چکیده (انگلیسی):

Background:This paper describes the development of a model of Comprehensive Primary Health Care (CPHC)
applicable to the Australian context. CPHC holds promise as an effective model of health system organization able
to improve population health and increase health equity. However, there is little literature that describes and
evaluates CPHC as a whole, with most evaluation focusing on specific programs. The lack of a consensus on what
constitutes CPHC, and the complex and context-sensitive nature of CPHC are all barriers to evaluation.
Methods:The research was undertaken in partnership with six Australian primary health care services: four state
government funded and managed services, one sexual health non-government organization, and one Aboriginal
community controlled healthservice. A draft model was crafted combining program logic and theory-based
approaches, drawing on relevant literature, 68 interviews with primary health care service staff, and researcher
experience. The model was then refined through an iterative process involving two to three workshops at each
of the six participating primary healthcare services, engaging health servicestaff, regional health executives and
central health department staff.
Results:The resultant Southgate Model of CPHC in Australia model articulates the theory of change of how and
why CPHC service components and activities, based on the theory, evidence and values which underpin a CPHC
approach, are likely to lead to individual and population health outcomes and increased health equity. The
model captures the importance of context, the mechanisms of CPHC, and the space for action services have to
work within. The process of development engenderedand supported collaborative relationships between
researchers and stakeholders and the product provided a description of CPHC as a whole and a framework for
evaluation. The model was endorsed ata research symposium involving investigators, service staff, and key
stakeholders.
Conclusions:The development of a theory-based program logic model provided a framework for evaluation that
allows the tracking of progress towards desired outcomes and exploration of the particular aspects of context
and mechanisms that produce outcomes. This is important because there are no existing models which enable
the evaluation of CPHC services in their entirety.