Evaluating local primary health care actions to address health inequities: analysis of Australia's Primary Health Networks

Abstract

Abstract Background Meso-level, regional primary health care organisations such as Australia’s Primary Health Networks (PHNs) are well placed to address health inequities through comprehensive primary health care approaches. This study aimed to examine the equity actions of PHNs and identify factors that hinder or enable the equity-orientation of PHNs’ activities. Methods Analysis of all 31 PHNs’ public planning documents, case study interviews with a sample of five PHNs’ stakeholders, and analysis of internal planning guidance documents, employing an existing framework to examine equity actions. Results PHNs displayed clear intentions and goals for health equity and collected considerable evidence of health inequities. However, their planned activities were largely restricted to individualistic clinical and behavioural approaches, with little to facilitate access to other health and social services, or act on the broader social determinants of health. PHNs’ equity-oriented planning was enabled by organisational values for equity, evidence of local health inequities, and engagement with local stakeholders. Equity-oriented planning was hindered by federal government constraints and lack of equity-oriented planning process mechanisms. Conclusions PHNs’ equity actions were limited. They need greater autonomy and systematic planning mechanisms to capitalise on their local evidence and connections to address health inequities.