RURAL WOMEN’S HEALTH NEEDS PROJECT BENALLA LOCAL GOVERNMENT AREA (JULY-OCTOBER 2019) FUNDED BY MURRAY PRIMARY HEALTH NETWORK (PHN) Contents 1 Title Page: Rural Women’s Health Needs Project – Benalla Local Government Area ..................... 3 2 Executive Summary ........................................................................................................................ 4 3 Background ..................................................................................................................................... 7 4 Summary of activity ....................................................................................................................... 11 5 Findings ........................................................................................................................................ 18 5.1 Rural Women’s Health Needs ................................................................................................... 18 5.2 Service Needs Analysis ............................................................................................................. 32 5.3 Proposed Service Model .......................................................................................................... 33 6 Recommendations ........................................................................................................................ 34 7 Achievements, challenges and key learnings ................................................................................ 35 8 References ................................................................................................................................... 36 9 Appendices ................................................................................................................................... 37 9.1 Acronyms ............................................................................................................................... 37 9.2 Murray PHN Rural Women’s Health Needs Project (RWHNP) - Action Plan .......................... 38 9.3 Letter to Stakeholders ............................................................................................................ 40 9.4 List of contacts and flyer dissemination points ....................................................................... 41 9.5 Flyer ...................................................................................................................................... 42 9.6 Murray PHN Rural Women’s Health Needs Project (RWHNP) – Survey Questions ............... 43 9.7 Proposed Service Model Indicative Costs .............................................................................. 51 Page 2 of 51 1 TITLE PAGE: RURAL WOMEN’S HEALTH NEEDS PROJECT – BENALLA LOCAL GOVERNMENT AREA Central Hume Primary Care Partnership was funded by the Murray Primary Health Network (PHN) to undertake this rural women’s health needs project in the Benalla Shire. Contract Number FF-93 Project / Program Rural Women’s Health Needs Organisation Central Hume Primary Care Partnership, auspiced by NESAY Location of Service 56 Samaria Road, Benalla Victoria 3672 Contact Huw Brokensha Position Executive Officer Phone 0436690156 Email [email protected] This report was compiled by the following Central Hume Primary Care Partnership (PCP) project staff: Staff Central Hume PCP Role Project FTE Ellie Stringer Program Coordinator: Prevention and Early Intervention 0.2 Catherine Fuller Program Coordinator: Dry Conditions Resilience 0.2 Page 3 of 51 2 EXECUTIVE SUMMARY Central Hume Primary Care Partnership was funded by the Murray Primary Health Network (PHN) to undertake one of four rural women’s health needs projects; this project was to be specifically conducted in the Benalla Local Government Area (LGA), between July and October 2019. The aim of this project was to determine the health and service needs of women living in the Benalla Municipality, and propose a new service model to address the prioritised need. 3 objectives were established: 1. To leverage local relationships with health and community organisations in the Benalla LGA to maximise service system knowledge and engagement strategies. 2. To engage with a broad range of women in the Benalla LGA using a place-based approach to identify specific self-reported health needs and the potential service models to meet these needs. 3. To propose place-based (service model) solutions that will address the identified health needs of the rural women in the Benalla LGA. For expediency, the project scope was limited to women over 18 years of age living in the Benalla LGA. It was anticipated that the evaluation indicators would be a gained understanding of: The enablers and barriers for women living in the Benalla LGA to accessing health and wellbeing services; the service gaps; and the models that would address their health and wellbeing needs. Key project activities, based on the objectives, included: Using partners and established networks to identify and/or contact key stakeholders who acted as champions to disseminate the project flyer or to help establish individual / group contacts. Establishing and conducting an online (and hard copy) survey that also provided the baseline for small group discussions. Analysing the data to establish a gained understanding of barriers and enablers; service gaps and models to address the health and wellbeing needs of rural women; the emerging themes provided evidence for the project recommendations and proposed placed-based service delivery models or models of care. Key Findings The key over-arching theme that applied to all the findings was that of ‘Access’. Women reported a range of access issues (physical, geographical, structural/system, cultural, social, etc.). This access lens applied to general / primary health care services, specialist / secondary health care services, or hospital / tertiary health care services and community care and wellbeing services. Page 4 of 51 205 women participated in the 2-month online (Survey Monkey) and hard copy survey, which had a 49% completion rate for 24 questions: 16 quantitative questions and 8 qualitative open-ended questions. The project workers were guests at 10 groups not confined to project eligible participants. There were 91 group participants in total with 77 women; four groups provided survey information only to 41 women; 50 people participated in six discussion groups with 39 eligible women. The open-ended survey questions were conversational prompts in the group discussions. Irrespective of the cohort (e.g. age, location or other demographic), three common themes emerged within both the survey and group discussions. A. Service availability - 72 survey respondents and all discussion groups identified service availability as a barrier to use or affecting service access. The issues raised were for one or multiple elements of the three sub-themes within this category: i. Service awareness ii. Issues accessing local services iii. Issues accessing specialist services B. Service affordability / Cost - 31 survey responses and all discussion groups reported the financial costs of health care being a barrier to use or affecting service access. Issues raised covered elements of the two sub-themes in this category: i. Costs associated with Public vs. Private services ii. Impact of high service costs C. Transport - 18 survey responses and all discussion groups reported transport or travel as a barrier to use or affecting service access. Issues raised covered elements of the two sub-themes in this category: i. Public transport ii. Rural travel Recommendations The project recommendations summarise the issues identified in the project findings and needs analysis, i.e. recommendations addressing identified service gaps and access issues. Unless stated the recommendations are for the Murray PHN to follow-up. 1. Develop rural healthcare models that promote the main service features important to rural women, i.e.: - Being affordable; - Being local; - Being physically accessible (including accessible transport); - Having multiple services in the one place; - Having (access to) outreach services; - Being all-age friendly. 2. Seek ways for local and regional services, and the Murray PHN, to improve healthcare service awareness and dissemination to rural women, including service availability and costs. Page 5 of 51 3. Seek ways to address the perceived gap in the lack of bulk-billing services, e.g. make additional bulk-billing services available in the LGA, and increase the transparency of bulk-billing items for better consumer understanding around bulk billing and pricing of services 4. Seek ways to increase options for after-hours medical services in the LGA 5. Seek ways to fund medical staff at the local hospital, Benalla Health 6. Seek options to increase access to women’s health services in the LGA, including - Service delivery elements, such as mammogram and screening services - Systems that support women’s health, e.g. female GPs and gender specific services. 7. Explore ways to support the delivery of affordable services and service delivery options for rural women, especially related to general practice, dental health and mental health. 8. Explore ways to support the delivery of outreach health and wellbeing services in the LGA. 9. Explore ways to increase the delivery of specialist services in the LGA, including specialist psychiatric services (including Headspace and youth mental health), physicians and surgeons, Alcohol and other Drugs (AOD) services