Talking to the Community: client-service dialogue in rural health centres

Aims and Rationale The principle of community participation in health services is well established. In practice, it has proven difficult to move much beyond limited involvement by a select group of community members. Difficulties appear to lie on both sides; professional resistance and community disengagement. This paper reports on some measures of community and professional attitudes to community participation undertaken as part of a project to test an innovative approach to fostering community-service dialogue. Approaches Questionnaires were administered to a purposive sample of 142 community members and 109 staff across two regional health centres exploring their experience with, and attitudes to, community-service dialogue. Findings The findings highlight some of the barriers to establishing a truly open dialogue between services and their communities. These include community members who don’t report concerns and the perception, and to some extent the reality, that often these concerns are not passed on, valued and/or attended to by the service . While the majority of individual staff - but by no means all - support the need for, and say they value community input, a substantial percentage feel that their own services need to do more, not only to engage with client feedback but to attend to the voices of their own staff. Benefits to the Community As rural and regional communities struggle to make the most of scarce health service resources it is vital that we find ways to overcome the barriers to allowing all voices to be heard and valued.