Community participation in rural primary health care: intervention or approach?
Community participation in rural primary health care: intervention or approach?
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DOI：
10.1071/py09053
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发表时间：
2010-01-01
影响因子：
1.3
通讯作者：
Taylor, Judy
中科院分区：
文献类型：
--
作者：
Preston, Robyn;Waugh, Hilary;Taylor, Judy
社区参与被认为对初级卫生保健发展很重要，有一些证据表明，社区参与会产生积极的健康结果。通过综合现有证据的过程中，社区参与的健康结果方面的有效性，我们确定了几个概念领域的混乱。本文建立在早期的工作，以解开在这一领域的概念差距，并澄清我们对社区参与的共同理解。我们对文献中的689项实证研究进行了综合研究，这些研究将农村社区参与和健康结果联系起来。对37份最后文件进行了分组和分析，其依据是：背景因素;社区参与的概念方法（使用现有类型的修改）;社区参与过程;证据水平;以及报告的成果。虽然有一些证据表明社区参与对健康结果有益，但我们发现只有少数研究证明了更高水平的证据。然而，很明显，没有证据证明效果不一定等于没有效果。我们关注的是文献中存在争议和缺乏明确性的领域。提高我们对社区参与及其在农村初级卫生保健服务设计和提供中的作用的理解，将增加真正的社区卫生部门合作伙伴关系和为农村社区提供更具响应性的卫生服务的可能性。
Community participation is considered important in primary health care development and there is some evidence to suggest it results in positive health outcomes. Through a process of synthesising existing evidence for the effectiveness of community participation in terms of health outcomes we identified several conceptual areas of confusion. This paper builds on earlier work to disentangle the conceptual gaps in this area, and clarify our common understanding of community participation. We conducted a research synthesis of 689 empirical studies in the literature linking rural community participation and health outcomes. The 37 final papers were grouped and analysed according to: contextual factors; the conceptual approach to community participation (using a modification of an existing typology); community participation process; level of evidence; and outcomes reported. Although there is some evidence of benefit of community participation in terms of health outcomes, we found only a few studies demonstrating higher levels of evidence. However, it is clear that absence of evidence of effect is not necessarily the same as absence of an effect. We focus on areas of debate and lack of clarity in the literature. Improving our understanding of community participation and its role in rural primary health care service design and delivery will increase the likelihood of genuine community-health sector partnerships and more responsive health services for rural communities.