10 years ago, a regional government created and implemented a model for primary healthcare in their region. The model was grounded in best practices from global health organizations, but a decade later, it wasn’t producing any improvements in health outcomes. The problem was that ownership of primary healthcare in the region rested squarely on the government’s shoulders; no one else was stepping up to take responsibility beyond their immediate concerns.
The government decided to launch five Syntegrations targeted towards key constituent groups, especially those that historically distrusted or were disconnected from one another.
One of those groups was mayors of towns and small cities, who tended to try and ‘poach’ healthcare practitioners from nearby towns. Through the Syntegration, they came to realize that sharing resources was far more effective than trying to compete and lock them down. As a result, one of the key recommendations that emerged was implementing hub-and-spoke system of care in rural and remote populations. Healthcare providers would travel between towns that lacked full-service hospitals, instead of being stationed in one place permanently.
Another important group who was effectively involved was the First Nation populations. At first, their representatives were highly skeptical about the government’s willingness to do anything for them. The government assured them that not only would each Syntegration have a First Nations representative, but there would be an entire Syntegration devoted to primary healthcare for First Nations populations. The conversations that ensued, which were full of heart-breaking stories shared by First Nations members, laid a foundation of understanding and trust between the First Nations communities, government leaders, and other healthcare stakeholders.
The five Syntegrations led to a strategy for primary healthcare that was not radically different from its predecessor ten years ago—the real difference was that this time, the strategy was co-developed and co-owned by a variety of stakeholders throughout the region.
When the new strategy was officially launched and rolled out across the region, it wasn’t just government ministers who were standing on stage to present it. This time, representatives from the medical associations, nurse practitioners, town mayors, and private physicians joined government ministers in presenting the new plan.
A senior government health director commented that she used to be the face of the primary healthcare model, but now it is co-owned by many other faces, all of whom had a role in developing the model. After a decade of stalled progress, the region finally started to see solid improvements on many primary healthcare metrics.
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