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latrobe.edu.au CRICOS Provider 00115M
Beyond Participation to CoproductionNerida Hyett MHSc BOT
PhD Candidate, LecturerLa Trobe Rural Health SchoolJuly 2013
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2La Trobe University
Improving the Health of Communities through Participation
INTERNATIONAL CASE STUDIES ON COMMUNITY PARTICIPATION AND HEALTH
INCLUSION AND EXCLUSION IN COMMUNITIES
COMMUNITY HEALTH LITERACY
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3La Trobe University
Community Participation and Health
Schmidt & Rifkin (1996) defined community participation in health as:
A social process whereby specific groups with shared needs living in a defined geographic area actively pursue identification of their needs, take decisions and establish mechanisms to meet their needs
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4La Trobe University
Iap2 Spectrum of Public Participation
Increasing level of public participation
INFORM CONSULT INVOLVE COLLABORATE EMPOWER
Adapted from the IAP2 Spectrum http://www.iap2.org.au/documents/item/83
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5La Trobe University
Arnstein’s Ladder
Arnstein, S. (1969)
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6La Trobe University
Inclusion and representation
• Seeking a diversity of views rather than a representative view
• Public is not homogenous
• Dynamic and self-defining entity
• Active public whose positions are formed through a process of engagement, and dialogue, with others
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7La Trobe University
Mobilisation and Sustainability
• Readiness
• Community assets, skills and resources
• Funding
• Community organising
• Local solutions
• Longevity
• Intensity
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8La Trobe University
Coproduction
• Involving consumers in the production of the services they consume
• Lived experience has equal weight with clinician experience
• Overcome challenges posed by health service silos
• Social process
• New health care delivery models resulting in long term changes
• More effective use of natural and existing resources
• Volunteers
• New pathways into education and training
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9La Trobe University
Examples of coproduction
National Health Service UK: Consumers co-design care pathways, primarily for chronic disease
Peterborough Citizen Power: Recovery Champions working with AOD services to co-design more effective interventions for service users, and institutional mapping to integrate care between services
Service Users Network South London: Co-design and co- facilitation of a group program for people with personality disorders
More examples available here: http://allinthistogetherwales.wordpress.com/coproduction/co-pro-case-studies
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10La Trobe University
Lessons learned
• Dialogue is critical
• Social and financial imperative
• There is no panacea and this is not easy
• Requires a cultural change
• Assumes that people want to be involved, some may not want to be, and this might change for different issues
• Does not necessarily need expensive or time-consuming methods
• Building coproduction into existing processes is more cost effective and meaningful
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11La Trobe University
References
Arnstein, S. A. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35, 216-224.
Bovaird, T. (2007). Beyond engagement and participation: User and community coproduction of public services. Public Administration Review, 67(5), 846-860.
Coproduction Network. Resources. Retrieved from http://coproductionnetwork.com/page/transitioning-to-coproduction
Draper, A. K., Hewitt, G., & Rifkin, S. (2010). Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social Science & Medicine, 71(6), 1102-1109. doi:10.1016/j.socscimed.2010.05.016
Nesta. (2011). The Business Case for People Powered Health . Retrieved from http://www.nesta.org.uk/areas_of_work/public_services_lab/health_and_ageing/people_powered_health/assets/features/the_business_case_for_people_powered_healt
Needham, C. (2007). Realising the potential of co-production: negotiating improvements in public services. Social Policy and Society, 7(2), 221-231.
Rifkin, S. B., Muller, F., & Bichmann, W. (1988,). Primary health care: On measuring participation. Social Science & Medicine, 26(9), 931-940. doi:http://dx.doi.org/10.1016/0277-9536(88)90413-3h
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Thank you
latrobe.edu.au CRICOS Provider 00115M
Contact:
Nerida Hyett
Dr Amanda Kenny