The participants involved in activities related to health care (whom we shall call here the actors), both in the health system itself and in the support systems, may be institutions, public or private agencies, or individuals. Some of them directly provide health services (e.g. nurses or doctors). Others work in areas in which certain aspects are relevant to health - they are indirect providers of care. They may belong to interprofessional groups which include health personnel, or occupy positions in which they are natural partners in dialogue or collaboration with health professionals (e.g. agronomists).
Then there are the users of the health services. Some will have occasional recourse to competences in the area of health (e.g. school-age children) while others will be more regular users (e.g. diabetics). Dialogue between all these users and providers will produce valuable feedback for those whose task it is to design training programmes for health personnel.
These actors are very numerous. We shall nevertheless attempt to identify them, simply in order to understand how important and necessary it is that there should be dialogue between them and how difficult and complex this is likely to be.
Personal notes
1.16
EXERCISE
1.17
For each of the high priority health problems (column 1) you listed previously (page 1.09), state the support systems concerned in your country (column 2); the providers of direct (column 3) or indirect (column 4) care and the occasional (column 5) or regular users (column 6).
High priority health problems | Support systems | Actors | |||
Providers | Users | ||||
Direct | Indirect | Occasional | Regular | ||
(1) | (2) | (3) | (4) | (5) | (6) |
There are nearly always more actors involved than you might expect! Compare your list with the list on the next page... and draw your own conclusions.
EXERCISE
1.18
Now examine the long list of actors1 reproduced below (for an example comprising only two health problems).
- Underline those you mentioned in the previous exercise;
- Place brackets round the actors you did not mention and relate them to the particular health problem(s) which concern them.
1 Drawn up by a group of participants in the Community Health Course, Faculty of Medicine University of Geneva, Switzerland, 1989.
Actors | |||||
High priority health problems | Support systems | Providers | Users | ||
Direct | Indirect | Occasional | Regular | ||
(1) | (2) | (3) | (4) | (5) | (6) |
Resulting from internal aggression (lifestyle) e.g. | - all citizens | - doctors | - teachers | - healthy individuals | - groups at risk |
Resulting from external aggression e.g. | - political system | - surgeons | - opticians |
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