A model proposal for the contribution of local goverments in meeting the health care needs of the society

The aim of this study was to determine the health care needs in the municipality of Değirmenlik in the Nicosia district of the Turkish Republic of Northern Cyprus by collecting the opinions of the people living in the area, health care professionals and the local administration, and to develop a model to be implemented by the municipality of Değirmenlik Akıncılar in accordance with these needs, and to evaluate the functioning of the model through a preliminary application. The first phase of the research was conducted on three different samples (local people, health workers and local administrators). The population of the quantitative phase of the research was the people living within the borders of Değirmenlik Akıncılar Municipality (Ntotal= 11,865). The sample consisted of 401 people aged 18 years and over (n=401). The population of the qualitative phase of the study consisted of health workers (N=29) and local administrators (N=11) working in three health centers serving within the borders of Değirmenlik Akıncılar Municipality, and the sample consisted of a total of 18 people, 7 health workers and 11 local administrators (n=18). The population of the second phase of the study consisted of individuals aged 65 years and over living within the borders of Değirmenlik Akıncılar Municipality (N=1,557). The sample of the second stage of the study consisted of six individuals who voluntarily applied to and benefited from the "Home Health Care and Social Support Model" (n=6). In the quantitative phase of the study, the "Social Diagnostic Form" and the "World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF) were used to determine the opinions of the people of the region. The implementation of this study to the people of the region was carried out between 01/12/2021 - 27/02/2022. In the qualitative phase of the study, "Semi-Structured Interview Form-Local Administrators" and "Semi-Structured Interview Form-Health Workers" were used to structure the interviews with health workers and local administrators to be used in individual in-depth interviews and to reveal their interviews, with different content for each group. Interviews were conducted between 02/08/2022-20/09/2022. Themes and sub-themes were created by finding commonalities between the sentences that expressed the same meaning from the determined codes. In the quantitative phase of the study, it was determined that 67.6% of the findings related to the services needed in the region were home care services and the highest mean among the quality of life sub-dimensions was found in social relations (0.75±0.17), followed by psychological health, physical health and general health, respectively. Income level and age were found to affect quality of life. In the qualitative phase, 3 themes and 14 sub-themes were formed from the opinions of local administrators and health workers. The participants stated that the region has a very high population over the age of 65, that with the increase in the population over the age of 65, it has become important to improve the services to be provided to this population, and that the home care model should be coordinated with a multidisciplinary team or in cooperation. In the second phase of the research, in line with the health needs of the people of the region identified in the first phase, a "Home Health Care and Social Support Model" was created to be carried out by local governments. Since the individuals were still benefiting from the service, at the end of the 3-month implementation, the evaluation of the results of the service provided to the individuals and their health levels was made on the basis of the scores obtained from the Care Dependency Scale, the opinions of health workers and satisfaction scores. It is thought that the "Home Health Care and Social Support Model" developed in line with the needs of the society and to be carried out under the responsibility of the municipality will improve the health levels of individuals aged 65 and over, make the health services provided more effective and contribute to the welfare of individuals and their families as an exemplary service model. Keywords: Local Government, Health Care, Home Care, Public Health