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PubMedDate not supplied

Australian enrolled nurses have their say--Part 1: Teamwork and recognition.

Nurses are a cornerstone to the Australian health care workforce and are under increasing pressure to respond to changes in health care demands, the redistribution of health care funding and shortages in nursing workforce availability and skill mix. It is in this context that the role and function of the enrolled nurse has come under recent scrutiny. This paper reports on the qualitative semi-structured interviews conducted as one aspect of an Australia wide multi-phased investigation of enrolled nursing practice and competency standards for this practice. In the reported phase, enrolled nurses from a variety of settings and from all states and territories participated in telephone interviews exploring their experiences of practice and the role of the enrolled nurse. Findings indicated various enabling and limiting influences on enrolled nurse role and function. In this paper two core themes of teamwork and recognition are described as they illustrate the rich interpersonal rewards of enrolled nursing and the significance of recognition by others of the enrolled nurse contribution to health care delivery. These themes are presented as an introduction to part two of this paper which reports more broadly on the dimensions of the enrolled nurse scope of practice.

Attitude of Health Personnel↗
PubMedDate not supplied

'Doi moi' and health: the effect of economic reforms on the health system in Vietnam.

The article examines changes which have taken place in the health system in Vietnam as a result of the economic reform process dating back to the late 1980s. With the liberalization of the economy have come not only growth for many, and increased choice, but also increased income and regional disparities and the problem of access to social services for those households which are less successful in the market economy. While state official policy emphasizes equity and free access to services for the poor, health costs for patients have risen substantially in the form of official and unofficial payments to staff and payments for drugs. The public sector faces an unprecedented challenge in the form of dramatic decreases in the utilization of public facilities; a shift towards self-prescription and, to a lesser extent, private practice by public employees; and, increasing reliance on foreign donors for support to preventive programmes. The article makes some recommendations on priorities for health policy in Vietnam to face these challenges.

Delivery of Health Care↗
PubMedDate not supplied

Shaping the health future in Turkey: a new role for human resource planning.

The expanding health needs and expectations of a growing and changing population in Turkey are placing new pressures on a health system that is increasingly financially constrained. These pressures are bringing into sharp focus the need to take radical approaches to the organization, planning and management of the health sector; and, in particular, in the planning and management of health human resources. Issues of effectiveness, efficiency and value for money are increasingly becoming the central issues for the 1990s and beyond. The article examines the development of the Turkish health system. Within a framework of health care reform proposals emerging from a major development project in the Ministry of Health itself, the text explores current initiatives and future needs in developing human resource planning if the health care reforms are to be successful in meeting the health needs of the population.

Developing Countries↗
PubMed1980

Outreach in urban clinics: a descriptive study.

Outreach services were initially conceived as important elements of neighborhood health centers, but they have not been shown to be effective in outcome evaluations. This study examines the outreach programs in 11 community clinics in Seattle. Interviews were conducted with the program directors and outreach workers of these clinics. Outreach programs have failed to provide an adequate number of jobs and career opportunities for the poor. Workers have not been carefully selected and trained, and goals and objectives of the program have been vague. Unstable funding of outreach has affected the quality as well as the size of the programs. Reasons for the inadequate implementation of the concept of outreach are discussed, and suggestions are made for future programs.

Career Mobility↗
PubMed1989

Towards an epidemiology of political violence in the Third World.

Political violence is distressingly widespread in many parts of the world. This paper reviews the forms and effects of political violence and devotes particular attention to experiences from Central America and Southern Africa. The forms of violence vary from those which are extensive such as civil unrest and war, to those which are intensive, such as assassinations, disappearances and torture. The effects of violence on health may be direct, such as deaths, disabilities, psychological stress and the destruction of health services, or indirect such as the erosion of innovative health policies in favour of increased military expenditure. Health workers have a role to play in opposing political violence, providing care for those affected by violence, and documenting and analysing its impact on health. Research needs include documenting the impact of different forms of violence on health, and analysing the social and political factors which promote and support political violence. It is hoped that increasing recognition of political violence and man-made violence as being of major public health concern will play a part in promoting a more peaceful world.

Developing Countries↗