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84 Cards in this Set
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An example of primary health care is an Aboriginal Community Controlled Health Organisation. |
Predictors of future population health include factors such as : - People’s circumstances - Childhood lifestyle factors - Geographic location of people |
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Allocation of health resources to one geographic area or group is an example of Health inequity |
What distinguishes primary health care from primary care? Works within a multidisciplinary framework |
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The term used to describe measurable differences in attaining health is Health inequality Equity = fairly shared Equality = exact same for all |
Alma Ata: WHO meeting that led to the shift in power from health care providers to health care consumers and communities |
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Health literacy is best defined as the capacity of a person to recognise and know how to find information about a health problem |
Most people view health based on their: - Personal knowledge and experience - Life situations - Cultural background |
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Understanding of health determinants is essential for effective programs to enable people to maintain good health |
Legislation enacted by the Federal Government with the aim of reducing health-related risk factors, such as increasing taxation on harmful products, has been due to Public health advocacy |
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The main aim of public health is to improve health by promoting health and preventing disease in populations |
Selective primary health care means care focused on individual technology rather than equity |
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Health equity refers to the right to fair distribution of health services |
Social justice refers to an ethical concept based on human rights and fairness |
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The primary health care approach is based on the social model of health |
Life expectancy is the number of years people in a specific group or population can expect to live |
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The Ottawa Charter described health in terms of the presence of health |
For primary health care to improve health, people must first have their basic needs met |
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Comprehensive primary health care is characterised by activities that work to change: - Social and political determinants of illness - Economic and educational well-being - Health status in communities, regions or cities |
Health is best described as a resource that allows a person to have a productive social and economic life |
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A determinant that is clearly related to a change in health status is defined as a proximal determinant |
Sustainability refers to the ability of a program to meet current needs without affecting the ability of people in the future to meet their needs |
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Primary health care focuses on reducing inequity and improving effects of disadvantage |
A person working as a health educator uses an approach that views health as related toBehavioural change |
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Reduction of inequality and empowerment within individuals and communitiesbest describes the principles that underlie the social health model |
WHO: Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity |
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Selective PHC: Primary medical care focused on treatment and management of illness and disease + prevention through immunisation and screening |
Comprehensive PHC: Social justice+equity issues and connects patients with local community organisations and advocacy movements to fix underlying social, economic and political causes of poor health |
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Social determinants of health and illness: social, economic and politically determined conditions that result in good health, ill health/disease, and in which people grow, live work and age SDoH may vary between similar populations |
Commission on SDoH in 2004 by WHO -> health equity was the cornerstone of its work. Key areas: 1. Tackling health disadvantages 2. reducing health gaps 3. addressing the health gradient across the spectrum of socioeconomic positions |
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Upstream Public health intervention (prevention): those at the macro level including government policies, global trade agreements and investment in population health research |
Downstream public health intervention(treatment): those at micro level including treatment systems, disease management and investment in clinical research |
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Health promotion action means: - Building healthy public policy - creating supportive environments - strengthening community action - developing persona skills - re-orienting health services to work in a more preventative way |
Biologicalapproach- Genetically predisposed to heart disease, and determinants ofhealth and lifestyle can either have a positive or negative influenceon this Biomedicalapproach- Person may develop a disease (eg cancer) and their health is nowdetermined by this |
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Behavioural approach - Successful health promotion may influence a person’s health for the better (anti-smoking campaigns decreasing the # of smokers and thus less linked diseases) Spiritual approach - People’s decisions about their health are determined by spiritual or religious beliefs (blood transfusion beliefs for Jehovah’s witness) |
Indigenous approach – Health and life are not separated + disease is not caused by a microorganism but by spiritual relations and the environment. Sociological approach - health and illness have social, political, economic and structural dimensions (eg. poorer countries unable to afford health services) |
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The Fourth International Health Promotion Conference decided that the dissemination of evidence of the effects on health and health equity was needed to help health promotion policy and practice |
Climate change impacting health is an event potentially constituting the largest public health challenge in the twenty-first century |
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The Nairobi Call for Action differed from the statements of previous conferences on health promotion with the provision of evidence-based strategies and actions. It was precipitated by widening inequities in health, in and between countries |
Healthy public policy: Creation of a supportive environment to enable people to lead healthy lives
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Communicable diseases are those that are easily spread orare communicated through normal practices andinteraction. Infectious diseases - most are preventable, spreadquickly and can have devastating outcomes |
Advocacy, mediation and enabling were the three ways to nurture health proposed in the Ottawa Charter |
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The Ottawa Charter Identified key concepts, actions, and strategies of health promotion |
The Ottawa Charter stated that the development of personal skills was a process that was lifelong to prepare the individual for life stages and to make choices to enhance their health |
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5 Action areas of the Ottawa Charter: • Developing healthy policy • Supporting community action • Developing personal skills • Creating supportive environments • Reorientating the health system to work in a more preventative way (3 levels prevention)(Ottawa Charter 1986) |
Primary prevention measures include: - Immunisation - Public health education - chlorination and filtration of public water - some screening - legislation requiring child restraints in motor vehicles |
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A common approach to secondary prevention is screening for disease. Eg.: Cancer screening, eye test for glaucoma, treatment for hypertension etc.. Screening: use of simple tests across a healthy population to identify those individuals who have a disease, but do not yet have symptoms. |
Individual risk assessment involves a process of detecting the overall risk of a single disease or multiple diseases and is a part of screening. These can include biological, psychological and behavioural risks. |
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Tertiary prevention: Therapeutic and rehabilitative measures once disease is firmly established eg. treatment of diabetics to prevent complications of the disease, the ongoing management of chronic heart disease, and patients improving functioning through rehabilitation. |
Surveillance: The collection of data, analysis,interpretation, and dissemination of health data to inform public health agencies and initiatives to monitor health, prioritize and develop appropriate preventative strategies |
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The Northern Territory Emergency Response intervention was stated to be initiated as a response to child sexual abuse |
Removal of Indigenous children from their families, segregation of Indigenous families onto settlements and missions, and the policies of assimilation were based on the principles ofSocial Darwinism |
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12.5% of non-Indigenous workerswas the initial level that wages for Indigenous workers were set by the Queensland government |
The General Inspector of the Board for Protection of Aborigines was the authority that removed Indigenous children from their families in Victoria in the late 1800s |
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Collective trauma describes the psychological trauma within the Indigenous community |
What effect on Indigenous children did separation from their families have? - Disruption to kinship patterns - Loss of cultural identity - Enforced dependency |
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Aboriginal people use a holistic approach to health as opposed to a Linear health model |
26% of the prisoner population was accounted for by Indigenous prisoners |
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What two myths continue to affect the future of Australian Indigenous health? Terra Nullis and the White Australia Policy |
The Indigenous perspective of land meant that they saw themselves as: - Having obligations to others in their clan - Having a spiritual connection to the land - Being custodians of the land |
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Health Education: - It is any combination of learning experiences designed to help people and communities increase their knowledge or influence their attitudes - Key role in addressing the SDoH - Occurs at all levels political, individual, community, and organisations. |
If health promotion is the process of enabling people to increase control over, and to improve their health, then health education therefore is the ‘how’ of enabling. Knowledge about health is a basic humanright, people have the right to accurateinformation about issues that affect theirhealth |
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Empowerment can be defined as the “processused to bring about personal, social andpolitical change” |
Models of Health Education: 1. Traditional medical model 2. Client-centred model 3. Behaviour-change model 4. Empowerment model |
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Traditional medical model: • Also known as the professional-patient model • Educational interventions are brief • More concerned with compliance rather than empowerment • Raises awareness of health risk. |
Client-centred model : • Seeks to strengthen patient autonomy and encourages active participation • May include tailored self-management plans • Patients are assessed for readiness to participate • But – still practitioner-driven |
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Behaviour-change model • Focuses on the transmission ofhealth info • Designed to encourage healthychoices and personal responsibility • Doesn’t take into account the SDoH • Can lead to victim-blaming |
Empowerment model: • Consistent with the principles ofpublic health and health promotion • Sensitive to person’s needs ( Autonomy encouraged & participation reinforced) • Aligned with strengthening.community participation and involvesfamily and significant others. |
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Power with has to do with finding common ground among different interests and building collective strength. Power-over describes relationships in which one party is made to do what another party wishes them to despite their resistance and even if it may not be in their best interest. Does not have to be negative. |
The Health Belief Model (HBM) is apsychological model that attempts to explainand predict health behaviors. This is done byfocusing on the attitudes and beliefs ofindividuals. The HBM was first developed inthe 1950s by social psychologists. |
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Health Belief model: • Based on social learning theory • Based on the belief that people’s perceptions are influenced by a range of factors (gender, age, income, health literacy) • Used to suggest interventions that would make some individuals more likely to engage in healthy behaviours |
Outcomes that measure efficacy, participatory ability and behaviour indicate if empowerment interventions have been successful |
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Traditional and client-centred models are models of health education most likely to increase health inequalities |
Psychological empowerment is a level of empowerment developed by providing a literacy program for a group |
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The process of empowerment is characterised by: - Development of personal skills to bring about change - Removal of formal and informal barriers to health - Transformation of power relations |
The likelihood that a child born in Africa will live past five years of age if their mother has had five years of education is 40% more likely |
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Capacity building refers to a set of processes that builds infrastructure, program sustainability and problem-solving |
Models of health education in which the health professional identifies the problems and learning needs has been called a domesticating model |
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The empowerment model of health education works best when it is conducted as part of a comprehensive approach to address disadvantage |
The goal of the Commission on Social Determinants of Health was to influence change in health policy by collecting and synthesizing scientific evidence. In the CSDH framework, social cohesion and psychological factors can be better approached through good health care policy. |
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Which influences does the Rainbow Model of determinants of health have as the core and the outermost layer? Individual person and general socio-economic, cultural and environmental conditions |
Talcott Parson’s view on the role of health services in society was that they promoted and maintained social order. |
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Social and economic status are the two determinants of health are being shown to be the most important in relation to health |
The major reasons for the great differences in health outcomes and life expectancy worldwide are due to the effects of deprivation, marginalization, privilege and power |
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Wilkinson and Marmot (1998, 2003), by the term ‘social gradient' mean lower socio-economic conditions result in a shorter life expectancy than for those higher up the socio-economic ladder |
The structural drivers affecting health that form part of the Commission on Social Determinants of Health’s conceptual framework result from social stratification and inequity |
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Distal determinants for health examples are anti-discrimination laws and taxation. These determinants are more table and less eaisly changed. |
Medical care has contributed to the 10–15% increase in longevity since 1900 |
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The aim of the Commission on Social Determinants of Health’s conceptual framework is to explain influences on the distribution of health and well-being at a population level |
Unemployment or underemployment strongly influences an individual’s Physical, mental and social health |
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What percentage of economic activity did Kickbusch estimate the mainstream health sector contributed in South Australia? 10–13% |
The Rainbow Model is a systematic framework for showing the relationship between approaches to health and total, whole-of-life development, including the spiritual dimension. |
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The Bangkok WHO Charter included an argument that health promotion should be a requirement for good corporate practice |
Selective and comprehensive models of care Selective: based on medical model of care - is disease selective, treatment, immunization. Comprehensive: emphasis on addressing the social determinants of health - that is the conditions that generate health and ill health. |
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Environments can include: • Natural environment • Built environment • Work environment • Living environment |
Environmental health - those aspectsof human health determined byphysical, chemical, biological andsocial factors in the environment.Environmental health is aboutcreating and maintainingenvironments which promote goodpublic health. |
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Environmental health justice : The right of all people to a safe, healthy, productive and sustainable environment. Good environmental health management aims tocreate and maintain environments which areconducive to good health and well-being.It is by nature equitable since it depends onpopulation based-strategies. |
Health care waste includes: • infectious waste • pathological waste • sharps • chemicals • pharmaceuticals • genotoxic waste • radioactive waste • heavy metals waste: |
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1.7 million in preventable deaths have been estimated due to lack of access to treated water |
What percentage of years of life lost in low income countries are due to communicable diseases? 68% |
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Factors such as overcrowding, poor housing and infrastructure in Indigenous communities contribute to a hospital admission rate for respiratory disease that is Three times that of non-Indigenous Australians |
Life expectancy is 17 years less for Indigenous Australians |
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Run-off from fertilised land causes reduced oxygen carrying capacity of blood in young babies in developing countries |
Food production and the use of pesticides is the best example of an area where tension exists between health needs and environmental needs? |
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The World Health Organization has estimated that unsafe water supplies and poor sanitation result in 1.8 million deaths from diarrhea per year |
The effects of environmental risk and social and economic activity have given rise to environmental health problems that are long term, complex, cumulative problems |
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Developing countries undergoing rapid industrialisation are most at risk from a combination of traditional and modern environmental health threats |
WHO have estimated the percentage of the population in industrialised countries who are affected by gastroenteritis each year as 30% of the population |
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An important major projected health impact of climatic change related to the effects of drought is malnutrition and water shortages |
Public health is the science and art of: 1. preventing disease 2. prolonging life 3. promotion of health 4. focuses on the health of populations 5. directs lifestyle changes 6. addresses the social determinants of health |
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Public health is based on the principle of social justice, which entitles everyone to access affordable and appropriate basic health care. Public health is organised through the Federal Government and State and local government and non-government organisations |
Population health can be defined as the health of groups, families, and communities. Populations may be defined by locality, biological criteria such as age and gender, social criteria such as socio-economic status, or cultural criteria |
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The Robin Hood index is the portion of the total community income that would have to be redistributed (taken from the rich and given to the poor) for the society to live in perfect equality |
The Millennium Development Goal targets were to be met by 2015 |
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Australian governments have been inclined to use a population health model that concentrates onMeasurement of disease states |
The Australian federal department of health was established in 1924 |
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New public health signified a change from a behavioural to a social health paradigm |
Comprehensive primary health care is a core WHO commitment not currently adapted in the US and Australia |
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Water pollution controls, and waste and sewage disposal are the best reforms helping to prevent water-borne disease |
The first Public Health Act in Australia was passed in 1854 |
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Practical eugenics: was the belief that a healthier population could occur through developing the healthier members |
Prevalence of disease: Percentage of the population who experience a disorder at a given point or period of time |
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Black Report (1982): demonstrated the importance of socio-economic factors on health |
Vertical program: health program concentrating on the treatment of a specific disease |
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People are more likely to adopt a new idea if it is uncomplicated and Compatible with social norms and someone else is doing it |
An Australian survey of attitudes to road safety and factors contributing to road crashes found that Females identified speed and drink driving as contributing factors more than males |
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Exchange theory is best exemplified in a social marketing campaign that promotes the Positive effects to health if an old behaviour is stopped |
Cost benefits included when planning a social marketing campaign for smoking cessation: - Health costs to the individual over time if they change their behavior - Reduced costs to the health care system over time - Less absences from work due to less smoking-related illness |
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The theory underpinning social marketing campaigns is that if provided with information about the risks of behaving in certain ways and the benefits of alternative ways they will Adopt healthier behaviours |
Where within the health promotion framework is social marketing situated? Midstream |
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What is a particular challenge to the ability of social marketing in Australia to enable consumers to critically interpret mass media messages and make informed decisions? Adult literacy levels |
The effect of scare or fear campaigns is to decrease people’s acceptance of the message |
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Marketing is for commercial gain, social marketing for social benefit |
When planning location and distribution of the marketing campaign locations the target audience frequents, available distribution channels are identified toIncrease the campaigns access to the target audience |
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Iatrogenesis refers to unintended adverse effects due to treatment or advice from a health care provider |
The potential effects of a fear campaign are: - Creation of stigma - Message seen as irrelevant - That it has the opposite effect |
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The secret to communicating public health messages is knowing what motivates and interests people enough for them to change |
Social marketing is used in public health for public education on social issues |
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When is a campaign that uses fear for a current threat likely to be successful in changing behaviours? If people see the proposed behavioural change as useful and effective |
Health policy:
Formal statement by the government that define priorities and actions in response to health needs |
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What philosophy underpins welfare policies? Equitable redistribution of income and wealth |
Which of the following is NOT a principle underpinning the HiAP approach to policy development? That health is impacted by few factors that are evenly distributed in the community |
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State and Territory Governments are responsible for Funding for immunisation, maternal child care and health promotion |
Which of the following are policies for advocacy? Position statements |
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The Federal Government is responsible for Health insurance, food labelling and aged care |
A policy is a statement of: - Actions to be taken to solve a specific problem or set of problems - Procedures that end in definition, redefinition or change of an issue or situation - Intention including aims, goals, objectives |
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Which of the following types of policy may be viewed by government with some wariness due to the political affiliations and values of the organisation which produced it? Policy for Advocacy |
Population growth and environmental degradationcontribute to disturbance in the balance of the microbial world |
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The World Health Organization estimate in 2007 4 million children from developing countries did have died from preventable environmental causes |
Lack of economic power is the main reason it is difficult for low lying countries, such as those in the Pacific, to institute global action for the activities that are causing climatic change |
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Community engagement refers to a strategy that involves all of the following except working to decrease social inclusion |
Middle-class health practitioner programs are less likely to achieve their goal because they fail to use processes that truly engage the community |
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Barriers to community development in health include community expectations of service deliverers |
Example of use of a settings approach: A health promotion activity on bullying in the workplace is planned and carried out in a workplace. |
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Freire’s (1970) adult literacy method was based on aDynamic cyclic process involving critical reflection |
Benefits that accrue from working in partnership include shared resources, knowledge and skills |
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Partnerships between organisations and community groups are used to: - Improve health outcomes - Build capacity - Build communities |
Some communities will be without the knowledge and skills to set goals, prioritise issues and forward plan. Using community development the health practitioner works with the community at the point they are at and supports their decisions |
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Decreased corruption and transparency isnot community/political outcomes of an empowerment program |
According to Raeburn and Corbett (2003), which of the following practices is not characteristic of community-controlled community development? Health professionals work as co-facilitators to empower and build capacity in the community |
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Partnerships, organisational and workforce development, resource allocation and leadership are all required for capacity building |
Sustainability is an organisational outcome of an empowerment program |
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Community development requires the health professional to do: - Empower the people or community to make change - Support the people or community to make change - Incorporate the opinions of the people or community into decision-making |
Community participation where any member of the community may have input into the process is underpinned by these principles: - Human rights - Democracy - Citizenship |
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Community development is a process based onHaving the people draw on resources and actively drive the social change |
Cooperating partnership: includes altering activities and sharing resources for mutual benefit and common purpose |
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Community engagement is a process where health workers engage with communitiesOn health or social issues affecting them and the processes that will tackle the issues |
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