Advancing Community Engagement in Healthcare in Rural BC: A gap analysis to improve community involvement in healthcare
A recent gap analysis has been published by the UBC Centre for Rural Health Research (Department of Family Practice) and the BC Rural Health Network.
The Gap Analysis project was funded by the Social Planning and Research Council of BC to understand and address the gap between rural community voices and their inclusion in policy and decision making. The project came from the desire to understand the disconnect between the perception of engagement offered by the decision and policy makers and the experience of community leaders.
“There is no mechanism in place to hear from the community or to improve services based on community input. There is no accountability to the community from the administration of services… as there is no provincial standard for engagement or model for engagement, a disconnect has grown between the everyday resident and their healthcare system.”
– Study Participant
Objectives
Led by Dr. Jude Kornelsen, the research team’s objectives included understanding the culture change that may need to occur to increase receptivity of the output of community-oriented voices. They wanted to understand how community input is weighed alongside other policy influences, such as resources at hand, political values and the electoral cycle, cultural beliefs, experience, expertise and research. They were also interested in grasping the level of priority given to diversity of voice and how diversity and inclusion is facilitated. With that, they recognized gaps in the resources needed to actualize the inclusion of community voices in healthcare transformation.
Outcomes
- 90% of survey respondents did not feel that their community’s healthcare needs were adequately represented in the healthcare planning process. Responses from participants who felt unrepresented focused on the lack of mechanisms for engagement, the urban orientation of health planning, and lack of accountability of decision-makers.
- Most survey respondents expressed that their community’s needs were not met through the health planning process, and that there is a need for accessible, authentic engagement with reciprocal information flow.
- Participants noted that the political structure of healthcare highlights the lack of accountability and transparency of decision-makers and residents’ concerns of bureaucratic influences.
- Rural community leaders expressed the importance of accountability in decision-making and engagement processes.
- Participants identified community advocacy as an effective strategy.
- Policymaker participants noted challenges in decision-making during a health crisis, emphasizing their desire to make meaningful improvements but acknowledging that it is a complicated process, balancing the needs of elected officials and opinions of interest groups.
“For far too long, the voices of rural residents have been ignored and disregarded in healthcare system planning. Thanks to the support of SPARC, Dr. Kornelsen and the team at UBC Centre for Rural Health Research transformed these stated grievances into undeniable evidence. Recognizing these gaps is our initial stride towards bridging them. Now, armed with this research, we stand at the cusp of devising and implementing strategies that will reforge the bonds with rural communities across the province. Our journey towards inclusive healthcare begins now.”
– Paul Adams, Executive Director, BC Rural Health Network
Rural communities have become sites of healthcare innovation due to isolation and constricted resources. This gap analysis opens the potential to learn from rural communities in a way that may be applicable to larger settings. With the information they have from this study, steps can be taken toward the creation of a pan-provincial solution to include rural community voices in healthcare planning and decision making.
Read the full report here.