Community engagement in health systems interventions and research in conflict-affected countries: a scoping review of approaches.
Community engagement in health systems interventions and research in conflict-affected countries: a scoping review of approaches.
复制标题
DOI：
10.1080/16549716.2022.2074131
复制
发表时间：
2022-12-31
影响因子：
2.6
通讯作者：
Howard, Natasha
中科院分区：
文献类型：
--
作者：
Durrance-Bagale, Anna;Marzouk, Manar;Tung, Lam Sze;Agarwal, Sunanda;Aribou, Zeenathnisa Mougammadou;Ibrahim, Nafeesah Bte Mohamed;Mkhallalati, Hala;Newaz, Sanjida;Omar, Maryam;Ung, Mengieng;Zaseela, Ayshath;Nagashima-Hayashi, Michiko;Howard, Natasha
医疗保健研究，规划和交付与最低限度的社区参与可能会导致财政浪费，无法实现目标，并在社区的方案旨在帮助挫折。让社区--个人服务用户和用户组--从一开始就参与医疗保健计划的规划、交付和评估，这有助于提高透明度、问责制和“所有权”。受冲突影响的卫生系统必须努力确保干预措施能让社区参与，而不会加剧现有问题。让社区参与对受冲突影响的卫生系统的干预和研究，对于开始处理对服务提供和获取的影响至关重要。本审查旨在确定和询问文献的社区参与卫生系统的干预措施和研究在受冲突影响的环境。我们使用Arksey & O 'Malley的框架进行了范围审查，并对数据进行了综合。我们包括了2,355个潜在来源中的19个。每个小组讨论了12个受冲突影响国家社区参与的至少一个方面，主要是参与性方法。主要的经验教训包括：必须让社区和宗教领袖以及社会经济地位较低的人参与设计和提供文化上可接受的保健服务;动员社区成员并让他们参与方案的交付，以提高可接受性;在政府、武装团体和其他组织之间进行调解，以提高保健服务提供者留在岗位上的能力;为社区成员提供对医疗保健提供反馈的空间，为社区提供方案和举措正在发挥作用的证据。社区参与确定和确定优先事项，决策，实施和评估潜在的解决方案有助于人们分享他们的观点，鼓励主人翁感，并增加医疗干预的成功可能性。然而，在受冲突影响的环境中，让社区参与可能特别困难，因为在这些环境中，优先事项可能不容易确定，而且必须考虑许多其他因素，如安全、权力关系和根深蒂固的不平等。
Healthcare research, planning, and delivery with minimal community engagement can result in financial wastage, failure to meet objectives, and frustration in the communities that programmes are designed to help. Engaging communities – individual service-users and user groups – in the planning, delivery, and assessment of healthcare initiatives from inception promotes transparency, accountability, and ‘ownership’. Health systems affected by conflict must try to ensure that interventions engage communities and do not exacerbate existing problems. Engaging communities in interventions and research on conflict-affected health systems is essential to begin addressing effects on service delivery and access. This review aimed to identify and interrogate the literature on community engagement in health system interventions and research in conflict-affected settings. We conducted a scoping review using Arksey & O’Malley’s framework, synthesising the data descriptively. We included 19 of 2,355 potential sources identified. Each discussed at least one aspect of community engagement, predominantly participatory methods, in 12 conflict-affected countries. Major lessons included the importance of engaging community and religious leaders, as well as people of lower socioeconomic status, in both designing and delivering culturally acceptable healthcare; mobilising community members and involving them in programme delivery to increase acceptability; mediating between governments, armed groups and other organisations to increase the ability of healthcare providers to remain in post; giving community members spaces for feedback on healthcare provision, to provide communities with evidence that programmes and initiatives are working. Community engagement in identifying and setting priorities, decision-making, implementing, and evaluating potential solutions helps people share their views and encourages a sense of ownership and increases the likely success of healthcare interventions. However, engaging communities can be particularly difficult in conflict-affected settings, where priorities may not be easy to identify, and many other factors, such as safety, power relations, and entrenched inequalities, must be considered.
登录
查看更多内容
影响因子：
3.6
作者：
Adams, Ben;Vallieres, Frederique;Eaton, Julian
通讯作者：
Eaton, Julian
影响因子：
7.2
作者：
Kozuki, Naoko;Ericson, Katja;Miller, Nathan P.
通讯作者：
Miller, Nathan P.
影响因子：
8.3
作者：
Nabatchi, Tina
通讯作者：
Nabatchi, Tina
影响因子：
5.4
作者：
Cornwall, A;Jewkes, R
通讯作者：
Jewkes, R
影响因子：
3.6
作者：
Anwari Z;Shukla M;Maseed BA;Wardak GF;Sardar S;Matin J;Rashed GS;Hamedi SA;Sahak H;Aziz AH;Boyd-Boffa M;Trasi R
通讯作者：
Trasi R