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Community Health Services

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The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race. This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960's, community health centers have served the needs of the poor in the tenements of New York, the colonials of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment. Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.

Community health services --- History.

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This widely researched study demonstrates convincingly that neither grandiose promises nor nightmare scenarios have much to do with actual care practices employing telecare. Combining detailed ethnographic studies of nurses and patients involved in telecare with a broad theoretical frameworky from various disciplines, the author concludes that these practices leads to more rather than less intense caring relations, resulting from a spectacular raise in the frequency of contacts between nurses and patients. Patients are much taken with this, not because they feel they are finally able to manage themselves, but because they can 'leave things to the experts'. The patients find that caring is something that is best done for others. The book frames urgent questions about the future of telecare and the ways in which innovative care practices can be built on facts rather than hopes, hypes or nightmares. Politici promoten telezorg als de meest efficiënte oplossing van het probleem van de vergrijzing en ontgroening. Met behulp van telezorg, zo beweren ze, gaan chronisch zieke ouderen 'zichzelf managen' en zullen er minder professionals nodig zijn. Aan de andere kant stellen technologie-pessimisten dat er een verschraling en verkilling in de zorg zal optreden als professionals telezorg grootschalig gaan invoeren. Zieke ouderen zullen hun laatste adem uitblazen onder toezicht van camera's en sensoren, ver van menselijk contact.

Grootse beloften noch inktzwarte nachtmerries hebben veel te maken met de praktijk waarin professionals en patiënten daadwerkelijk met telezorg werken. Dat blijkt uit dit boek, waarin de auteur gedetailleerd en uiterst leesbaar verslag doet van de wederwaardigheden van patiënten en verpleegkundigen in een aantal pioniersprojecten van telezorg. De combinatie van etnografisch onderzoek en theoretische inzichten uit onder andere wetenschaps- en techniekstudies en ethiek levert verrassende inzichten op. Zo blijkt telezorg de zorg intensiever te maken omdat het contact tussen patiënten en professionals vaak spectaculair toeneemt. De ouderen zijn hier doorgaans erg tevreden over, niet omdat ze zichzelf nu eindelijk kunnen managen, maar juist omdat ze zich veilig en gekoesterd voelen door al die extra zorg die via apparatuur mogelijk wordt gemaakt. Het boek stelt een aantal prikkelende vragen over de toekomst van telezorg en de manier waarop we innovaties in de zorg zouden kunnen baseren op feiten in plaats van dromen, hypes of nachtmerries.

Community health services --- Administration.

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A majority of people living in rural areas and urban slums worldwide have minimal access to healthcare. Without information about what to give a child with stomach flu, how to relieve the pain of a broken bone, and how to work against increased substance abuse in a village, the whole community suffers. Children, adolescents, adults, and older people are all affected by the lack of basic healthcare, such as vaccination, pain killers, and contraceptives. To improve living conditions and life expectancy, the people in urban slums and rural areas need access to a trained health care worker, and a functioning clinic. This text illustrates how to start, develop, and maintain a health care programme in poor areas across the world. The focus is on how people can work together to improve health through sanitation, storage of food, fresh water, and more.

Community health services --- Community Health Services --- Developing Countries

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Community health services --- Community health services --- Evaluation. --- Management.