Participatory action research to address lack of safe water, a community-nominated health priority in rural South Africa.
Participatory action research to address lack of safe water, a community-nominated health priority in rural South Africa.
复制标题
DOI：
10.1371/journal.pone.0288524
复制
发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
尽管国际证据支持社区参与健康以改善健康结果并建立更敏感和更公平的卫生系统，但关于如何做到这一点的实际证据却很少。这项工作旨在了解由多个利益相关者制定的与健康相关的地方行动计划的集体实施过程。社区、政府部门和非政府利益相关者在参与式行动研究 (PAR) 学习周期的三个迭代阶段召开会议。利益相关者参与了问题的识别、制定和当地行动计划的实施、对行动的反思以及流程的重申。参与者进行反思练习，探索权力和兴趣等因素如何影响成功或失败。地方行动计划取得了部分成功，实现了七个行动项目中的三个。高水平的权力和兴趣是实现行动项目的关键因素。对于已实现的项目，利益相关者报告说，彼此之间的持续互动通过实施过程的所有权创造了权力和利益的转变。拥有重要权力和影响力的参与者能够利用资源和人脉来克服障碍和障碍，以推进计划。缺乏财政支持、优先事项的转移以及利益相关者的支持不足阻碍了实施。该过程提供了新的思维方式，并支持利益相关者为行动和学习生成当地证据。该过程还可以探索具有不同权力和利益水平的不同利益相关者如何联合起来设计、规划和根据证据采取行动。创建安全空间是可以实现的，同时改变利益相关者的权力和利益水平是可能的，但具有挑战性。这项研究表明，当研究人员、服务提供者和社区作为学习平台的合法参与者连接起来，能够获取信息和做出决策时，权力和利益的转变可能是可行的。
Despite international evidence supporting community participation in health for improved health outcomes and more responsive and equitable health systems there is little practical evidence on how to do this. This work sought to understand the process involved in collective implementation of a health-related local action plan developed by multiple stakeholders. Communities, government departments and non-government stakeholders convened in three iterative phases of a participatory action research (PAR) learning cycle. Stakeholders were involved in problem identification, development, and implementation of a local action plan, reflection on action, and reiteration of the process. Participants engaged in reflective exercises, exploring how factors such as power and interest impacted success or failure. The local action plan was partially successful, with three out of seven action items achieved. High levels of both power and interest were key factors in the achievement of action items. For the achieved items, stakeholders reported that continuous interactions with one another created a shift in both power and interest through ownership of implementation processes. Participants who possessed significant power and influence were able to leverage resources and connections to overcome obstacles and barriers to progress the plan. Lack of financial support, shifting priorities and insufficient buy-in from stakeholders hindered implementation. The process offered new ways of thinking and stakeholders were supported to generate local evidence for action and learning. The process also enabled exploration of how different stakeholders with different levels of power and interest coalesce to design, plan, and act on evidence. Creation of safe spaces was achievable, meanwhile changing stakeholders’ level of power and interest was possible but challenging. This study suggests that when researchers, service providers and communities are connected as legitimate participants in a learning platform with access to information and decision-making, a shift in power and interest may be feasible.
登录
查看更多内容
影响因子：
6.3
作者：
Achoki T;Sartorius B;Watkins D;Glenn SD;Kengne AP;Oni T;Wiysonge CS;Walker A;Adetokunboh OO;Babalola TK;Bolarinwa OA;Claassens MM;Cowden RG;Day CT;Ezekannagha O;Ginindza TG;Iwu CCD;Iwu CJ;Karangwa I;Katoto PD;Kugbey N;Kuupiel D;Mahasha PW;Mashamba-Thompson TP;Mensah GA;Ndwandwe DE;Nnaji CA;Ntsekhe M;Nyirenda TE;Odhiambo JN;Oppong Asante K;Parry CDH;Pillay JD;Schutte AE;Seedat S;Sliwa K;Stein DJ;Tanser FC;Useh U;Zar HJ;Zühlke LJ;Mayosi BM;Hay SI;Murray CJL;Naghavi M
通讯作者：
Naghavi M
影响因子：
2.6
作者：
Hove J;D'Ambruoso L;Twine R;Mabetha D;van der Merwe M;Mtungwa I;Khoza S;Kahn K;Witter S
通讯作者：
Witter S
影响因子：
2.4
作者：
Andrews, Jeannette O.;Newman, Susan D.;Bunting, Shelia
通讯作者：
Bunting, Shelia
影响因子：
3.4
作者：
Akhmouch, Aziza;Clavreul, Delphine
通讯作者：
Clavreul, Delphine
影响因子：
1.3
作者：
Glassman, Michael;Erdem, Gizem
通讯作者：
Erdem, Gizem