Abstract
Background
Canadian political discourse supports the importance of health promotion and advocates the allocation of health resources to health promotion. Furthermore, the current literature frequently identifies financial and human resources as important elements of organizational capacity for health promotion. In the Alberta Heart Health Project (AHHP), we sought to learn if the allocation of health resources in a regionalized health system was congruent with the espoused support for health promotion in Alberta, Canada.
Methods
The AHHP used a mixed method approach in a time series design. Participants were drawn from multiple organizational levels (i.e., service providers, managers, board members) across all Regional Health Authorities (RHAs). Data were triangulated through multiple collection methods, primarily an organizational capacity survey, analysis of organizational documents, focus groups, and personal interviews. Analysis techniques were drawn from quantitative (i.e., frequency distributions, ANOVAs) and qualitative (i.e., content and thematic analysis) approaches.
Results
In most cases, small amounts (<5%) of financial resources were allocated to health promotion in RHAs’ core budgets. Respondents reported seeking multiple sources of public health financing to support their health promotion initiatives. Human resources for health promotion were characterized by fragmented responsibilities and short-term work. Furthermore, valuable human resources were consumed in ongoing searches for funding that typically covered short time periods.
Conclusions
Resource allocations to health promotion in Alberta RHAs are inconsistent with the current emphasis on health promotion as an organizational priority. Inadequate and unstable funding erodes the RHAs’ capacity for health promotion. Sustainable health promotion calls for the assured allocation of adequate, sustainable financial resources.
MeSH terms: Public health, health promotion, health organizations, funding, health resources
Résumé
Contexte
Le discours politique canadien convient de l’importance de promouvoir la santé en y affectant les ressources sanitaires nécessaires. De plus, dans les articles d’actualité, les ressources humaines et financières sont souvent considérées comme d’importants éléments des capacités organisationnelles de promotion de la santé. Dans le cadre d’un projet albertain sur la santé cardiovasculaire (AHHP), nous avons cherché à déterminer si l’affectation des ressources au sein d’un réseau de santé régionalisé en Alberta, au Canada, était conforme aux prises de position sur la promotion de la santé.
Méthode
Le projet AHHP faisait appel à une démarche plurielle inscrite dans un modèle en séries chronologiques. Les participants provenaient des trois paliers organisationnels (fournisseurs de services, gestionnaires, administrateurs) de toutes les régies régionales de la santé (RRS). Les données ont été recueillies selon plusieurs méthodes (une étude de la capacité organisationnelle, l’analyse de documents organisationnels et la tenue de groupes de discussion et d’entretiens en personne) pour faciliter les croisements. Nous avons choisi des techniques d’analyse quantitatives (distribution de fréquences, analyse de la variance) et qualitatives (analyse du contenu, analyse thématique).
Résultats
Dans la plupart des cas, les ressources financières affectées à la promotion de la santé dans les budgets centraux des RRS étaient minimes (<5 %). Les répondants se sont dits obligés de recourir à plusieurs sources de financement pour leurs projets de promotion de la santé. Les ressources humaines affectées à la promotion de la santé avaient des mandats fragmentés et de courte durée. De plus, il fallait consacrer de précieuses ressources humaines à la recherche constante de budgets ne couvrant le plus souvent que de brèves périodes.
Conclusion
Les enveloppes budgétaires de promotion de la santé dans les RRS de l’Alberta ne correspondent pas à la priorité que l’on dit accorder à cet outil. Le financement irrégulier et insuffisant érode les capacités des RRS en matière de promotion de la santé. Pour être durable, la promotion de la santé exige l’affectation assurée de ressources financières suffisantes à long terme.
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