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Open Access Barriers to Population-Focused Health Promotion: The Experience of Public Health Nurses in the Province of Manitoba Les obstacles à la promotion de la santé axée sur la population : l'expérience des infirmières hygiénistes du Manitoba

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There is growing evidence that population health is influenced by broad socio-environmental factors that require population-focused health promotion strategies. The author reports on a study of the perspectives of public health nurses (PHNs) on the nature of their health promotion practice in the Canadian province of Manitoba, highlighting their perceptions about barriers to population-focused health promotion. A descriptive, exploratory research design was used to conduct standardized open-ended interviews with 24 PHNs in 3 geographically and demographically diverse health authorities. There were remarkable similarities in PHNs' perceptions about their practice. Three categories of barrier to population-focused health promotion were identified: barriers at the level of individual PHNs; organizational barriers (culture, policies, processes); and extra-organizational barriers at the level of the community or province. The results point to a gap between the theory that population-focused health promotion is at the heart of PHN practice and the experience of PHNs at the 3 sites. A concerted effort to address the barriers is needed so that PHNs in Manitoba can play a leadership role in creating a health-care system that truly invests in population health.

Tout porte à croire qu'un ensemble de grands facteurs socio-environnementaux influent sur la santé de la population, ce qui nécessite l'adoption de stratégies de promotion de la santé axées sur cette dernière. L'auteure rapporte les conclusions d'une étude sur les perceptions des infirmières hygiénistes à l'égard de leur travail dans la province canadienne du Manitoba, notamment en ce qui concerne les obstacles à la promotion de la santé axée sur la population. L'étude repose sur un plan expérimental descriptif et exploratoire; on a mené des entrevues qualitatives auprès de 24 infirmières hygiénistes, qui travaillent sous trois autorités sanitaires présentant chacune des caractéristiques géographiques et démographiques distinctes. On a défini trois catégories d'obstacles à la promotion de la santé axée sur la population : obstacles d'ordre individuel, liés aux infirmières; obstacles d'ordre organisationnel (culture, politiques, processus); obstacles d'ordre extra-organisationnel, concernant l'ensemble d'une localité ou de la province. Dans chacun des trois sites étudiés, on a constaté un écart entre la théorie, voulant que la promotion axée sur la santé de la population constitue l'essence même du travail des infirmières hygiénistes, et l'expérience de celles-ci. L'auteure conclut que seul un effort concerté permettra de lever ces obstacles, pour faire en sorte que les infirmières hygiénistes du Manitoba puissent jouer un rôle déterminant dans la création d'un système de santé qui investit réellement dans la santé de la population.


Document Type: Research Article

Publication date: 2006-09-01

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