Capability ... what's in a word? Rural Doctors Network of New South Wales Australia is shifting to focus on the capability of rural health professionals

Rural and Remote Health

卷:20

Laura Hardaker¹  Bernadette Gotch²  Dave Karlson²  Chris Russell²  Callaghan²  Robyn Ramsden³  Alexandra Martiniuk⁴  Sharif Bagnulo⁵  Emer O&039⁶  Arna Wotherspoon⁶  Nicole Turner⁶  Estrella Lowe⁶  Richard Colbran⁶  Mike Edwards⁶  John Kramer⁶  John Curnow⁶  ImogeneRothnie⁶  Ros Bullock⁶  Elizabeth Barrett⁶ 

[1] and Beach Street Family Practice, Woolgoolga, NSW 2456, Australia;

[2] and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia;

[3] Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia;

[4] Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2000, Australia;

[5] Medical Company;

[6] NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia;

关键词: access;    capability;    Capability Approach;    capacity;    competence;    rural health workforce;   

DOI  :  10.22605/RRH5633

来源: DOAJ

【 摘 要 】

Rural health services, and the workforces that provide those services, are under unprecedented pressure due to insufficient health workforce numbers and distribution of health workforce weighted to urban areas. This creates health service access issues in rural areas, compounding existing health inequalities between rural and urban people. Many approaches to date have aimed to rectify these issues, with moderate success. In this article we present a call to action to pursue a complementary approach: supporting the capability of the rural health workforce. We hypothesise that further exploring what it means to be a 'capable' rural health professional and what processes or conditions support or erode capability may additionally bolster efforts toward strong rural and remote health systems. The Capability Approach is a theory proposed by Amartya Sen, who was awarded the Nobel Memorial Prize in Economic Sciences in 1998 for this work. Although the Capability Approach inspired, for instance, the UN's Human Development Index, it has not been deeply explored in the context of rural health workforce. While still untested, a focus on capability may assist us in taking a broader view, which encompasses functioning and the freedom to pursue different functioning combinations. The feasible freedom and opportunities are paramount to the concept of capability. We posit that competence is static and the responsibility of the practitioner (and their education), but that capability is fluid and multi-dimensional and the responsibility of the practitioner, community and system. Therefore, we hypothesise that a focus on a Capability Approach, which modulates the relation between the contextual factors and outcomes, may provide us with greater understanding and avenues for action when we aim to improve outcomes such as rural health service sustainability. Developing a list of appropriate capabilities and setting strategies to support capability and its more nuanced domains may present unique opportunities for influence, and these may have positive effects on the rural health workforce. Of course it will need to be determined if improving rural primary health professionals' capability has positive impacts upon quality and access to care, and whether supporting capability is sustainable and worthy of investment.

【 授权许可】

Unknown