Abstract:
CONTEXT:The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disability (PWCD), as a consequence of their atypical communication, may be more likely to be excluded from society, and denied their basic human rights, than other people with disability. Fiji, a multicultural and multilingual nation in the south-western Pacific Ocean, has limited services for PWCD. Service providers in Fiji include disability care workers, special education teachers, traditional healers, and a small number of visiting volunteer speech-language pathologists. This paper outlines the historical and current barriers to, and drivers of change for, service development for PWCD in Fiji. ISSUES:Five barriers to service development for PWCD in Fiji were identified. (1) A major structural barrier is the small population size to develop appropriate infrastructure including professional education programs. (2) Geographical barriers include the dispersed geography across 300 islands, low population density, the rural-urban divide, and risk of disaster from cyclones and flooding. (3) Linguistic diversity, while culturally important, can present a barrier to the provision of quality services that are available in the languages spoken by PWCD. (4) Cultural barriers include historical political instability, although Fiji has become more stable due to the recent democratic elections. The social climate affects development of services that are appropriate for different dominant cultural groups. (5) Financial barriers include low gross domestic product, low financial security and low human development index; however, the financial outlook for Fiji is steadily improving due to the change in political stability. LESSONS LEARNED:Three levels of drivers of change were identified. Macro-level drivers included Fiji's endorsement of international policy and increased globalisation (eg tourism). Meso-level drivers of change included receipt of foreign aid and support from international non-government organisations, development of disability-inclusive legislation and policy within Fiji, and strengthening of government policies that support disabled people's organisations. Micro-level drivers of change included establishment of disabled people's organisations by consumers, adoption of disability-inclusive policy and procedures by service providers, and changes in the perceptions of disability within the general community. Fijian prevalence data confirms that there is an underserved population of PWCD in need of specialist services. Significant advocacy work in the disability field by Fijian and international disabled people's organisations has led to the Fiji government signing international policy (eg Convention on the Rights of Peoples with Disabilities), inclusion of disability rights in national legislation (eg 2013 Constitution of Fiji Islands) and localised policy and practice documentation (eg inclusive education policy by the Fiji Islands Ministry of Education). Continued service development is required if Fijians with communication disability are to have their needs met. The drivers of change at all levels are positioned well to overcome current barriers to change; however, a coordinated approach including macro-, meso-, and micro-level drivers is required to ensure the future development of adequate services for PWCD in Fiji.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Hopf SC,McLeod Ssubject
Has Abstractpub_date
2015-07-01 00:00:00pages
2863issue
3issn
1445-6354pii
2863journal_volume
15pub_type
杂志文章abstract::The Rural Physician Associate Program (RPAP) has 34 years experience in training 1097 medical students as independent distance learners in a 36 week, community-based continuity primary care experience. This program has been successful in preparing competitive students who select primary care residencies and return to ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:CONTEXT:Diabetes mellitus is a healthcare burden in India. Seventy-four percent of India's population lives in rural areas with limited access to healthcare resources. Telemedicine can play a big role in screening people with diabetes at grassroots level. In the telescreening model, single field 45-degree photographs a...
journal_title:Rural and remote health
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Australia is the sixth largest country (in area) in the world with a total area of over 7.5 million km² (3 million miles²). To date much of the research and policy activity in the dental workforce has been based on simple statistical analysis including practitioner-to-population ratios; however, risks are ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2013-10-01 00:00:00
abstract:INTRODUCTION:Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professiona...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Breastfeeding provides health benefits to infants and mothers, yet many women decide against breastfeeding. This study examined differences in the prevalence of breastfeeding among national, urban, rural, and Appalachian regions of the USA. METHODS:Secondary data analysis of the US 2007 National Survey of...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract::Many rural Australian communities continue to endure a prolonged drought. The mental health effects of short-term natural disaster are well known; those of a long-term and chronic natural disaster such as drought are less well understood. However, in addition to immediate distress there are likely to be feelings of lo...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-07-01 00:00:00
abstract::Prostate cancer mortality worldwide has recently decreased by 6% after peaking in the 1990s. Based on the recently published results of the European Randomised Study for Screening of Prostate Cancer (which showed a relative prostate cancer mortality reduction of at least 20% by PSA-based population screening) it could...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract:CONTEXT:Suicide is an important public health issue among rural communities although there is no single pattern of suicide in rural areas. Despite this, there are common themes in much of the research evidence on suicide in rural areas. From the published research in the area, a conceptual model of rural suicide has be...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:North American rural residents have higher rates of chronic disease and they report being ill more frequently compared to their urban counterparts. We recently studied health-related quality in residents living in the isolated, rural community of Bella Coola, Canada. OBJECTIVE:To assess health-related qua...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract::Iodine deficiency disorder (IDD) is an important health problem in Thailand. Due to the geographical limitation of marine salt distribution, the Northern and Northeastern regions of Thailand are endemic areas of this disorder. In this study, a cross-sectional survey on the domestic use of iodine-enriched salt by the p...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Physician shortages in the USA, an issue that has been particularly challenging in Mississippi, have been a concern among health scholars and policy makers for several decades. Physician shortages hinder residents from easily obtaining routine care, potentially magnifying health disparities. This study exa...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-04-01 00:00:00
abstract::The poor health of Indigenous Australians is highlighted by the fact that their life expectancy is 17 years less than that of non-Indigenous Australians. The cause of this health disparity is multifactorial, and includes the under use of health services and medications. Distance, cost, and embarrassment, or fear of se...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Following a percutaneous coronary intervention (PCI), emphasis is placed on healthy lifestyle modification by means of secondary prevention. The literature suggests Australians have difficulty within the period following a PCI, particularly the rural cohort. Despite having a higher incidence of cardiac dis...
journal_title:Rural and remote health
pub_type:
doi:10.22605/RRH4854
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practic...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:In Italy the course to become a general practitioner (GP) lasts 3 years and includes both theoretical and practical study. Different from the theoretical part, until recently the practical activity has not been assessed at all. The Emilia Romagna Regional Health Authority has developed a special program ca...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract:INTRODUCTION:Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Retirement from paid work is a major life change for men and women. It has been suggested that, for men, self-identity is more strongly associated with paid work than is generally the case for women. If this is so, then the retirement transition for men, in which not only the behaviours of a lifetime but a...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract:INTRODUCTION:Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Mental health literacy assists patients to recognize, manage and prevent emotional disorders such as depression. Depression literacy is a specific type that varies among populations; however, there is a paucity of research on the depression literacy of rural Americans. The purposes of this study were to ev...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:For many women, and particularly rural women, birthing locally and within their own community is important for personal, social and/or cultural reasons. If concerns about the woman or her baby mean transfer to a secondary or tertiary facility is necessary, this can be disruptive and stressful, especially i...
journal_title:Rural and remote health
pub_type: 杂志文章,多中心研究
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:An unbalanced geographical distribution of physicians leads to important differences in healthcare outcomes and difficulties in accessing healthcare services in rural areas. As in many other countries in the world, the geographical distribution of physicians in Turkey is unbalanced. Although there has been...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:The Australian Rural Clinical Schools, established nationally in 2000-2001, have provided an opportunity for medical students to undertake their clinical training across a network of hospitals, general practice surgeries and community medical centres in locations throughout Australia. The Rural Clinical Sc...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:CONTEXT:Entry to practice medical programs (graduate- and undergraduate-entry) in Australia are under considerable pressure to provide clinical training as a result of increased student numbers. At the same time modern medical curricula require the development of active placements in expanded settings to achieve gradua...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:CONTEXT:In February 2008, a new partnership between Maine Medical Center and Tufts University School of Medicine was formed to create a model medical school program. ISSUE:Major forces for change included: the increasing physician workforce needs of Maine, the need to increase access for medical education for Maine st...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:This study was undertaken to assess the prevalence and predominant causes of low back pain (LBP) among peasant farmers in Ebubu community in South-south Nigeria. METHODS:This was a community based cross-sectional study of 310 consenting, adult, full-time farmers, recruited using a two-stage cluster sampli...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:A lack of education capacity to support the development of medical supply management competency is a major issue affecting Pacific Islands countries (PICs). Limited human resources and underdeveloped medicines supply management competency are two significant impediments to reaching the health-related Mille...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:There has been much recent investment to improve the recruitment and retention of medical graduates in rural Australia. This paper describes the different outcomes of the strategies used at the James Cook University (JCU) medical school to improve the recruitment and retention of medical graduates in north...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:This paper will discuss health issues among Filipinas (women born in the Philippines) living in remote and rural environments in Queensland in comparison to Filipinas living in other parts of the state. The sample was recruited as part of the University of Queensland component of the Australian Longitudina...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:Health worker shortages and maldistribution have important implications for the capacity of health systems. Ghana has one of the highest physician emigration rates in the world, and over 75% of those who remain work in Ghana's two largest cities. The aim of this study was to investigate the contribution of...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:CONTEXT:People living in rural and remote areas have been found to suffer higher rates of mental illness and psychological distress than their urban counterparts. However, rural and remote Australians also suffer from a lack of specialist mental health services. Mental health consumers are concerned about the lack of a...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00