Abstract
BackgroundCommunity dialogues have been widely used as a method for community engagement and participation to cover a broad range of areas. However, there has been limited documentation and evaluation of the process, particularly as a method towards achieving family planning and contraception (FP/C) programme goals. As part of the development of an intervention package aimed at increasing community and health care provider (HCP) participation in the provision of FP/C, feasibility testing of the intervention approach (a community dialogue between communities and health facilities) was carried out. Our findings offer a systematic description and evaluation of the community dialogue process, with key recommendations towards future implementation.MethodsThe dialogue was evaluated in three ways: 1) through participant observation during the community dialogue, 2) via a standardised feasibility testing tick-list for all observers of the dialogue, and 3) through three focus group discussions (FGDs) consisting of different groups of stakeholders who participated in the community dialogue. In total, 28 community members, HCPs, and key stakeholders attended the community dialogue (22 females, 6 males). Twenty-seven of the community dialogue participants participated in one of 3 FGDs held after the dialogue. Six evaluators assessed feasibility of the dialogue process.ResultsThere was good attendance, representation and participation amongst community and provider sectors based on the participant observations using the standardized feasibility check-list. The community dialogue process received positive feedback in the FGDs and was demonstrated to be feasible and acceptable. Key factors contributing to the success of the community dialogue included a skilled facilitator, good representation of participants, establishing ground rules, good timekeeping, and using a Theory of Change to facilitate goal identification and dialogue. Issues to consider are the underlying power differentials related to age, profession and gender which caused initial feelings of anxiety amongst some participants.ConclusionsOur formative findings offer a systematic description and evaluation of a community dialogue process with key recommendations that may be considered when constituting similar community dialogues in the future.
Highlights
Community dialogues have been widely used as a method for community engagement and participation to cover a broad range of areas
Of key importance is the role that community participation has in promoting social cohesion - which is the level of interconnectedness and unity amongst groups in society, and which has long been linked to community level well-being and health [7, 8]
Previous health efforts adopting a community participation approach found that unequal power relationships between community members and health care provider (HCP) fundamentally impeded successful participation [10]
Summary
Community dialogues have been widely used as a method for community engagement and participation to cover a broad range of areas. As part of the development of an intervention package aimed at increasing community and health care provider (HCP) participation in the provision of FP/C, feasibility testing of the intervention approach (a community dialogue between communities and health facilities) was carried out. The concept of ‘community’ encompasses a wide range of actors within which not everyone will be viewed or empowered to participate [9]. This is especially salient when there are gendered, socioeconomic and class differentials which typically exist between HCPs and community members. Previous health efforts adopting a community participation approach found that unequal power relationships between community members and HCPs fundamentally impeded successful participation [10]
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