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AbstractObjective. Advance Care Planning (ACP) has been gaining prominence as an important component of good end-of-life care. This study explored how ACP is conceptualised by stakeholder organisations and clinicians involved in aged care and end-of-life care in Australia, in particular their views on the aim, appropriate context and settings for ACP, and how ACP should be facilitated. Participants. Twenty-three participants including expert clinicians and representatives of government organisations, professional societies, consumer groups and other organisations involved in aged care and end-of-life care. Design. Qualitative descriptive analysis of semi-structured telephone interviews. Results. Most participants viewed ACP as an ongoing process aimed at enhancing an individual's autonomy and ensuring good end-of-life care. However, there were significant differences in how this process was conceptualised. Some viewed ACP as a process undertaken by patients to define and communicate their treatment preferences. Others viewed ACP as discussions undertaken by health professionals to gain a better understanding of the patient's values and goals in order to provide good care. Implications. Our findings highlight significant differences in how ACP is conceptualised in Australia. A shared conceptualisation and agreement on purpose is needed to ensure a successful implementation of ACP in Australia. What is known about the topic? Advance care planning (ACP) has been gaining increasing prominence both internationally and in Australia and is seen as an important component of good end-of-life care. Originally conceptualised as a document outlining a patient's specific treatment preferences about life-sustaining treatments, ACP has been increasingly recognised in the literature as an ongoing process of discussion, communication and documentation of the patient's wishes and values regarding end-of-life care. What does this paper add? This paper shows that most expert clinicians and representatives of key stakeholder organisations view ACP as a process that aims to enhance individual autonomy and ensure good end-of-life care. However, our findings show that they often hold contrasting views on ACP - ranging from a consumer-orientated view that sees ACP as undertaken to define and communicate their care preferences; to a care-orientated view that sees ACP as discussions led by health professionals in order to gain an understanding of patients' values and wishes in order to provide better care. What are the implications for practitioners? Our findings highlight significant differences in how ACP is conceptualised in Australia. This can cause confusion and conflict, leading to reduced effectiveness of ACP. A shared conceptualisation and agreement on purpose is needed to ensure a successful implementation of ACP in Australia.

Kinchin, I orcid:0000-0003-0133-2763; Mccalman, JR orcid:0000-0002-3022-3980 ; Background: The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research. ; Associated Grant:this review was supported in part by National Health and Medical Research Council Early Career Fellowship ; Associated Grant Code:APP1113392

I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations' political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care.

Rawal, LB orcid:0000-0003-1106-0108 ; Noncommunicable diseases (NCDs) have been increasing rapidly and are now the major cause of disease burden and deaths in the Asia Pacific region. This rising disease burden has challenged health systems in countries of the region and could hamper achievements of the Millennium Development Goals. This has raised concerns among policy-makers about the need to identify innovative approaches to control NCDs and meet the health needs of the public. Strengthening primary health care (PHC) services and the workforce to deliver such services has been considered as an option to address the growing need of services for NCDs. Community health workers (CHWs) have increasingly been recognized as a frontline health-care workforce to support government actions to combat NCDs. However, the role of CHWs within the PHC system is not well defined. To provide policy-makers with a package of options to engage CHWs in NCD care, this policy brief summarizes CHW-led programmes, describes challenges to integrating CHW-led NCD programmes and make recommendations. The development of this policy brief was based on experiences in four countries of the region – Bangladesh, China, Nepal and Viet Nam. However, it is worth emphasizing from the outset that our study is not designed to be representative of the four countries but exploratory in nature.

Intro -- Acknowledgments -- Preface -- Reference -- Series Editor Introduction -- Contents -- Contributors -- Chapter 1: Men's Health in 2010s: What Is the Global Challenge? -- What Is Men's Health? -- Are We Improving the Lives of Men? -- Life Expectancy -- Mortality, Morbidity, and Leading Causes of Death -- Why Is Creating/Providing Adequate Men's Health Such a Challenge? -- Is the ACA Appropriately Poised to Improve the Preventive Healthcare of Men? -- Future Directions for Improving Men's Health -- Conclusion -- References -- Chapter 2: Masculinity in Men's Health: Barrier or Portal to Healthcare? -- Masculinity in Men's Health -- Conceptualizing and Measuring Masculinity -- Stress, Masculinity, and Men's Health Behavior -- Masculinity Changes over Time -- Social Determinants of Masculinity and Men's Health -- How Do Men Conceptualize Health? -- Conclusion -- References -- Chapter 3: Health-Seeking Behavior and Meeting the Needs of the Most Vulnerable Men -- Introduction -- Root Causes of Disparities in Healthcare -- Navigating Healthcare Systems -- Health-Seeking Behaviors and Barriers -- Self-Management and Self-Advocacy -- Next Steps to Improve Health-Seeking Behavior -- References -- Chapter 4: Providing Preventive Services to Men: A Substantial Challenge? -- Introduction -- Challenges to Implementing Appropriate Preventive Healthcare -- Challenges Unique to Men -- Adhering to Current Age- and Risk Factor-Appropriate Guidelines for Preventive Care in Men -- Implementing Preventive Healthcare Services for Men in the Office -- Conclusion -- References -- Chapter 5: The Evidence-Based Physical Examination of the Child and Adolescent Male -- The Well-Child Examination for Children and Adolescents/Young Adults -- Child Examination -- Weight for Length/Body Mass Index -- Blood Pressure -- Eyes -- Mouth -- Neurologic/Developmental -- Skin.

The following paper sets out to examine three issues: primary health care, chiropractic care, and the challenges to both in the next decade. The current crisis of primary health within the health care system provides chiropractic with an opportunity to choose between functioning as primary care or primary contact care. Chiropractic has seldom met its potential, or its own rhetoric, with regard to holistic health care which would make the case for being primary health care much stronger. There have been numerous social and political factors that have influenced this but part of the problem is that chiropractic has failed to clearly articulate itself as primary health care, and in some instances, has denied that it was. New opportunities and challenges will force chiropractors to resolve the issue of whether chiropractic is a general model of health care, or a form of health specialty (the neuromusculoskeletal practitioner verses the primary health practitioner).

Analyzing the dimensions of the struggle for effective health care in the developing countries, this study demonstrates how current governmental and donor agency policies in such countries as Uganda, Ghana, Nepal, Pakistan and Vietnam have failed to develop efficient systems. The author argues against the current emphasis on decentralization and privatization, and outlines a framework for a long-term approach that should bring benefits and improvements in health care

AbstrakEksistensi hak kesehatan sebagai fundamental right yang dimiliki oleh setiap individu telah diakui secara kontitusional. Hakikatnya, kesehatan harus dijamin dengan adanya suatu kepastian hukum melalui upaya peningkatan kualitas kesehatan. Namun, beberapa daerah masih memiliki keterbatasan akses pelayanan kesehatan dasar di puskesmas. Hambatan tersebut terlihat dari minimnya jumlah puskesmas dan kesenjangan fasilitas antardaerah, kurangnya berbagai faktor penunjang, serta terbatasnya kuantitas tenaga kesehatan yang akan mempengaruhi capaian kesehatan masyarakat. Pemberlakuan jam operasional dalam rangka mengurangi angka penyebaran covid-19 mengakibatkan terjadinya dua kondisi yang kontras. Kondisi pertama menimbulkan overcapacityyang berisiko memicu kerumunan, sedangkan kondisi kedua menyebabkan penurunan jumlah kunjungan masyarakat ke puskesmas. Hal ini perlu menjadi fokus pemerintah, guna meningkatkan pemerataan pelayanan kesehatan pada daerah terdampak. Penelitian ini menggunakan metode penelitian hukum normatif dengan pendekatan peraturan perundang-undangan dan studi kepustakaan. Hasil penelitian ini menunjukkan bahwa perlu strategi oleh pemerintah dalam mengatasi dinamika kesehatan sebagai suatu penyempurnaan kerangka kebijakan dalam mewujudkan target Sustainable Development Goals (SDGs) pada sektor pelayanan kesehatan di daerah. Untuk itu, penulis beranggapan perlu adanya kepastian jaminan melalui Primary Health Care Improvement sebagai solusi alternatif yang tepat, guna meningkatkan kualitas pelayanan puskesmas di daerah terdampak dalam memitigasi covid-19. Abstract The existence of the right to health as a fundamental right that every individual owns has been recognized constitutionally. In essence, health must be guaranteed by the presence of a legal certainty through efforts to improve the quality of health. However, some areas still have limited access to essential health services at community health centres. These obstacles can be seen from the minimal number of community health centres and the gap in facilities between regions, the lack of various supporting factors, and the limited quantity of health workers that will affect public health outcomes. The implementation of operating hours to reduce the spread of COVID-19 resulted in two contrasting conditions. The first condition causes overcapacity, which risks crowds, while the second condition causes a decrease in the number of community visits to the community health centres. These conditions need to be the government's focus to increase the distribution of health services in affected areas. This study uses a normative legal research method with an approach to legislation and literature study. The results of this study indicate that the government needs a strategy in overcoming the dynamics of health as a refinement of the policy framework in realizing the Sustainable Development Goals (SDGs) targets in the regional health service sector. For this reason, the authors think that there is a need for guarantees through Primary Health Care Improvement as an appropriate alternative solution to improve the quality of community health centres services in affected areas in mitigating COVID-19.

Safeguarding children from harm has, until recently, been driven primarily by social work practitioners. With current shifts in child care and protection practice and policy, combined with an overwhelming message of 'working together', primary health care professionals have an increasingly central part to play. There is a strong argument that cases of suspected child abuse and neglect should warrant the same level of urgent response as any potentially fatal childhood illness. This book provides an overview of the challenges primary health care professionals now face in recognising and respondi

Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.