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Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive sampling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning divergent sectoral agendas early in the collaborative process was essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes.

Background Schools are increasingly asked to participate in a range of public health programs, but there has been little consideration of the impact of these programs on policy and/or implementation. We investigated intersectoral collaboration between the health and education sectors using a case study of a school-based immunization program (SBIP). Methods The study was undertaken in South Australia. We undertook an ethnographic review examining health and education system functioning at a variety of levels using a mixed methods approach, informed by an interactive and multidirectional knowledge transfer framework. Results Facilitators for intersectoral collaboration included: explicit responsibilities for specific activities; clear communication channels; including the core values of each sector in planning and implementation; and collaborative development of health educational programs. Including consumers as key stakeholders in planning and implementing intersectoral programs is important. While the SBIP itself is currently successful, threats to its sustainability were identified. Conclusions Outcomes included: (i) a clearer understanding of the functioning of the SBIP in SA including wide-ranging and practical recommendations to facilitate the implementation of the program in both sectors, including revisions to enhance the experience for students; (ii) a broader outcome focusing on identification of barriers and facilitators for intersectoral collaboration and suggestions for enhancing such collaborations.

End of life care for people with advanced chronic disease is a growing international imperative, with the majority of deaths in the world now related to chronic disease. The provision of care that meets the needs of people with advanced chronic disease must be guided by appropriate policy. The key policy areas impacting directly on end of life care are related to chronic disease, palliative care and, increasingly, aged care. This paper describes the outcomes of an audit of Australian chronic disease and end of life/palliative care policies. We identified that chronic disease health policies/strategies demonstrate a focus on prevention, early intervention and management, with scant recognition of end of life care needs. The majority assume that a referral to palliative care will address end of life care needs for people with chronic disease. By contrast, palliative care policies recognise the need for the incorporation of a palliative approach into advanced chronic disease care, but there are few connections between these two policy areas. Whilst palliative care policies intersect with carer and advance care planning policies, chronic disease policy does not. Key concerns requiring consideration when developing policy in this area are discussed and possible policy options identified.

Objectives Completion of adolescent immunisation schedules in Australia is sub-optimal despite a well-established school based delivery program. The aim of this study was to seek adolescent and adult views on how existing adolescent school based immunisation policy and program delivery could be improved to increase adolescent immunisation uptake. Method Two citizens’ juries held separately, one with adolescent participants and one with adult participants deliberated on recommendations for public policy. Jury members were selected using a stratified sampling technique and recruited from a standing panel of community research participants through a market research company in South Australia. Juries were conducted in Metropolitan South Australia over two days and used university facilities with all meals and refreshments provided. Results Fifteen adults and 16 adolescents participated in the adult and youth juries respectively. Similar recommendations were made by both juries including increased ensuring the accuracy of information provided to adolescents and parents; employing a variety of formats for information delivery; and greater consideration of students’ physical and emotional comfort in order to improve the experience for adolescents. While the youth jury recommended that it should be compulsory for adolescents to receive vaccines through the school based immunisation program, the adult jury recommended an ‘opt-out’ system of consent. Both juries also recommended the use of incentives to improve immunisation uptake and immunisation course completion. Conclusions Eliciting adolescent views and including the perspectives of adolescents in discussions and development of strategies to improve engagement in the school based immunisation program provided valuable insight from the group most impacted by these policies and practices. Specifically, incorporation of adolescent and community views using citizens’ juries may lead to greater overall support from the commun

Objectives Adolescent immunizations such as human papillomavirus vaccine have been implemented through school based immunization programs (SBIPs) in Australia. We assessed community attitudes toward immunization of adolescents though SBIPs. Methods A cross-sectional population survey of rural and metropolitan households in South Australia in 2011. Univariate and multiple regression analyses identified predictors of support for a SBIP. Results Participation rate was 57.3% with 1926 adults interviewed. Overall, 75.9% regarded school as the best place to offer adolescent immunizations, with 16.4% preferring the family physician. Parents of high school students were most supportive (88.4%) of a SBIP with 87.9% of their adolescents reported as having participated in the program. Adults 18–34 years (79.4%) were more likely to support a SBIP compared to older adults (68.7% of >55 years) [adjusted OR = 2.39, p = 0.002] and men were more supportive (80.3%) than women (71.7%) [adjusted OR = 1.54, p = 0.003]. Reasons for participation in the SBIP included convenience (39.9%), public funding for the service (32.4%), and confidence in immunization recommendations (21.0%). Conclusions Public support for the SBIP was very high particularly amongst parents whose adolescent/s had participated in the program.

Considerable efforts have been made, both nationally and internationally, to address the growing “epidemic” of chronic disease. Chronic disease accounts for more than half of all Australian deaths, treatment of chronic disease in Australia accounts for almost 70% of total health expenditure2 and hospitalisations associated with chronic disease are a major component of this expenditure (see the Box for a definition of chronic disease as used in the context of this article). Systematic processes to prevent and manage chronic disease have been developed, and all incorporate the concept of a continuum of care from prevention and early intervention, through disease management to the end of life. While there is a strong focus on systematic care, health education, chronic disease self-management and regular review, comparatively scant attention is paid to the actual care required as people approach the end of their life.

Aims: To determine general practitioners’ research training needs, and the barriers to involvement in research. Method: Semi-structured interviews with 11 GPs in rural and metropolitan South Australia, analysed using a grounded theory approach. Results: General practitioners’ perceptions about their research needs were limited by their own experience and focussed at an individual level. Overlapping needs and barriers emerged, categorised as: ‘individual issues’ (a lack of research training or experience, concepts and attitudes to research, and research interest) and ‘systems issues’ (funding arrangements for general practice, access to resources, opportunity for publication and the role of The Royal Australian College of General Practitioners [RACGP]). Discussion: Our data provide an exploratory model that may assist in developing suitable strategies for research capacity building programs. General practitioners perceived both individual and systems solutions to building research capacity, including multifaceted interventions.

Aims: To determine general practitioners’ research training needs, and the barriers to involvement in research. Method: Semi-structured interviews with 11 GPs in rural and metropolitan South Australia, analysed using a grounded theory approach. Results: General practitioners’ perceptions about their research needs were limited by their own experience and focussed at an individual level. Overlapping needs and barriers emerged, categorised as: ‘individual issues’ (a lack of research training or experience, concepts and attitudes to research, and research interest) and ‘systems issues’ (funding arrangements for general practice, access to resources, opportunity for publication and the role of The Royal Australian College of General Practitioners [RACGP]). Discussion: Our data provide an exploratory model that may assist in developing suitable strategies for research capacity building programs. General practitioners perceived both individual and systems solutions to building research capacity, including multifaceted interventions.

HIV/AIDS has emerged as a serious epidemic in Nepal, concentrated amongst the most-at-risk populations. Volun-tary Counseling and Testing (VCT) is a proven strategy for the prevention and management of HIV/AIDS especially in developing countries. Given that the utilization of VCT is low in Nepal, it is important to understand the barriers and challenges that Nepal is facing in the provision and utilization of these services. This study aimed to provide recommendations for policy makers to improve the utilization of VCT services in Nepal. A qualitative study of VCT health service providers and government officials was undertaken in 4 cities of Nepal. Sixteen interviews, three joint interviews and one focus group discussion were conducted, audio recorded and transcribed verbatim. Data were then analyzed using a thematic analysis framework and major themes were identified. Various barriers including socio-cultural issues, geography, the presence of stigma and discrimination faced by people with HIV/AIDS and a lack of knowledge and awareness were identified as important factors limiting the utilization of VCT services. Current gov-ernment efforts to improve VCT service provision, although promising, require ongoing development. Systemic barriers included the sustainability of the temporary NGO VCT services, lack of staff and training, inadequate moni-toring and evaluation and limited access to services for people living in rural areas. To increase the sustainability and utilization of VCT services, the Government can intervene in a number of areas including the integration of VCT services with existing primary health care services and addressing ongoing education and quality assurance.