencies to navigate change. Read more about how we work with clients to respond to statewide, catchment or target group health needs or get in touch to discuss further.