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Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary

BACKGROUND: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clust...

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Autores principales: Katona, Cintia, Gutási, Éva, Papp, Magor, Varga, Orsolya, Kósa, Karolina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568832/
https://www.ncbi.nlm.nih.gov/pubmed/33069209
http://dx.doi.org/10.1186/s12875-020-01281-z
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author Katona, Cintia
Gutási, Éva
Papp, Magor
Varga, Orsolya
Kósa, Karolina
author_facet Katona, Cintia
Gutási, Éva
Papp, Magor
Varga, Orsolya
Kósa, Karolina
author_sort Katona, Cintia
collection PubMed
description BACKGROUND: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communities – including its vulnerable Roma members – to existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. METHODS: As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. RESULTS: Three themes emerged from the transcripts. The first focused on the health mediators’ personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. CONCLUSIONS: Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.
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spelling pubmed-75688322020-10-20 Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary Katona, Cintia Gutási, Éva Papp, Magor Varga, Orsolya Kósa, Karolina BMC Fam Pract Research Article BACKGROUND: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communities – including its vulnerable Roma members – to existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. METHODS: As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. RESULTS: Three themes emerged from the transcripts. The first focused on the health mediators’ personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. CONCLUSIONS: Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations. BioMed Central 2020-10-17 /pmc/articles/PMC7568832/ /pubmed/33069209 http://dx.doi.org/10.1186/s12875-020-01281-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Katona, Cintia
Gutási, Éva
Papp, Magor
Varga, Orsolya
Kósa, Karolina
Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title_full Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title_fullStr Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title_full_unstemmed Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title_short Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary
title_sort facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in hungary
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568832/
https://www.ncbi.nlm.nih.gov/pubmed/33069209
http://dx.doi.org/10.1186/s12875-020-01281-z
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