Transforming the delivery of rural health care in Georgia: state partnership strategy for developing rural health networks.

Since 1996, 19 networks covering 74 of the 117 rural counties in Georgia have emerged. This grassroots transformation of rural health care occurred through a series of partnerships launched by state government officials. These partnerships brought together national and state organizations to pool resources for investment in an evolving long-term strategy to develop rural health care networks. The strategy leveraged resources from partners, resulting in greater impact. Change was triggered and accelerated using an intensive, flexible technical assistance effort amplified by developmental grants to communities. These grants were made available for structural and organizational change in the community that would eventually lead to improved access and health status. Georgia's strategy for developing rural health networks consisted of 3 elements: a clear state vision and mission; investment partnerships; and proactive, flexible technical assistance. Retrospectively, it seems that the transformation occurred as a result of 5 phases of investment by state government and its partners. The first 2 phases involved data gathering as well as the provision of technical assistance to individual communities. The next 3 phases moved network development to a larger scale by working with multiple counties to create regional networks. The 5 phases represent increasing knowledge about and commitment to the vision of access to care and improved health status for rural populations.