To the Editor: Owing to the emergence of numerous public health concerns and overburdened doctors/health systems, the concept of the health team has been highlighted and practised to ensure delivery of health care services to all.Citation1 Broadly, a health team has been defined as a group of persons who share a common health goal/objective, based on the needs of the community, and toward the achievement of which each member of the team contributes in accordance with their competence or skills.Citation2 This health team concept has been encouraged as most of the functions of the physician can be performed by trained health workers (viz. nurses, social workers, health assistants, outreach workers, and a host of others), and it also assists in strengthening the ties of commitment among programme managers, health care professionals, and members of the community.Citation1,2 In fact, it is visualized as a sort of most appropriate care, delivered by the most appropriate workers in the most appropriate settings.Citation3
The members of the health team work in collaboration with the community (with special emphasis on the family as a unit) and develop action plans based on their felt needs to ensure delivery of comprehensive care to the individual and their families.Citation4,5 As a part of their discharge of duties, the members of a health team establish bonds with the people which indirectly assists them in improving their communication, ensuring removal of the prevalent myths and misconceptions related to a specific health condition, and maintaining a follow-up to monitor the anticipated change in health behaviour of the community.Citation4,6 The members of a health team play a crucial role in the public health set-up by providing comprehensive care to familiesCitation1; identifying health problems/associated potential risk factors and encouraging community participation and action in solving their problemsCitation1,6; facilitating early detection of violence against children and adolescentsCitation5; promoting healthy maternal and child welfare practicesCitation7; extending social support to disadvantaged segments of populationCitation8; and in performing evaluation of health planning interventions.Citation9
Despite the availability of multiple evidences reflecting the utility of the health team in the public health arena, the initiative still faces a lot of hurdles.Citation2 It has been realized that the mere presence of a variety of health professionals is not sufficient to establish teamwork as it is a highly complex task to ensure interdisciplinary collaboration.Citation7 In addition, multiple other bottlenecks have been recognised (such as qualities of the team leader; poor knowledge among the members of the health team; unspecified roles and responsibilities; the number of families allotted to each team; poor level of co-ordination among the leader, team members, and community; lack of perception of difficulties by the workers concerning their work; bureaucracy in the public health system; and lack of adequate infrastructure support, viz. transport services or materials and equipment to carry out the work) that in combination are having a significant impact on the success of the health team.Citation4,7,10,11
To enhance the contribution of health teams in reducing the magnitude of a disease or improving the quality of life of people, it is of utmost importance to have the right ‘mix’ of health personnel with clear roles and sufficient freedom to exercise their skills.Citation2,12 Furthermore, implementation of other strategies has also been recommended (such as selecting a good leaderCitation2; scientific and rationale decision to decide members of health team based on health concernCitation6,8; organizing training sessions for the members of the health teamCitation1,7; ensuring effective inter-professional collaborationCitation13,14; facilitating regular interaction and feedback on performanceCitation12; extending adequate infrastructure supportCitation11,12; and encouraging research activities to promote better understanding among members of the team at different levelsCitation14) in order to expand the benefits of the health team.
To conclude, the health team concept has emerged as a significant form of health care delivery and has substantial potential to assist programme managers in taking evidence-based policy decisions in both developed and developing countries.
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India
[email protected]
References
- Loch-Neckel G, Seemann G, Eidt HB, et al. Challenges to an interdisciplinary action in basic care: implications related to composition of family health teams. Cien Saude Colet. 2009;14(Suppl 1):1463–72.10.1590/S1413-81232009000800019
- Park K. Concept of health and disease. In: Park K, editor. Textbook of preventive and social medicine. Jabalpur: Banarsidas Bhanot; 2009. p. 30–2.
- Goldman J, Meuser J, Rogers J, et al. Interprofessional collaboration in family health teams: an Ontario-based study. Can Fam Physician. 2010;56(10):e368–74.
- de Marqui AB, Jahn Ado C, Resta DG. Characterization of family health teams and their work process. Rev Esc Enferm USP. 2010;44(4):956–61.
- Luna GL, Ferreira RC, Vieira LJ. Mandatory reporting of child abuse by professionals of family health teams. Cien Saude Colet. 2010;15(2):481–91.10.1590/S1413-81232010000200025
- Reis CB, Andrade SM, Cunha RV. Allies of A. Aegypti: factors contributing to the occurrence of dengue according to social representations of professionals of family health teams. Cien Saude Colet. 2013;18(2):517–26.10.1590/S1413-81232013000200023
- Caldeira AP, Nobre de Aguiar G, Cavalcanti Magalhaes WA. Knowledge and practices in breastfeeding promotion by family health teams in Montes Claros, Brazil. Cad Saude Publica. 2007;23(8):1965–70.10.1590/S0102-311X2007000800023
- Alvarenga MR, Oliveira MA, Domingues MA, et al. Social support networks for elderly patients attended by family health teams. Cien Saude Colet. 2011;16(5):2603–11.10.1590/S1413-81232011000500030
- Sarti TD, Campos CE, Zandonade E, et al. Evaluation of health planning activities by family health teams. Cad Saude Publica. 2012;28(3):537–48.10.1590/S0102-311X2012000300014
- Santos AM, Giovanella L, Mendonça MH, et al. Healthcare practices of family health teams in four major cities. Cien Saude Colet. 2012;17(10):2687–702.10.1590/S1413-81232012001000018
- Green ME, Weir E, Hogg W, et al. Improving collaboration between public health and family health teams in Ontario. Health Policy. 2013;8(3):e93–104.
- Collier R. Verdict still out on family health teams. CMAJ. 2011;183(10):1131–2.10.1503/cmaj.109-3864
- Bélanger E, Rodríguez C. More than the sum of its parts? A qualitative research synthesis on multi-disciplinary primary care teams. J Interprof Care. 2008;22(6):587–97.10.1080/13561820802380035
- Hansson A, Friberg F, Segesten K, et al. Two sides of the coin – general practitioners' experience of working in multidisciplinary teams. J Interprof Care. 2008;22(1):5–16.10.1080/13561820701722808