Community Engagement Research Articles

The Importance of Sustainable Wetland Management

Wetlands have faced a global reduction from 64% to 71% during the 20th century, and it is estimated that habitat loss could lead to the extinction of around 1,700 vertebrate species by 2070. This study analyzed data from SCI, Scopus, Web of Science, Google Scholar, and a range of theses to explore sustainable wetland management. While previous research focused on the consequences of wetland degradation, this study highlights the critical need for sustainable management. Wetlands are biodiversity hotspots, home to numerous endemic and endangered species, making their conservation vital for protecting global biodiversity. Wetlands also contribute significantly to climate change mitigation by sequestering carbon, regulating water flow, and reducing catastrophe risk. Sustainable wetland management is essential to harness these benefits, particularly in light of growing environmental challenges. Wetlands also provide crucial ecosystem services, such as water purification, flood control, and recreational opportunities, emphasizing their socio-economic importance. Despite these benefits, wetlands face ongoing threats from habitat destruction, pollution, and unsustainable use. Effective management requires a comprehensive approach, incorporating conservation, community engagement, policy development, and scientific research. Embracing sustainable practices is essential to preserve wetlands for future generations, reaffirming their role as critical ecosystems that support life and resilience. This abstract calls for global action to prioritize sustainable wetland management as a key aspect of environmental protection and sustainable development.

Community-Engaged Approaches for Improving the Inclusion of Diverse Communities in a Nutrition Clinical Trial

Background: Cardiometabolic disease (CMD) disproportionately affects African American/Black (AA) and Latino communities. CMD disparities are exacerbated by their underrepresentation in clinical trials for CMD treatments including nutritional interventions. The study aimed to (1) form a precision nutrition community consultant panel (PNCCP) representative of Latino and AA communities in Los Angeles to identify barriers and facilitators to recruitment and retention of diverse communities into nutrition clinical trials and (2) develop culturally informed strategies to improve trial diversity. Methods: A deliberative community engagement approach was used to form a PNCCP for the Nutrition for Precision Health (NPH) trial, part of the of the All of Us research initiative. The PNCCP included individuals that provide services for Latino and AA communities who met during 11 virtual sessions over 1 year. Discussion topics included enhancing recruitment and cultural acceptance of the NPH trial. We summarized CCP recommendations by theme using an inductive qualitative approach. Results: The PNCCP included 17 adults (35% AA, 47% Latino). Four thematic recommendations emerged: reducing structural barriers to recruitment, the need for recruitment materials to be culturally tailored and participant-centered, community-engaged trial recruitment, and making nutrition trial procedures inclusive and acceptable. We outlined the study response to feedback, including the constraints that limited implementation of suggestions. Conclusion: This study centers community voices regarding the recruitment and retention of AA and Latino communities into a nutrition clinical trial. It highlights the importance of community engagement early on in protocol development and maintaining flexibility to enhance inclusion of diverse communities in nutrition clinical trials.

A Collaborative Approach to Promote Sustainable Learning for Vulnerable Learners in Zimbabwean Rural Secondary Schools

Purpose. Many children who attend rural schools are faced with challenges which make them vulnerable. Vulnerability does not only affect those learners, but it also disrupts the teaching and learning process; that is teachers and other learners and the well-being of people in the community. Arguably, the responsibility of supporting learners who are vulnerable so that they can attain an education which is sustainable rests in the hands of the entire community. The purpose of this study was to explore how a collaborative approach utilising community capitals can promote sustainable learning for vulnerable learners in Zimbabwean rural secondary schools. The study used the Community Capitals Framework (CCF) as the analytical framework for the study. Methodology. The study employed a qualitative methodology using Participatory Action Research (PAR) and Critical Emancipatory Research (CER) paradigms. Data were generated through discussion meetings and photovoice with learners, teachers, and parents from two rural secondary schools in Zimbabwe. Fairclough’s (1992) critical discourse analysis principles and a photovoice methodology were used for data analysis. Results. Results show that there is a need to develop a good learning environment, community engagement, and untap opportunities in local capitals to support the vulnerable learners, enhancing sustainable learning. The study also stresses the need for a positive relationship and engagement with communities, alongside leveraging all the types of capital in the community, including human capital, cultural capital, built capital, and social capital to mitigate some of the risks that learners may face. Conclusions. From the study, it is evident that a stakeholder-supported approach and leveraging on community capital is an appropriate way of addressing learner vulnerability and fostering learning in the rural secondary schools in Zimbabwe. The involvement of the community can also be used as a force to encourage the development of an environment conducive to learning that will foster the achievement of the education goals for vulnerable learners.

Applying Systems Thinking to Sustainable Beef Production Management: Modeling-Based Evidence for Enhancing Ecosystem Services

We used systems thinking (ST) to identify the critical components of beef cattle production through the lens of ecosystem services (ES), offering a holistic approach to address its adverse externalities. We identified eight critical feedback loops in beef production systems: (i) grazing and soil health, (ii) manure management and soil fertility, (iii) feed efficiency and meat production, (iv) water use and soil moisture, (v) cultural services and community engagement, (vi) energy use, (vii) carbon sequestration and climate regulation, and (viii) environmental impact. Our analysis reveals how these interconnected loops influence each other, demonstrating the complex nature of beef production systems. The dynamic hypothesis identified through the loops indicated that improved grazing and manure management practices enhance soil health, leading to better vegetation growth and cattle nutrition, which, in turn, have a positive impact on economic returns to producers and society, all of which encourage the continuation of interlinked beef and ecosystem stewardship practices. The management of beef production ES using ST might help cattle systems across the globe to contribute to 9 of the 17 different United Nations’ Sustainable Development Goals, including the “zero hunger” and “climate action” goals. We discussed the evaluation framework for agrifood systems developed by the economics of ecosystems and biodiversity to illustrate how ST in beef cattle systems could be harnessed to simultaneously achieve the intended environmental, economic, social, and health impacts of beef cattle systems. Our analysis of the literature for modeling and empirical case studies indicates that ST can reveal hidden feedback loops and interactions overlooked by traditional practices, leading to more sustainable beef cattle production outcomes. ST offers a robust framework for enhancing ES in beef cattle production by recognizing the interconnectedness of ecological and agricultural systems, enabling policymakers and managers to develop more effective and sustainable strategies that ensure the long-term health and resilience of humans and ES.

Bystanders or active participants? Mobilising meaningful participation in River Basin management: lessons from the Gauteng Province, South Africa

ABSTRACT This paper explores the concept of meaningful participation in river basin management, using the case study of the Hennops River in Gauteng Province, South Africa. Experiences of different stakeholders and communities regarding their involvement in the management of the Hennops River basin are analysed following engagement through interviews, workshops and clean-up initiatives. Several barriers and enablers for meaningful participation, such as lack of awareness, capacity, coordination, trust and incentives, are identified. Some recommendations are proposed for improving stakeholder and community participation, based on the lessons learned from the case study. This includes the formulation of a social fund to support small community-based projects such as clean-up campaigns. Projects should be reflective, keeping the community engaged and active. The paper argues that meaningful participation requires not only formal mechanisms of engagement and decision-making but also informal and practical actions that empower stakeholders and communities to take ownership and responsibility for their water resources and environment. For meaningful participation to take place, more needs to be done to shift communities away from a ‘bystander’ position to a more active role. A new approach to community engagement is therefore necessary to support stakeholder-driven initiatives and the raising of awareness in poorer communities.

Development Potential of Fisheries as a Maritime Activity in Supporting Area Planning

This paper aimed to identify and discuss the gains on the development of fishery, maritime tourism and community engagement towards the regional planning of Belakang Padang District in Indonesia. Based on both exploratory and explanatory qualitative and quantitative data collected for the study, the study establishes and examines the economic, cultural, and environment opportunities and barriers to region development in the district. The studies show that fisheries are the largest and most important economy sector that influences the planning of regions; at the same time, the challenges are observed in terms of outdated technique and restricted access to markets. Maritime tourism has a lot of prospects and long-term influences for countries but it is restricted by the lack of sufficient infrastructure and capital. The study also highlights a major research agenda concerning the lack of citizenship in planning where most of the local actors are rarely involved in planning processes. Environmental sustainability as an additional challenge was discovered with pollution together with the inadequate disposal of wastes contributing to the harm of the district’s development. Therefore, the study recommends an integrated regional development plan, focusing on the modernization of fisheries, tourism development, participation of community and conservation of the environment as key factors for sustainable development of Belakang Padang. Hence the research is useful in the existing literature on sustainable coastal development and charles district future planning activities.

Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: a scoping review

BackgroundAs a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles.MethodsThis scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups.ResultsA total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection.ConclusionsMost interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.

Equitable community-based participatory research engagement with communities of color drives All of Us Wisconsin genomic research priorities.

The NIH All of Us Research Program aims to advance personalized medicine by not only linking patient records, surveys, and genomic data but also engaging with participants, particularly from groups traditionally underrepresented in biomedical research (UBR). This study details how the dialogue between scientists and community members, including many from communities of color, shaped local research priorities. We recruited area quantitative, basic, and clinical scientists as well as community members from our Community and Participant Advisory Boards with a predetermined interest in All of Us research as members of a Special Interest Group (SIG). An expert community engagement scientist facilitated 6 SIG meetings over the year, explicitly fostering openness and flexibility during conversations. We qualitatively analyzed discussions using a social movement framework tailored for community-based participatory research (CBPR) mobilization. The SIG evolved through CBPR stages of emergence, coalescence, momentum, and maintenance/integration. Researchers prioritized community needs above personal academic interests while community members kept discussions focused on tangible return of value to communities. One key outcome includes SIG-driven shifts in programmatic and research priorities of the All of Us Research Program in Southeastern Wisconsin. One major challenge was building equitable conversations that balanced scientific rigor and community understanding. Our approach allowed for a rich dialogue to emerge. Points of connection and disconnection between community members and scientists offered important guidance for emerging areas of genomic inquiry. Our study presents a robust foundation for future efforts to engage diverse communities in CBPR, particularly on healthcare concerns affecting UBR communities.

Integrating planetary health education into tertiary curricula: a practical toolbox for implementation

ObjectiveTo present a series of case studies from our respective countries and disciplines on approaches to implementing the Planetary Health Education Framework in university health professional education programs, and to propose a curriculum implementation and evaluation toolbox for educators to facilitate the adoption of similar initiatives in their programs. We emphasize the importance of applying an Indigenous lens to curriculum needs assessment, development, implementation, and evaluation.MethodsCase studies from Australia and United States were collated using a six-stage design-based educational research framework (Focus, Formulation, Contextualization, Definition, Implementation, Evaluation) for teaching planetary health and methods of curriculum evaluation. These components were then mapped to derive the curriculum implementation toolbox reflecting the six-stage design-based educational research framework.ResultsThe case studies demonstrated different approaches to successful integration of the Planetary Health Education Framework in medicine, nursing, public health, and allied health disciplines. This integration often involved Indigenous perspectives on environmental stewardship, holistic health, and community well-being into the curriculum. The case studies also highlighted the importance of community engagement, cultural competency, and interdisciplinary collaboration in curriculum development. Findings from case studies were used to propose a curriculum implementation toolbox to assist educators in adapting and integrating planetary health education into their own programs.DiscussionWhile valuable frameworks for teaching planetary health in health science programs exist, challenges remain in implementing these frameworks in real-world educational environments. The proposed curriculum implementation toolbox offers practical strategies and resources for educators to incorporate these principles into their teaching. Additionally, the case studies reported here contribute to the growing body of literature on planetary health education pertinent to addressing the triple planetary crisis.

The Real Value of CSR Performance in the NEV Industry: Evidence from China

Corporate social responsibility (CSR) is increasingly becoming a major concern for investors and consumers, prompting companies to devote more resources to community engagement to manage conflict and improve business performance. In this study, we conducted an empirical analysis with a sample of 385 listed companies in China’s new energy vehicle (NEV) industry to analyze the relationship between CSR performance and corporate value (CV). With the ordinary least squares (OLS) regression analysis, our study’s results show a positive relationship between the CSR performance of these companies and corporate value. In addition, our findings indicate a lagged effect in the relationship between CSR and CV. The mechanism analysis suggests that corporate CSR performance helps to improve corporate reputation, reduce financing constraints, and thus increase corporate value. Moreover, high analyst attention and information transparency can enhance the positive effects of corporate CSR. This study contributes to the existing literature and empirical evidence by exploring the correlation between CSR performance and firm value in the context of emerging countries and the NEV industry.

LGBTQ+ themed public art: promoting an expanded view on genders and advancing gender education

This essay explores the transformative role of LGBTQ+ themed public art in promoting an expanded view of genders and advancing gender education. By engaging with Judith Butler’s theory of gender performativity, I want to stress how public art both serves as a medium for aesthetic expression and also acts as a crucial participant in the performative act of gender identity construction. From the vibrant defiance of rainbow crosswalks to the poignant narratives of the AIDS Memorial Quilt and the impactful murals by Keith Haring, LGBTQ+ themed public art challenges traditional gender roles and identities, offering alternative visions that resist binary classifications. These public artworks create inclusive spaces that foster community engagement, historical commemoration, and activism, effectively enhancing public pedagogy in gender education. By embedding diverse and non-normative expressions of gender and sexuality in public consciousness, such art prompts a reevaluation of societal norms, thereby contributing to a broader understanding and acceptance of gender diversity. This essay emphasizes the potential of LGBTQ+ -themed public art to serve as a dynamic medium for communicative pedagogy, manifesting its significance in shaping social consciousness and advancing the cause of gender equality and LGBTQ+ rights.

Commercial Tobacco Cessation Interventions for American Indian and Alaska Native Persons Living in the United States: A Narrative Systematic Review of Effectiveness Using a Health Equity Lens.

Identify commercial tobacco cessation interventions for American Indian and Alaska Native (AI/AN) communities, focusing on strategies used to advance health equity, including strategies to address social determinants of health (SDOH), community engagement, and cultural tailoring. We searched Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, ProQuest Central, Academic Search Complete, JSTOR, and Indigenous/Tribal health-related journals and databases. We included peer-reviewed studies on commercial tobacco cessation for AI/AN persons published January 1998-April 2023 that reported quit rates/attempts. We excluded studies that only used pharmaceutical interventions. Two reviewers independently assessed each study against our inclusion/exclusion criteria. A reviewer extracted data, and another checked for completeness. Synthesis focused on reported intervention effectiveness and strategies used for addressing SDOH, community engagement, and cultural tailoring. We used a synthesis matrix which allowed for comparison across studies. We screened 1116 articles and included 12 for synthesis. Of the 12, five engaged community health workers; four included SDOH elements; and six were reported effective. Of these six, five included early-stage community engagement and four were culturally tailored. There are few commercial tobacco cessation interventions for AI/AN populations. Building capacity, including tribal capacity, to develop and test multi-level, culturally grounded cessation interventions that address relevant SDOH may advance commercial tobacco cessation efforts in these populations.

Community Engagement in Local Governance

Community engagement in local governance is crucial for effective and inclusive decision-making. Lack of Awareness and Information has been found that limited knowledge can have its community members may not fully understand the governance processes or their rights and responsibilities. Information gaps have been found that the insufficient information about local issues and decision-making processes can hinder meaningful participation. Low Participation Rates have been found that apathy and disinterest is that some community members may be disengaged due to a lack of trust in the system or a perception that their participation will not make a difference. Barriers to access has been found that the physical, economic, or social barriers may prevent certain groups from participating, such as the elderly, disabled, or economically disadvantaged. During the initial phase (2008-2013) of the Local Governance and Community Development Program (LGCDP) in Nepal, social mobilization emerged as one of its most effective components. Approximately 1 million citizens actively influenced local government decisions, leading many local bodies to develop annual plans that more accurately addressed the needs of citizens, particularly marginalized and disadvantaged groups. However, there remain several lessons to be learned in addressing the challenges of implementation. It is crucial to harmonize local social mobilization efforts and enhance the quality and support of social mobilization initiatives across Nepal. Addressing the challenges of community engagement in local governance involves a multifaceted approach that includes enhancing communication, building capacity, fostering inclusivity, and ensuring accountability. Public education campaigns have been found to Conduct outreach programs to educate community members about their rights, governance processes, and how they can participate. Workshops and training have been identified to offer workshops and training sessions to increase understanding of local governance and decision-making procedures. Diverse engagement channels have to utilize multiple platforms for engagement, including town hall meetings, online forums, surveys, and community events, to reach a broader audience. Inclusive scheduling has to schedule meetings and events at times that are convenient for different community groups, including evenings and weekends.

The Role of Local Government and Environmental Management in Managing Tidal Floods in Bintan Regency

Indonesia is highly vulnerable to natural disasters, with tidal floods being a significant concern in Bintan Regency due to its exposure to sea tides and extreme weather events. The local government's role and environmental management strategies are crucial in mitigating these risks. This research seeks to evaluate these aspects by focusing on the measures implemented by Bintan Regency to manage tidal floods. The study employs a qualitative approach, relying on literature reviews to collect data from various sources such as scientific journals, books, research reports, and other relevant documents. This method provides a comprehensive understanding of the current practices and effectiveness of flood management and environmental management strategies in Bintan Regency. The research findings indicate that the Bintan Regency local government has undertaken significant initiatives to reduce tidal flood risks. These initiatives include spatial planning that integrates disaster risk considerations, the development of flood management infrastructure, and community education programs aimed at increasing preparedness. The effective implementation of environmental management practices, including the use of advanced technology for monitoring and evaluation, has been instrumental in these efforts. The local government’s approach reflects a proactive stance in addressing the challenges posed by tidal floods, emphasizing both preventative measures and responsive strategies. The study concludes that a holistic and sustainable approach is essential for effective tidal flood management. The integration of comprehensive spatial planning, infrastructure development, community engagement, and modern technology forms a robust framework for disaster mitigation.

Using Collective Impact to Examine Direct Service Worker Training and Credentialing in North Carolina: Recommendations for Change.

Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 113,000 often under-resourced and inadequately supported direct service workers (e.g., personal care aides, direct support professionals, nurse aides) in North Carolina. The demand in NC is projected to be ∼ 23,000 new direct service jobs from 2020 to 2030. We conducted a Medicaid-funded landscape analysis of direct service training/credentialing requirements and practices across service delivery models using the Collective Impact (CI) framework. With input from HCBS, licensing entities, advocates, and those with lived experience, we characterized NC's HCBS training/credentialing landscape and generated a first-of-its-kind comprehensive crosswalk resource. This project revealed the complexity and limitations of the multiple and varied training and credentialing requirements for direct service workers in NC. Robust community engagement efforts drove the development of preliminary findings and recommendations for improving the training and credentialing requirements for direct service workers in NC.

Seeing the Whole Together Through Relational Mapping: A Method for Engaging in Complex Systems Change

Complex global challenges cut across organizational and sectoral boundaries, increasing calls for holistic responses. Seeing the whole across diverse stakeholders is challenging for participants in complex systems, yet doing so is essential for engaging effectively in systems change. A promising new method known as relational mapping, based on relational coordination theory, has been used to facilitate complex systems change. Here, we propose that relational mapping can be applied to help participants (1) see the whole in relation to the parts, (2) share their explicit and tacit knowledge, (3) engage in dialogue across distinct perspectives supported by the map as a boundary object, (4) reduce the impact of power differences, and (5) prepare to co-design interventions from multiple perspectives. This paper presents an illustrative case of relational mapping in the context of public administration in a South Carolina community engaging in complex systems change. Our analysis suggests a set of boundary conditions for the success of relational mapping, including the willingness of participants to seek integrative solutions to a conflict or problem and facilitation that is attentive to differential power and status among stakeholders. We conclude that relational mapping is a powerful, theoretically grounded method that enables the visual assessment of multi-level stakeholder relationships, preparing participants to engage in complex systems change and then present a template for use of relational mapping more broadly.

Green horizons: Exploring the potential of vertical green walls

The term “Green walls” also known as vertical gardens or living walls has emerged as a promising solution to combat the environmental challenges posed by rapid urbanization. This review explores the concept ornamental, plant choice suitable and benefits associated with green walls in urban settings. Utilising vegetation to cover vertical surfaces, green walls offer several benefits to the environment, society and economy. They contribute to improved air quality, noise reduction, energy conservation and biodiversity enhancement. Vertical greenery allows for the utilization of unused wall surfaces, creating green areas without occupying valuable ground space, which is often scarce in urban environments. Additionally, green walls offer aesthetic appeal, promote urban agriculture and create opportunities for community engagement. However, their implementation requires careful consideration of factors such as structural integrity, irrigation and maintenance. Despite these challenges, green walls offer a sustainable and innovative approach to enhancing the quality of urban life while mitigating the negative impacts of urban development on the environment. The current emphasis highlights the significance of green walls as an effective tool in sustainable urban planning, underscoring the need for further research and their integration into urban planning practices.

The Evolution of Potable Water Security: A Temporal Analysis of Key Indices and Trends

Water security is a critical global issue that has gained increasing attention from researchers, policymakers, and practitioners over the past few decades. This paper presents a comprehensive overview of the evolution of potable water security indices from the 1980s to the 2020s, focusing on the key research themes, trends, and influential factors in the field. We conducted a comprehensive search of the relevant literature and examined the development of water security indices to provide insights into the current state of research and identify future research directions. This paper will explore the historical context, key indicators, sector-specific challenges, climate change implications, governance and policy considerations, technological advancements, community engagement efforts, and future directions for research in this critical field. Researchers and policymakers will find this review valuable as it offers insights into the existing knowledge and the areas that require further exploration to address global water security challenges.

Practices and Challenges on the Relationship to Support the Goals of Impact Ranked Universities in the Philippines

This study investigated the collaborative efforts of Philippine Higher Education Institutions (PHEIs) with NGOs, government agencies, and other stakeholders in advancing the Sustainable Development Goals (SDGs). By leveraging their academic capabilities, PHEIs ranked by the Times Higher Education Impact Ranking played a crucial role in addressing global challenges through a multi-sectoral approach. This study emphasized the importance of collaborating with regional NGOs and government agencies for policy-making and multi-sectoral dialogue in promoting participatory decision-making. It also highlighted the significance of international collaborations in standardizing data gathering and sharing best practices, thus enhancing the quality and impact of research related to public policy and sustainable development. PHEIs' engagement with NGOs was pivotal in mobilizing resources for community-targeted projects, including disaster risk reduction, health and well-being, educational outreach, and environmental conservation. These initiatives contributed to immediate community needs and built long-term resilience and sustainability. Findings revealed that PHEIs were not only centers of learning but also key players in the global sustainable development agenda. Their ability to bridge knowledge gaps, coupled with the operational reach of NGOs and the policy influence of government bodies, formed a powerful force for societal transformation. As the world progressed towards the 2030 Agenda, it was essential for PHEIs to strengthen partnerships, expand research scope, and enhance community engagement practices. This would not only advance the SDGs but also shape an inclusive and resilient sustainable future. The study called for continued innovation in partnership models and inclusive strategies that engaged all societal sectors, ensuring substantial and measurable progress towards the SDGs. The ongoing commitment of PHEIs would be crucial in achieving a sustainable world for future generations.

Community members’ perspective on social accountability in the health system: a cross- sectional study from Tanzania

Introduction: Social accountability initiatives are considered a way to address inefficiencies and improve overall health system performance. Tanzania has introduced Health Facility Governing Committees (HFGCs) to improve social accountability of the health system. However, information on how communities perceive these committees is lacking. This study aimed to assess the prevalence and social determinants of the HFGCs accountability from the community perspective in Tanzania. Methods: The research employed a cross-sectional survey design in two Tanzanian districts (Handeni and Mbarali) selected for their contrasting health performance. Data collection took place from July to October 2022, involving 1184 households in 31 villages/mitaa. The study measured social accountability through a set of six questions, focusing on community support, sensitization, feedback, trust, engagement, and overall accountability of HFGCs. Socio-demographic data such as sex, age, education, occupation, type of health facility and district were also collected and analyzed using linear regression to identify factors influencing perceptions of accountability. Results: The findings revealed a low prevalence of social accountability as measured by the variables of community awareness and engagement with the HFGCs. Only a small percentage of respondents felt adequately informed or involved in the activities of these committees. Social determinants such as higher education levels and certain occupations, such as business and retirement and those living in Handeni district, correlated positively with a better perception of social accountability. Conclusion: The study highlights significant challenges in the operational effectiveness of HFGCs in Tanzania, with a notable disconnect between these bodies and the communities they serve. Despite the theoretical framework for social accountability, actual community engagement remains low, impacting the overall efficacy of health governance at the local level. Future research should focus on improving community awareness and participation in these committees to improve their functionality and accountability, thereby aligning with national health objectives and local needs.