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Developing trauma care systems: a nursing perspective.

Emergency medical services (EMS)/trauma care systems offer unique opportunities for nurse administrators in community hospitals and medical centers to encourage a professional practice model for the department of nursing. The development of local and regional EMS/trauma services involves nurse administrators and their staffs in the legislative process; community networking; program planning, operation, and evaluation; and clinical research. This, the first in a series of articles, reviews the history of trauma care in America, explains the process of regionalization and designation as provided for in the proposed federal legislation, discusses appropriate roles and responsibilities for nurse leaders in trauma care systems, and outlines planning and operational functions for nursing departments in designated trauma care facilities.

Administrative Personnel↗

Strengthening primary health care: building the capacity of rural communities to access health funding.

Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities.

Budgets↗

Integrated child development services scheme (ICDS) in India: its activities, present status and future strategy to reduce malnutrition.

Integrated Child Development Services Scheme (ICDS) provides an integrated approach for converging all the basic services for improved child care, early stimulation and learning, health and nutrition, water and environmental sanitation aimed at the young children, expectant and lactating mothers, other women and adolescent girls in a community. Its objectives are: To improve nutritional and health status of children of 0-6 years; to reduce the incidence of mortality, morbidity, malnutrition and school dropout; to achieve effective co-ordination amongst various departments to promote child development; to lay foundation of proper psychological,physical and social development of the child; to enahance mother's capability to look after normal health and nutritional needs of the child. ICDS services are provided through a village based centre ie, the Anganwadicentre for the services of: Supplementary nutrition, immunisation, health check-up, referral services, treatment of minor illnesses, nutrition and health education to women, preschool education to children and supports for water supply, sanitation, etc. Several government departments and their services are co-ordinated at village, block, district, state and central levels. The Anganwadiworker is the most peripheral functionary which implements the programme services at the village/community level. In projects where able leadership has been provided, ICDS has been reported to be better. Though there are some shortcomings in ICDS, till future thrust of the programme is necessary for aiming of the upliftment of underprivileged section of the population. Operative research in various areas is suggested which can help in improving the efficiency of ICDS.

Child Development↗