GOOD PRACTICE: IN HEALTH & PARTICIPATION 20-minute DVD to get the message out. On the international front, the World Health Organisation (WHO) now feature the work in County Donegal on their website. The WHO coverage is remarkable as the work in Lifford is placed alongside examples of development work from Brazil, Chile, France and other countries. So far, Lifford has taken calls and visits from Donegal to Cork and Mayo to Laois. This is partly because there is no current agreed national framework for ‘Community Participation’ when establishing primary care teams. Brid McMenamin.
WHO highlights Lifford’s work - CDPs can and do support primary health care Community reps are working with health workers in Co. Donegal so that the roll-out of frontline services at local level matches the people’s real health-care needs. A strong emphasis has been placed on taking a Community Development approach to health and so members of the community play a crucial role. Lifford-Clonleigh Resource Centre, one of nine CDPs in Co. Donegal, is among the partner organisations. Communities in other parts of the country are taking a lead from Donegal, and basing their work on what is known as the Lifford/ Castlefinn model, named after the first area in the county to set up a Primary Care Team (PCT). It was one of ten pilot projects established in various parts of the State back in 2003.
Meaningful Participation
“We have been inundated with people calling to find out how we achieved meaningful community participation,” says Lifford’s CDP co-ordinator, Brid McMenamin. To cope with the demand for information, the CDP produced two booklets and a
lead from the ground up – set an example
Plan Is For 600 If and when plans come to fruition, there will be around 600 PCTs nationwide as the Republic’s health system shifts from its hospital-focus towards primary and community-based healthcare. It is a crucial part of the reform of the health services. By now, Ireland should be spending around €1.5 billion per annum on these preventative measures, saving money on surgical procedures and keeping hospital numbers down. However, the roll-out has proceeded in fits and starts since first announced (in the Primary Care Strategy in 2001). Nonetheless, there are now over 90 Primary Care Teams in operation around the State and some of these teams have sought support from CDPs. Thanks to the Community Development Programme, national initiatives such as this can be rolled out relatively quickly while respecting the principles of consultation and participation. * To view the WHO coverage, log onto: www.euro.who.int/socialdeterminants/ socmarketing/20080812_2
“Thanks to the Community Development Programme, national initiatives such as this can be rolled out relatively quickly while respecting the principles of consultation and participation.”
Locals Lead Donegal To Good Health In Donegal, real progress has taken place because local people had their say on what shape new health-focused projects should take. The talking took place through focus groups (17 in all) and by establishing Community Health Forums (CHFs) which support the participation of community representatives. Now, there are four Primary Care Teams operating in Co. Donegal (the
18.
Lifford’s pension day bus project
plan calls for 20 such teams and forums). “Health workers now seek the advice of the community reps on the Primary Care Team, and doctors in particular have become great promoters of the Forums’ work and of the community approach to promoting health,” says Marie McLaughlin, Community Worker with the East Donegal Primary Care Network Marie works a two-day week to support three of the forums and insists both commitment and resources from the HSE at national level are crucial for continued development The successes in Lifford to date came about through collaboration between Lifford/ Clonleigh Resource Centre (the local CDP) and the HSE. The CDP has continued to support the development of meaningful (and they stress the word ‘meaningful’) community participation and continues to ensure there is real community representation on the Primary Care Teams and Forums.
Reaches The Most Excluded “The Lifford/Castlefinn Community Health Forum aims to act as a voice to address issues effecting the health and well-being of people from prenatal care to old age. It particularly emphasises matters of concern to the most vulnerable and excluded groups or individuals,” says Marie. “Nonetheless, additional resources are required to reach the most disadvantaged groups. In the start up phase this was achieved by an extensive community consultation process where some 17 focus groups were convened specifically to obtain the views of the ‘hard to reach’ groups,” she says. The feedback from the focus groups informed the needs assessment which in turn informed both the work of the PCT and CHF. A second community consultation is now being undertaken jointly by the Lifford/ Castlefinn CHF, the Lifford/Clonleigh Resource Centre and the Castlefinn Local Area Team. Note: A list of the projects established through the work in Donegal is published om the next page. * Nationally, Lifford/Castlefinn was one of 10 areas selected in 2001 as pilot projects for implementing the delivery of primary care and the development of community participation as an integral part of this project was supported by the HSE and the Combat Poverty Agency (through its Building Healthy Communities Programme)