Community engagement in health systems interventions and research in conflict-affected countries: a scoping review of approaches

被引:14
作者
Durrance-Bagale, Anna [1 ,2 ,3 ]
Marzouk, Manar [1 ,2 ]
Tung, Lam Sze [1 ,2 ]
Agarwal, Sunanda [4 ]
Aribou, Zeenathnisa Mougammadou [1 ,2 ]
Ibrahim, Nafeesah Bte Mohamed [1 ,2 ]
Mkhallalati, Hala [1 ,2 ]
Newaz, Sanjida [5 ]
Omar, Maryam [6 ]
Ung, Mengieng [1 ,2 ]
Zaseela, Ayshath [1 ,2 ]
Nagashima-Hayashi, Michiko [1 ,2 ]
Howard, Natasha [1 ,2 ,3 ]
机构
[1] Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore
[2] Natl Univ Hlth Syst, Singapore, Singapore
[3] London Sch Hyg & Trop Med, Dept Global Hlth & Dev, London, England
[4] Stanford Distinguished Careers Inst, Campus Dr, Stanford, CA USA
[5] Univ Manitoba, Rady Fac Hlth Sci, Dept Community Hlth Sci, Winnipeg, MB, Canada
[6] Chelsea & Westminster Hosp NHS Fdn Trust, London, England
关键词
Health systems; community engagement; co-creation; people-centred healthcare; conflict; CARE; PROGRAMS;
D O I
10.1080/16549716.2022.2074131
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background 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. Objective This review aimed to identify and interrogate the literature on community engagement in health system interventions and research in conflict-affected settings. Methods We conducted a scoping review using Arksey & O'Malley's framework, synthesising the data descriptively. Results 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. Conclusion 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.
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页数:10
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