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Annabelle Temple 2008



Alongside recent developments in community participation and voluntary involvement in rural health, has been the emergence of a range of community-based initiatives for the delivery of primary care services. Of public health significance and interest is the sustainability of rural communities, through the presence of such collaborative efforts, in terms of social capital and social cohesion, as well as in the consideration of the responses of these rural communities to changes in their health and social environments.


This research attempted to understand the scope, attributes and outcomes of these alternative arrangements, within the health and wider community setting, through a comparative analysis of primary care developments in two settings: North Canterbury, New Zealand, and in Northern California, United States.


Qualitative research methods were used in the documentation and comparison of the emergence of these two community-based primary care initiatives, while placing their developments within a local and national context. Thematic analysis was used to establish theoretical connections between the three part literature review and emergent themes and issues.


Community responses to addressing wider rural health service trends in both settings have been unique, innovative and informative. In the New Zealand setting, specific recommendations were made for primary health care delivery, particularly in relation to the existing Primary Health Care Organisation (PHO) model. In the United States, several policy and research issues are highlighted, including the importance of the reported experiences of rural health consumers for future rural health planning and policy development. While the two policy environments were characterised by quite different economic and social processes, each shared some common issues in relation to primary care and rural health policies.

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