title: Remote area health service delivery in central Australia: primary health care and participatory management.
abstract: This paper provides a description of initiatives and changes made in remote primary healthcare service delivery in Central Australia. These changes included the introduction of an orientation and Aboriginal cultural awareness program, revising the recruitment process to include communities in staff selection, developing policies and protocols to support practice, and increasing support for remote area staff through managers being out and about in remote areas. The change from centralised management to an increasingly decentralised participatory management model, and involving local communities and local staff in decision making, was initiated early in the change process and continues to be of prime importance. After 5 years of intensive effort, it is clear that despite these initiatives sustainable change has been elusive and some problems remain. Further change and development is necessary. A number of new initiatives are described, including a Menzies School of Health Research project that examines structural issues, which will provide direction for the future by providing better support for remote area staff and facilitating greater community participation.
authors.affiliation: Menzies School of Health Research, Alice Springs, Northern Territory, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Wakerman
authors.forename: P
authors.initials: P
authors.lastname: Field
mesh_terms: D003256:Community Participation; D003659:Decision Making, Organizational; D003695:Delivery of Health Care / Q000458:organization & administration*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D015876:Northern Territory; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*