Determinants of maternal knowledge on neonatal danger signs and care-seeking practices in a rural area of southeastern Ethiopia. <>>> A qualitative research approach was followed in which data was gathered through document analysis and field interviews. Some communities had limited access to facilities because of distance, difficult terrain and lack of funds for transport, while health service providers may face problems trying to reach communities and supervise community health workers [16, 18, 19]. For instance, in-charges of health facilities, who are also secretaries of HFGC, were partially informed on CCHP and plans of health facilities and most of them had heard about the CCHP through attending certain workshops/training. The .gov means its official. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Some respondents stated that HFGC have played little or no role in monitoring collection and utilization of user fees and CHF in their facilities but they are aware that health facilities are responsible for collecting funds through user fees and CHF. Discussion paper for the Strengthening Health Partnership of Nova Scotia, Summary of an assessment of comprehensive council health plans 2008/09 and third quarter (January March 2008) Progress reports and regional health management, monitoring and capacity building plans July 2008 to June 2009, Priority setting on malaria interventions in Tanzania: strategies and challenges to mitigate against the intolerable burden, World Health Organization- Regional Office for South East Asia. Report of the International Conference on Primary Health Care, Alma-Ata, USSR, Implementing decentralization policies an introduction, Guidelines for the establishment and Operations of Council Health Service Boards and Health Facility Governing Committees, Joint external evaluation of health sector in Tanzania, Tanzania health system assessment 2010 report. Health Policy Plan. Despite availability of policies, guidelines, and community representative organs, actual implementation of decentralization strategies is poorly achieved. (KI 15: in-charge of dispensary). Furthermore, lack of funds allocated for organizing planning sessions between facility management and HFGC members largely contributed to poor performance of HFGC activities. However, largely, such plans are prepared at the council level by Council Health Management Team (CHMT). WebFactors Affecting the Management of Women Income Generating Projects in Kikuyu Division of Kiambu District Youth Violence in Secondary Schools in Kenya: Prevalence, 2014. eCollection 2022 May. PMC The paper used a multi-case study design were used in describing various issues relating to the study. 2022 Feb 19;22(1):359. doi: 10.1186/s12889-022-12730-y. (KI 1: CHMT member). This contributed to the failure of the committee to function as per government guidelines. Methods for community participation. Dinajpur SafeMother Initiative Final Evaluation Report. Political environment 4. 2002;10(6):48591. (KI 15: in-charge of dispensary). Formal permission in the district was obtained from District Executive Director and DMOs, Wards Executive Officer, and Villages Executive Officer. BMC Pregnancy Childbirth. And here are seven factors that leaders may see when they get that honest perspective. 2014; 29:ii98-ii106. The functionality of health facility governing committees and their associated factors in selected primary health facilities implementing direct health facility financing in Tanzania: A mixed-method study. Building social accountability to improve reproductive, maternal, newborn and child health in Nigeria. 2015 Mar 29;15:75. doi: 10.1186/s12884-015-0501-8. (KI 13: chairperson of health center GC), Some members were interested to be members of HFGC with the intention of receiving allowances and other payments, therefore the absence of such allowances has discouraged them to participate in HFGC activities. Furthermore, little is known about the attitudes and characteristics of the local leaders, particularly members of the CHSBs and HFGCs, who form part of the health planning and decision-making process. However, the Nepal youth study suggests that strengthening a communitys capacity to work together effectively without paying careful attention to developing specific health-related knowledge and skills may not result in the desired improvement of specific health outcomes, at least in the short term (presumably in a context in which community level health related knowledge and skills are not well developed) [26, 27]. (KI 1: in-charge of health center). via stakeholder committees; intercultural sensitivity; and a focus on interventions to strengthen community capacity to support health. We would like to gratefully acknowledge the contributions of the participants of the WHO Technical Consultation on Health Promotion Interventions for Maternal and Newborn Health that took place between 15 and 17 of July 2014 at WHO headquarters in Geneva, for discussing the preliminary outcomes of the systematic reviews and for their contributions to the first version of the report. Anayda Portela is a staff member of the World Health Organization and is responsible for the views expressed in this article which do not necessarily represent the decisions, policy or views of the World Health Organization. Public Heal Res. Regarding the hindering aspects, the staff expressed the feedback they obtained from the volunteer during the intervention. Correspondence to This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, reproduction in any medium, provided the original work is properly cited. In this article we explore different factors. The findings from the youth survey indicate that the major factor of youth motivation for program participation is related to meeting personal goals. (KI 13: chairperson of health center GC). Background of Study: In Pakistan, political process has been distracted due to many reasons especially lack of political participation. -, Zakus JD, Lysack CL. World Health Organization. << Bethesda, MD 20894, Web Policies A respondent from the dispensary governing committee said: the existing system of information sharing between CHMT and HFGCs is not adequate. Occupational therapists need to recognise that enhancing the factors enabling participation in leisure and assisting clients to overcome the factors hindering participation in leisure will lead to the increased wellbeing of people with enduring Semantic Scholar is a free, AI-powered research tool for scientific literature, based at the Allen Institute for AI. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? Youth reproductive health in Nepal. They reported of never hearing or having been introduced to CCHP and its processes before. In short, we do not implement any activities outlined in the CCHP. A qualitative approach was employed in this study to allow in-depth interviews and discussion with key informants about the factors influencing community participation in developing CCHP. These categories include: lack of awareness on CCHP among members of HFGCs, poor means of communication and information sharing between CHMT and HFGCs on CCHP, little knowledge among HFGCs on their roles and responsibilities, limited capacity among HFGCs due to lack of training, and lack of financial resources to support the implementation of HFGC activities. The studies in Bangladesh showed how women suffered from violence in multiple settings: at home, in communities and in health services [17, 18]. x^\KsWq`039ETb$R3| ;zwWG_:?W#/jo}XBcsui[U>xX?7J^U//{1 [Wqf>wN|qZy6? 2012;7(8):85668. Key facilitators of community participation included supportive policy and funding environments where communities see women's health as a collective The communities where this shift in norms occurred were also reportedly more likely to sustain their efforts to improve health and maintain mechanisms such as transport systems compared with those that remained focused on individual responsibility [23]. awareness about community participation contributes to low participation of community members in developing and implementing various health projects. This study foundthatlowlevelsofeducationamongHFGCmembers contributedtolowawarenessonthethemeofparticipation of HFGCs in developing and implementing health plans. WebThe analysis of the factors influencing community participation in the development and implementation of CCHP has generated five main categories, which explain why it has Culturally-appropriate materials in local languages are needed that are suitable for a range of literacy and numeracy skills for programmes where community members participate in analysis of health data as a basis for decision-making and action [14, 15, 17, 18, 24, 28]. *`?4e)g$2]PJA1M0w8jz|> ?~N:$ tOiE WWt4( Community participation ranged from outreach educational activities to communities being full partners in decision-making. They concluded that the social and economic factors such as (gender, age, education, place of residence, family, tribal affiliation, unemployment, income, poverty, economic growth, social relationships, and regional affiliation) affected political participation, especially voting in elections. Strengthened capacity can lead to shifts in the balance of power through partnerships or coalitions between different groups (for example through stakeholder committees) or increased skills, education and confidence of members who become empowered to tackle their own problems (for example through community-based monitoring and increased accountability) [5, 31,32,33,34]. Data generated were analyzed for themes and patterns. We have been collecting user fees and CHF and submitting all to the DMOs office. 2022 May 1;14(5):e24643. Better understanding of how best to support community participation processes to improve maternal and newborn health is essential, particularly methods of investigating adequately the effects of different programmes in what are inevitably complex and dynamic social settings. WebWhat factors hinder community participation in collaborative governance? 1 0 obj The WHO commissioned systematic reviews of health promotion interventions involving community participation. A key factor influencing implementation in most studies included whether interventions helped communities address the issues that affected them. Honduras Promot Educ. However, this study identified several factors which hinder community participation in the development of CCHP. The Role of Community Participation in Planning and Executing Malaria Interventions: Experience from Implementation of Biolarviciding for Malaria Vector Control in Southern Tanzania. However, the committees are reportedly performing or involved partially with other roles such as sensitizing the community to join the CHF, receiving and opening new drug kits, creating awareness on health problems, monitoring disease outbreaks, and giving advice to communities on health matters. While some facilitating and inhibiting factors identified in this secondary analysis may be beyond the control or influence of a particular programme, it may be helpful for programme designers and implementers to be aware of them and the possible implications they may have for implementation and results. A thematic guide was developed to guide interviews. 7(L&,spA!rQ\.r9+Q:n-s->fZf3-(fX.iQ|YKHhX&iuQqTCt"]+_x(=SsOX*J(}o{ Studies on community participation in planning and implementation of health programmes reported positive experiences of programme participants, although they reported few details. FOIA For example, working in a setting in which there is a very low level of trust among members of the community is likely to require a great deal more time and effort spent on building trust before meaningful engagement in joint programme planning can take place. Members of committees in India and Kenya were reported to appreciate having a better understanding of their own roles and responsibilities, for instance in the decision making process for resource allocation and financial management [15, 19]. Community participation is regarded as an important tool for successful health sector development and it has been talked about since the mid-1950s (1, 2). PubMed In: Kahssay H, Oakley P, editors. Article Implementation requires careful consideration of the context: previous experience with participation, who will be involved, gender norms, and the timeframe for implementation. Several studies reported that joint assessments between healthcare providers and members of the community helped improve quality by providing valuable information to feed into priority setting and identify opportunities and challenges [19, 27, 28]. PubMed Health Promot Int 2000;15(2):99107. Int Health. Strategies to increase rural maternal utilization of skilled health personnel for childbirth delivery in low- and middle-income countries: a narrative review. 2004. International Center for Research on Woman. This section is structured into the main themes that emerged from the findings of this study which include: low awareness of HFGC on participation in health planning, poor communication and information sharing between CHMT and HFGC, lack of awareness of the roles and responsibilities of HFGC, lack of management capacity, and lack of financial resources allocated to support implementation of HFGC activities. Such involvement occurred because the implementation of the projects had a requirement that facility committees must endorse the implementation of such activities as explained by one of the HFGC chairperson: Yeah to tell the truth, we cannot say that we are implementing CCHP activities but in 2008 we were involved only in rehabilitation of our dispensary. /Type /Page Examining the links between community participation and health outcomes: a review of the literature. The findings revealed that almost all HFGC members had not been oriented or trained on their roles and responsibilities. However, the education system in Kenya has not favored women. Implementation requires careful consideration of the context: previous experience with participation, who will be involved, gender norms, and the timeframe for implementation. Communities and health services may face challenges in coming together to plan and implement programmes. A gender roles analysis study in China advocated a gender rights focus as a way to help raise community awareness about inequities in womens access to services and other opportunities, making the case for womens participation in bottom up planning processes in resource-poor settings where womens status is low to better inform decision-makers about womens needs and views [27]. These concepts were further analyzed based on the research objectives to categorize their similarities and differences as well as identifying the main emerging themes. -. It is advocated for providing a mechanism for potential beneficiaries of health services to participate in the design, implementation, and evaluation of activities, with the aim of increasing responsiveness, sustainability, and efficiency of health services (3, 4). Community involvement in health development: a review of the concept and practice. MeSH Population Council: New Delhi; 2008. Similarly, in India husbands were reluctant to participate in maternal health interventions, describing maternal health as a womens issue. Study authors reported, It was clear that efforts to make husbands more supportive questioned deep-rooted norms and beliefs, and met with considerable resistance; consequently, husbands were slow to change their views. [27]. Workshop Paper 11, Institutional and economic perspectives on government capacity to assume new roles in the health sector: a review of experience, in University of Birmingham series The Role of Government in Adjusting Economies Paper 4, UK, November 1995, Making it work! Other cited benefits included policies and actions that reflected and addressed womens needs [27]. Results: 2010;71(6):11021109. We use cookies to improve your website experience. Process evaluation for community participation. PubMedGoogle Scholar. Since I became a member of HFGC I never saw or heard that our committee is consulted or involved in any stage of preparing what you called CCHP. Matern Neonatal Heal. (KI 2: CHMT member). Bethesda, MD 20894, Web Policies Provided by the Springer Nature SharedIt content-sharing initiative. The designs of the original studies, along with the complexity of the integrated multi-component interventions and the different approaches to community participation, make it difficult to link specific implementation strategies to specific outcomes [7, 8]. Reviewing the transcripts was done simultaneously with coding the data by listing down phrases that captured emerging concepts. and transmitted securely. Health Policy Plan. A qualitative approach was conducted in this study with key informants from Health Facility Governing Committees (HFGC), Council Health Service Board (CHSB), and Council Health Management Team (CHMT). Accessibility The key informants from HFGC pointed out that the higher-level authority does not disseminate important information for developing and implementing facility plans and CCHP to health centers and dispensary committees. 2011;377(9763):40312. The interviews were carried out in May 2013 and each interview lasted between 60 and 90 min and was held in the offices of the respondents or special rooms provided by the district medical officer (DMO) or in-charge of a health facility. Other studies (1923) reported that a high level of education among key actors in health systems increased confidence and influenced participation in decision making in health activities and intervention. This, in turn, created opportunities for programme participants to advocate for more accessible services for women [27]. The way it was established has a lot to say about its current discriminatory GF reviewed the manuscript and contributed to its revision and also provided overall guidance to the conception and design of the study. PLoS One. Article The study revealed that most of the HFGC members were unaware of the concept of CCHPs and how they were supposed to participate in developing and implementing CCHP at the health facility level. An evaluation of a community-based approach to safe motherhood in northwestern Tanzania. The guide comprised of questions on the awareness of community participation in health planning, roles and responsibilities of CHSB, HFGCs and CHMT, information sharing among governance structures, management capacity, and availability of resources. HHS Vulnerability Disclosure, Help Privacy The https:// ensures that you are connecting to the The quality improvement studies provided very limited information on stakeholder perspectives. Reported benefits of community involvement in monitoring health data and quality included increased accountability of the health system to the community. Disclaimer, National Library of Medicine 2009;87(9):7249. Under section 86A of Act No 7, 1982, Prime Ministers Office Regional Administration and Local Government, Summary of an assessment of comprehensive council health plans 2010/11 and third quarter (January March 2011), The interview is a conversation with a purpose, School of Health & Social Services, Massey University, Understanding mechanisms for integrating community priorities in health planning, resource allocation and service delivery: results from a literature review: EQUINET Discussion Paper No. Howard-Grabman, L., Miltenburg, A.S., Marston, C. et al. In six programmes, community members participated at different levels at different points during the intervention [17, 18, 22, 23, 25, 26, 28]. Keywords: Studies reporting qualitative data were included. By the end of the project, young people were leading many of the intervention activities, with the implementation team acting only as facilitators [20, 21]. This study employed a qualitative method of data collection which involved conducting in-depth interviews with key informants. Nelson N, Wright S. Participation and power. 8600 Rockville Pike WebThe study established that high cost of living coupled with high unemployment rate and lack of morale contributed to negligible community participation in the development of ECD Hindering factors: To know the supply-side perspective, we enquired the staff regarding the difficulties faced by the CHVs during the program. Registered in England & Wales No. Glob Public Health. HHS Vulnerability Disclosure, Help Over time, the members of the community began to value collective responsibility and action [22, 23]. 2009;124(2):73569. 0 obj the WHO commissioned systematic reviews of health center ) 5:... 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