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Beyond Participation to Coproduction Nerida Hyett MHSc BOT PhD Candidate, Lecturer La Trobe Rural Health School July 2013 latrobe.edu.au CRICOS Provider 00115M Improving the Health of Communities through Participation COMMUNITY HEALTH LITERACY INCLUSION AND EXCLUSION IN COMMUNITIES INTERNATIONAL CASE STUDIES ON COMMUNITY PARTICIPATION AND HEALTH La Trobe University 2 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 La Trobe University 3 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 La Trobe University 4 Arnstein’s Ladder Arnstein, S. (1969) La Trobe University 5 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 La Trobe University 6 Mobilisation and Sustainability • Readiness • Community assets, skills and resources • Funding • Community organising • Local solutions • Longevity • Intensity La Trobe University 7 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 La Trobe University 8 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 cofacilitation of a group program for people with personality disorders More examples available here: http://allinthistogetherwales.wordpress.com/coproduction/co-pro-case-studies La Trobe University 9 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 La Trobe University 10 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-tocoproduction 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 La Trobe University 11 Thank you Contact: Nerida Hyett [email protected] Dr Amanda Kenny [email protected] latrobe.edu.au CRICOS Provider 00115M