Community participation in primary health care projects of the Muldersdrift Health and Development Programme (original) (raw)
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Introduction: This paper synthesises reports on community participation (CP) concept and its practicability in countries' health service systems, much focus being on developing countries. Methodology: We narratively reviewed the published and grey literature traced from electronic sources and hard copies as much as they could be accessed. Findings: CP is a concept widely promoted, but few projects/programmes have demonstrated its practicability in different countries. In many countries, communities are partially involved in one or several stages of project cycles -priority setting, resource allocation, service management, project implementation and evaluation. There is tendency of informing communities to implement the decisions that have already been passed by elites or politicians. In most of the project/programmes, professionals dominate the decision making processes by downgrading the non-professionals or non-technical people's knowledge and skills. CP concept is greatly...
Community Empowerment and Community Partnerships in Nursing Decision-Making
Healthcare, 2019
Community empowerment has been studied as a process and result phenomenon throughout the last 40 years. Community partnership, which has been studied during the last 20 years, has been identified as a key process to promote intervention and research within communities. In this paper, we introduce the relation between these two concepts, from the research that is being developed at the Centre for Interdisciplinary Health Research (CIIS) in Universidade Católica Portuguesa. We comment on the available evidence regarding community partnership and community empowerment within the Nursing Decision-Making process. There is a particular focus on Community Health Nursing Specialists (CHNS) and the aim to promote the identification of CHNS as potential community partnership developers within society. It is also important to analyze how community partnership processes are intentionally integrated as a nursing intervention within the nursing process. This analysis should occur from the nursing diagnosis to the evaluation of health gains in communities sensitive to CHNS care in a Nursing Theoretical Model developed from a Nursing PhD process-the Community Assessment, Intervention, and Empowerment Model.
Paradigms lost: Toward a new understanding of community participation in health programmes
Acta Tropica, 1996
Community participation has been a critical part of health programmes, particularly since the acceptance of primary health care as the health policy of the member states of the World Health Organisation. However, it has rarely met the expectations of health planners/professionals. This paper argues that the reason for this failure is that community participation has been conceived in a paradigm which views community participation as a magic bullet to solve problems rooted booth in health and political power. For this reason, it is necessary to use a different paradigm which views community participation as an iterative learning process allowing for a more electric approach to be taken. Viewing community participation in this way will enable more realistic expectations to be made. Community participation in disease control programmes focusing on community health workers is used as an example to show the limitations of the old paradigm. Participatory rapid appraisal is used to illustrate the new.
BMC Health Services Research, 2022
Background: Community participation is essential for the successful implementation of primary health care programmes across the globe, including sub-Saharan Africa. The Community-based Health Planning and Services (CHPS) programme is one of the primary health care interventions in Ghana which by design and implementation heavily relies on community participation. However, there is little evidence to establish the factors enabling or inhibiting community participation in the Ghanaian CHPS programme. This study, therefore, explored the enabling and inhibiting factors influencing community participation in the design and implementation of the CHPS programme in the Builsa North Municipality in the Upper East Region of Ghana. Methods: A qualitative approach, using a cross-sectional design, was employed to allow for a detailed in-depth exploration of the enabling and inhibiting factors influencing community participation in the design and implementation of the CHPS programme. The data were collected in January 2020, through key informant interviews with a stratified purposive sample of 106 respondents, selected from the 15 functional CHPS facilities in the Municipality. The data were audio-recorded, transcribed and manually analysed using thematic analysis. Results: The results showed that, public education on the CHPS concept, capacity of the community to contribute material resources towards the construction of CHPS facilities, strong and effective community leadership provided by community chiefs and assembly persons, the spirit of volunteerism and trust in the benefits of the CHPS programme were the enablers of community participation in the programme. However, volunteer attrition, competing economic activities, lack of sense of ownership by distant beneficiaries, external contracting of the construction of CHPS facilities and illiteracy constituted the inhibiting factors of community participation in the programme. Conclusion: Extensive public education, volunteer incentivization and motivation, and the empowerment of communities to construct their own CHPS compounds are issues that require immediate policy attention to enhance effective community participation in the programme.
Community health needs, community participation, and evaluation research
Evaluation and Program Planning, 1995
The rulue.s which underlie u ,socirdprogrwn. and the NIIJ~S in which the), uw reulized in the progrutn itself; are often left unspecified by the program plunners. Two procedures to give pructicul effkt to so&l wdues in u comnumity health project ure discussed in this puper: cureful und .s~'stetnutic assessment of' need; und community purtic'ipcrtion and inroh~ement.
BMC Health Services Research
Background: Many international health policies recognise the World Health Organization's (2008) vision that communities should be involved in shaping primary healthcare services. However, researchers continue to debate definitions, models, and operational challenges to community participation. Furthermore, there has been no use of implementation theory to study how community participation is introduced and embedded in primary healthcare in order to generate insights and transferrable lessons for making this so. Using Normalisation Process Theory (NPT) as a conceptual framework, this qualitative study was designed to explore the levers and barriers to the implementation of community participation in primary healthcare as a routine way of working. Methods: We conducted two qualitative studies based on a national Initiative designed to support community participation in primary care in Ireland. We had a combined multi-stakeholder purposeful sample (n = 72), utilising documentary evidence (study 1), semi-structured interviews (studies 1 and 2) and focus groups (study 2). Data generation and analysis were informed by Participatory Learning and Action (PLA) Research Methodology and NPT. Results: For many stakeholders, community participation in primary healthcare was a new way of working. Stakeholders did not always have a clear, shared understanding of the aims, objectives and benefits of this way of working and getting involved in a specific project sometimes provided this clarity. Drivers/champions, and strong working partnerships, were considered integral to its initiation and implementation. Participants emphasised the benefits of funding, organisational support, training and networking to enact relevant activities. Health-promoting activities and healthcare consultation/information events were generally successful, but community representation on interdisciplinary Primary Care Teams proved more challenging. Overall, participants were broadly positive about the impacts of community participation, but were concerned about the scope to sustain the work without the 'protected' space and resources that the national Initiative afforded.
Community participation in action: involving communities in primary care teams
2019
Background: The concept of involving communities in healthcare planning is enshrined in health policy across international settings. There is evidence of community participation impacting positively on health services. However, despite this policy context, there are major gaps in our knowledge. It is not routine across all primary health care settings and there is a lack of theoretically informed studies about implementation of community participation on interdisciplinary teams. This theoretically informed study draws on three interrelated projects to explore the perspectives of various stakeholders implementing community participation on primary care teams (PCTs) in Ireland. Method: Based on the pragmatic paradigm and principles of participatory qualitative health research, a case study approach was adopted using a sequential exploratory mixed methods design underpinned by Normalisation Process Theory (NPT). Participants represented health care professionals, GPs, community representatives, patients from marginalised groups and health service planners and policy makers from across a variety of primary health care settings. Data analysis took place at two levels-individual study level and data integration level and was informed by NPT constructs. Findings: Levers to implementation of community participation on PCTs included a shared understanding among stakeholders of the value of the work and good relationships and champions who support community initiatives. Barriers included a lack of resources for PCTs, complex health care structures, mistrust among team members and lack of formal appraisal of outcomes.