David Schmitz, MD, FAAFP Professor and Chair, Department of Family and Community Medicine University of North Dakota School of Medicine and Health Sciences
Rural Proofing Tools Why What Useful How to Gap Filled Use Results
Gain Perspective • Environment for a Rural Focus and Process Design, implementation, and delivery based on user decisions/needs o Leveraging capacity and resources of local people and organizations o Hettinger, North Dakota USA Fargo, North Dakota, USA
Achieve Context • Rural is locally applied • Sensitivity to diversity is necessary Rural India Hettinger, North Dakota USA
Determine Applicability Evidence based • Needs analysis • Political and • managerial leadership External governance • arrangements Costs • Resources, capacity • and support for change
Estimate Impact • Must have a clear set of overarching indicators and targets against which performance will be measured o Issues o Consequences • Intended • Unintended
Create Solutions • Suggestions • Solutions • Strategies for Negotiation
National Models Rural-proofing in the United Kingdom Department for Environment, Food and Rural Affairs (DEFRA) o Canada’s Rural Lens Approach Rural Secretariat oversees across government departments o Mexican micro-regions strategy Law on Sustainable Rural Development o Inter-Ministerial Commission o Rural Doctors Association of Southern Africa Rural-Proofing for Health Guidelines o United States Rural Proofing Tool A checklist of considerations with a community centered, rural lens o
UK Rural Proofing Has been applied at a local level Has Has generated addressed tangible user rural issues benefits Source: Defra RE0246 Local Level Rural Proofing Project http://randd.defra.gov.uk/Default.aspx?Module=More&Location=None&ProjectID=18130
UK Rural Proofing Tool http://www.ruralproofingforhealth.org.uk/rural-toolkit/
SA Tool “Rural-Proofing For Health: Guidelines, A Guide to Accounting for Rural Contexts in Health Policy, Strategic Planning and Resourcing” • Rural Health Advocacy Project, January 2015 www.rhap.org.za o • Rural Health Partners: Rural Doctors Association of Southern Africa (RuDASA) o Rural Rehab South Africa (RuReSA) o Professional Association of Clinical Associate South Africa (PACASA) o Rural Health Advocacy Project (RHAP) o Wits Centre for Rural Health o UKZN Centre for Rural Health o Ukwanda Centre for Rural Health o The rural health student clubs at WITS and UKZN o Africa Health Placements (AHP) o
SA Tool
Rural Proofing in the USA National Rural Health Association, American Academy of Family Physicians • American Academy of Family Physicians
Rural Proofing Checklist
Summary • It is the due diligence of organizations • It’s about community context • It’s patient centric With the rural lens in place, the focus is on better health of our friends and neighbors.
References http://www.ruralproofingforhealth.org.uk/ • Department for Environment, Food & Rural Affairs, The Rt Hon Elizabeth Truss MP, and Natural • England (2013). Policy: Rural economy and community. https://www.gov.uk/government/policies/making-sure-government-policies-and-programmes- benefit-rural-businesses-and-communities Department for Environment, Food & Rural Affairs (2013). Guidance for policy officials in • government and local level policy makers to support the needs of rural people, communities and businesses. https://www.gov.uk/rural-proofing-guidance Department for Environment, Food & Rural Affairs (2013). Local Level Rural Proofing Project – • Good Practice Literature Review. http://randd.defra.gov.uk/Default.aspx?Menu=Menu&Module=More&Location=None&Comple ted=0&ProjectID=18130#RelatedDocuments (Lit review link about middle of page) Rural People Matter: The Community Inquiry – The Report (2012). • http://www.ruralproofingforhealth.org.uk/wp-content/uploads/2012/11/Rural-People-Matter- The-Community-Inquiry-Report-FINAL.pdf.pdf Rural Health Advocacy Project (2015). Rural-Proofing for Health: Guidelines – A guide to • Accounting for Rural Contexts in Health Policy, Strategic Planning and Resourcing. http://www.health-e.org.za/wp-content/uploads/2015/02/2015-01-13-RHAP-Rural-Proofing- Guideline-A4-Email-1.pdf Presentation by RHAP Project Manager DAygan Eager on Guidelines: http://www.health- • e.org.za/wp-content/uploads/2015/02/Guideline-Launch1.pdf Response by National Department of Health Director General Jeanette Hunter: • http://www.health-e.org.za/2015/02/02/guidelines-rural-proofing-health/ The WHO Health Systems Framework: • http://www.wpro.who.int/health_services/health_systems_framework/en/ NRHA Rural Proofing Tool:https://www.ruralhealthweb.org/getattachment/Advocate/Policy- • Documents/RuralProofingPolicyPaperSeptember2015-(1).pdf.aspx?lang=en-US
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