Advancing Community Engagement in Healthcare in Rural BC

BC Rural Health Network (BCRHN) and UBC Centre for Rural Health Research (CRHR)

BCRHN and UBC Centre for Rural Health Research jointly carried out a gap analysis to understand and address opportunities for improving the relationship between rural community voices.

In 2020, the University of British Columbia’s (UBC) Centre for Rural Health Research (CRHR) conducted a provincial survey to understand and document the healthcare priorities of rural communities across British Columbia. One unexpected finding from that study was that rural community members felt a lack of communication with healthcare policy makers and planners and expressed a desire to be consulted on healthcare planning and decision making.

Based on these findings, CRHR partnered with the BC Rural Health Network (BCRHN) to further explore the gaps between the inclusion of community voice and current healthcare planning practices in British Columbia. They used a mixed methods approach by combining interviews with policy and decision makers and rural community leaders with findings from an online survey with rural community members.

Selected Findings from Survey Respondents:

  • 90% of survey respondents felt that their community’s healthcare needs were not adequately represented during the planning process[1]
    • Many complained that there were no existing structure or channels for public consultations during the planning process
    • When consultations did happen, respondents felt that they did not happen with those “on the ground” (e.g., volunteer organizations and lay community members who are recipients of services)
    • Health planning at the provincial level is often not targeted to meet the needs of residents in rural communities
  • Three out of four survey respondents felt their community needs were not being met through the health planning process
  • Most respondents (86%) felt that their needs and concerns were not being acted upon, and thus did not have much confidence in decision-makers making decisions best for their community
  • Given the tendency to make decisions based on large regions, rural residents felt that the decisions made privileged urban settings and did not capture their health needs

Selected Findings from Rural Community Leaders:

  • Participants noted that accountability was one of the biggest issues—lack of accountability in large bureaucracies and institutions, decisions made from the top with insufficient evidence
  • Need for community advocacy to inform decision-making
  • Highlighted lack of engagement with decision-makers, and lack of follow-through when suggestions were made
  • Felt that decisions made reflected urban-centric planning

Selected Findings from Policy-Makers:

  • Feeling stretched to make decisions that satisfy everyone amidst multiple interests and an ongoing healthcare crisis.
  • Desire to improve the healthcare system is there, but there’s a lack of funding and resources (and support from the health minister) to do so
  • Emphasized the importance of leadership and need for the people at the top to remember and implement the ideas suggested
  • Some successes have been found in certain rural communities, but it is difficult to replicate those successes in other rural communities

This survey included responses from 707 people.

To learn more about this research project and its findings, view the entire body of work here:

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