The bridging role of social work: the quest towards installing a structural approach within primary health care

ABSTRACT

Primary health care is globally recognised as a key component of health systems. Its commitment to achieving social justice and addressing the social determinants of health is seen as a way to reduce social and health inequalities. As members of primary health care teams, social work professionals place the principle of social justice at the core of their operation by adopting a structural approach. Through this approach, social workers counter an exclusive focus on individual change and examine the social, political and economic forces that influence individual problems. However, little research has been done on the structural role of social work within primary health care. To address this issue, semi-structured interviews were conducted with 13 social workers from ten primary health care centres. Our findings are twofold. On the one hand, we conceptualise social workers’ role as a bridge in which they shape their structural approach incrementally on the micro, meso and macro levels. On the other, we address a few points of concern regarding some barriers to structural work identified by social workers.

SAMENVATTING

Eerstelijnsgezondheidszorg wordt wereldwijd erkend als een sleutelcomponent van gezondheidszorgstelsels. Deze zorg wordt beschouwd als een manier om sociale ongelijkheden en ongelijkheden op het gebied van gezondheid te verminderen. Als professionele actoren in de eerstelijnsgezondheidszorg stellen sociaal werkers het principe van sociale rechtvaardigheid centraal in hun handelen door te streven naar een structurele aanpak. Via deze benadering gaan sociaal werkers in tegen een exclusieve focus op individuele problemen en onderzoeken zij de sociale, politieke en economische factoren die individuele kwesties beïnvloeden. Er is echter tot op heden weinig onderzoek gedaan naar de structurele rol van sociaal werk binnen de eerstelijnsgezondheidszorg. Om deze kwestie te onderzoeken werden semi-gestructureerde interviews afgenomen bij 13 sociaal werkers uit tien wijkgezondheidscentra. Onze bevindingen zijn tweeledig. Enerzijds conceptualiseren we de rol van sociaal werkers als een brug waarin ze hun structurele aanpak stapsgewijs vorm geven op het micro-, meso- en macroniveau. Anderzijds gaan we in op enkele aandachtspunten met betrekking tot barrières om structureel werk mogelijk te maken.

KEYWORDS:

• Structural social work
• primary health care
• incremental changes
• social work

KERNWOORDEN:

• Structureel sociaal werk
• eerstelijnsgezondheidszorg
• stapsgewijze veranderingen
• sociaal werk

Acknowledgements

The authors are very grateful for the support of the VWGC, the umbrella organisation of the primary health care centres. In addition, we would like to thank all social workers for their time and enthusiasm to take part in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Nele Feryn

Nele Feryn is a PhD student at the Department of Social Work and Social Pedagogy at Ghent University (Belgium). Her research has particular interest in the integration of social work in primary health care settings.

Joris De Corte

Joris De Corte is a post-doctoral researcher at the Department of Social Work & Social Pedagogy at the Faculty of Psychology and Educational Sciences (Ghent University). His main research and teaching interests are linked to inter-organizational collaboration, the accessibility of social welfare provision, advocacy and the political role of social work.

Rudi Roose

Rudi Roose is associate professor of social work at the Department of Social Work & Social Pedagogy at the Faculty of Psychology and Educational Sciences (Ghent University). His research interest is the development of socially just social work in managerial contexts.