Chasing the dragon: Developing indicators for the assessment of community participation in health programmes
Chasing the dragon: Developing indicators for the assessment of community participation in health programmes
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DOI：
10.1016/j.socscimed.2010.05.016
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发表时间：
2010-09-01
影响因子：
5.4
通讯作者：
Rifkin, Susan
中科院分区：
文献类型：
--
作者：
Draper, Alizon Katharine;Hewitt, Gillian;Rifkin, Susan
正如 1978 年《阿拉木图宣言》中所阐述的那样，社区参与被确定为初级卫生保健的关键组成部分之一，并且在低收入和高收入国家中都重新受到关注。然而，如何评估其在实现健康改善方面的作用仍然是一个持续的挑战。这主要是由于社区参与的定义多种多样，因此很难评估其对预期计划成果的影响，例如吸收和可持续性以及更广泛的健康改善。本文通过首先定义社区参与的连续体来解决这一挑战，捕获其多种形式，然后将其纳入一个评估框架，该框架能够分析参与过程并将其与健康和计划结果联系起来。参与和框架的连续体基于 Rifkin 的蜘蛛图。 Muller 和 Bichmann (1988)，但根据越来越多的关于社区参与的文献以及我们评估社区参与在营养相关儿童生存计划中的作用的最初要求进行了修改。案例研究提供了评估框架及其在社区参与评估中的实用性的实例。虽然这是基于文献的回顾性分析，但它展示了评估工具如何能够对社区参与提供健康相关干预措施的不同方式进行细致入微的分析。参与计划设计和实施的人员可以前瞻性地使用它，以进一步了解社区参与及其与健康成果以及关键计划成果（例如可持续性）的关系。 (C) 2010 Elsevier Ltd. 保留所有权利。
Community participation was identified as one of the key components of Primary Health Care as articulated in the Alma Ata declaration of 1978 and is enjoying a renewal of interest in both low and high income countries. There remains, however, an on-going challenge in how to assess its role in achieving health improvements. This is largely due to the multiplicity of definitions of community participation, which has made it difficult to evaluate its impact on desired programme outcomes, such as uptake and sustainability, as well as broader health improvements. This paper addresses this challenge by first defining a continuum of community participation that captures its many forms, and then incorporates this into an evaluation framework that enables an analysis of the process of participation and links this with health and programme outcomes. The continuum of participation and framework is based upon the spidergram of Rifkin. Muller, and Bichmann (1988), but modified in the light of the growing literature on community participation and also in relation to our original requirements to evaluate the role of community participation in nutrition-related child survival programmes. A case-study is presented to provide a worked example of the evaluation framework and its utility in the evaluation of community participation. While this is a literature-based and retrospective analysis, it demonstrates how the evaluation tool enables a nuanced analysis of the different ways in which communities can participate in the delivery of health-related interventions. It could be used prospectively by those involved in programme design and implementation to further our understanding of community participation and its relationship with health outcomes, as well as key programme outcomes, such as sustainability. (C) 2010 Elsevier Ltd. All rights reserved.