1.3 The role of other providers
This learning object ‘The role of other providers’ presents a broad overview of the sources of health and social care which will generally extend beyond the formal health care system. A full understanding of the operation of the health care system is only possible when its scope and context are known. The diversity of care providers means that there are numerous permutations for the health care options available to individuals in specific locations at specific times.
Much (maybe most) health care is provided outside the formal health care system. The appropriateness and suitability of this care varies enormously between geographical and historical settings. The most basic level of health care is self-care: an individual’s ability to look after their own health is determined by many factors, including levels of education (for example with regard to nutrition and sexual behaviour) and the availability of resources (for example clean water, adequate food supply). Much self-care is preventive care, but also encompasses appropriate treatment of minor illnesses and injuries. There are many situations, especially with regard to children and the elderly, in which informal care at home from friends and relatives will be the most appropriate treatment strategy, but this needs to be situated within a context of adequate health education and the availability of specialist services when needed.
Beyond the informal network of friends and family, an wide range of agencies provide elements of health care: taking this broad definition the roles of environmental health, social services, pharmacists and providers of long-term residential care are all of relevance. The types and mixture of these types of provision interact with the formal care system, both responding to its perceived inadequacies and setting the context within which it must operate. Engagement with planning and spatial organization addressed at the formal health care system can only be effective when situated within a full understanding of the other health care providers.
Activity
Read the two key references by Department of Health (2005) and Nayar et al. (2004). They describe very different contexts of informal health care, addressing the understanding of self-care by individuals in an affluent developed society and the role of self-help in a range of developing world situations. Nevertheless they both deal with common elements in the organization of health care outside the formal health care system. Review these two documents and try to identify the spatial processes that may result from the situations they describe: what immediate implications can you identify for geographical planning in the formal health care system?
References (Essential reading for this learning object indicated by *)
* Department of Health (2005) Self care: a national view in 2007 compared to 2004-5. Department of Health, London http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085351
* Nayar, K. R., Kyobutungi, C. and Razum, O. (2004) Self-help: what future role in health care for low and middle-income countries? International Equity in Health http://www.equityhealthj.com/content/3/1/1