Rural community-centred co-planning for sustainable rural health systems

Abstract

Objective

Sustaining rural healthcare services is challenging because of numerous systemic factors. Rural communities can inform the design of sustainable rural health models; however, further evidence of effective co-design is needed to guide implementation. The study aim was to co-design a series of place-based and evidence-informed rural health models, to improve local health system sustainability.

Setting

A rural region (categorised as Modified Monash Model 5) defined by three adjoining Shires in Central and Northwest Victoria, Australia.

Participants

A health executive co-planning network led the co-design, with input and oversight from a broader cross-sector group. Healthcare professionals (n = 44) and consumers and carers (n = 21) participated in interviews, and an online survey was completed by healthcare professionals (n = 11) and consumers and carers (n = 7) to provide feedback on the preliminary results.

Design

Community-based participatory action research was applied incorporating co-design methods and systems thinking. Data were collected through qualitative interviews followed by an online feedback survey. Mixed method data analysis (QUAL-quant) was conducted with qualitative directed content analysis of interview transcripts and quantitative descriptive analyses of survey responses to aid prioritisation.

Results

Healthcare priorities, strengths and challenges, and proposed rural health models are described. A rural health system sustainability strategy was developed with three integrated pillars: 1. Workforce strengthening, 2. Integrated health services and 3. Innovative models of care.

Conclusion

Community-centred co-design with rural health stakeholders was effective for generating locally tailored ideas and potential health models that emulate community strengths and resources, and provide a foundation for further planning, implementation and evaluation.