Community Participation In Care Research Articles

Knowledge of health rights and community participation in primary care

Background/Aims Primary care providers are encouraged to promote community participation in care, so that patients are engaged in health priorities and solutions. This study assessed the level of knowledge regarding health rights and community participation in a town in Mizan-Aman, Ethiopia. Methods A community-based cross-sectional study design was used. A structured questionnaire was administered to 374 community health leaders assessing their knowledge of health rights and the level of community participation in primary care, according to five indicators: leadership, organisation, management, resource mobilisation and needs assessment. Results A total of 326 out of 374 questionnaires were returned. The majority (n=205, 62.9%) had limited knowledge of health rights, while 189 (58%) indicated poor community participation in primary healthcare. There was no significant association between knowledge of health rights and level of community participation. Conclusions Knowledge of health rights is generally lacking in these communities, as is public participation in primary care service planning. A community-based health education programme is needed to raise awareness of patient rights and enhance community participation in primary care.

On the move: exploring Inuit and non-Inuit health service providers\u2019 perspectives about youth, family and community participation in care in Nunavik

BackgroundLiterature about participation in health and social services suggests that youth, and more specifically Indigenous youth, are difficult to engage within health and social services. Youth are less likely to access services or to actively participate in decision-making regarding their personal care. Service providers play a crucial role in engaging youth based on the ways in which they seek, establish, and maintain relationships with youth and their families. The way in which providers engage with youth will depend on various factors including their own perceptions of the roles and relationships of the various people involved in youth’s lives. In this article, we analyze health and social service providers’ perspectives, experiences and expectations regarding the roles of Indigenous youth, families and community in care settings in Nunavik, Quebec.MethodsUsing a snowball sampling approach, we recruited 58 interview participants (39 non-Inuit and 19 Inuit), including psychiatrists, general practitioners, nurses, social workers, school principals, teachers, student counsellors, representatives of local committees, and police officers. The interviews focused on three broad areas: 1) participants’ current and past positions and roles; 2) participants’ perceptions of the clientele they work with (youth and their families); and 3) participants’ understandings of how collaboration takes place within and between services and the community. We conducted inductive applied thematic analyses and then analyzed the interview transcripts of Inuit and non-Inuit participants separately to explore the similarities and differences in perceptions based on positionality.ResultsWe organized the findings around three themes: I) the most commonly described interventions, II) different types of challenges to and within participation; and III) what successful participation can look like according to service providers. Participants identified the challenges that families face in moving towards services as well as the challenges that services providers face in moving towards youth and families, including personal, organizational and historical factors.ConclusionWe adopt a critical lens to reflect on the key findings in order to tease out points of tension and paradoxes that might hinder the participation of youth and families, specifically in a social context of decolonization and self-governance of services.

Care of stroke survivors in community: a case study of rural Thai community

PurposeThis study aims to describe survivors of stroke circumstances, issues with providing care for survivors of stroke and services expected by caregivers and survivors of stroke.Design/methodology/approachA qualitative research design was conducted in Singburi Province. Data collection methods included in-depth interviews, focus groups and participatory observations. Semi-structured in-depth interview guides, quality-of-life scale and depression scale were used to collect data from survivors of stroke, their caregivers, health personnel, local governors and village health volunteers. Naturalistic research tradition was used for qualitative data analysis and descriptive statistics for quantitative data analysis.FindingsThe majority of survivors of stroke had hemiplegic limb and severe deficits in their activities of daily living. Caregivers were family members, and they often developed depression. Issues with providing care to stroke survivors included lack of knowledge about stroke and home care, inadequacy and discontinuity of care and the shortage of stroke care personnel in the community. A stakeholder's expected stroke services included the provision of effective continuing care, community participation in care and enhancing the village health volunteer's capacity.Originality/valueThis study illustrated the stroke service systems in rural Thai communities. The study's findings could be applied when planning future research using community participation to test a model of care for stroke survivors to promote better outcomes and be responsive to the needs of stroke survivors, especially those who are disabled.

Ethical, Socioeconomic, and Cultural Considerations in Gynecologic Cancer Care in Developing Countries

Gynaecologic cancers contribute significantly to the cancer burden in developing countries, resulting in higher mortality and morbidity rates among women in these nations. This situation is further compounded by the occurrence of wars, famine, poverty and natural disasters, and infectious diseases like hepatitis B and HIV/AIDS. In addition, merge resources and manpower lack in these countries further compound this very delicate situation. Often times, socioeconomic, cultural, and ethical factors such as truth-telling, choice of place of care, place of death, treatment choices, medication use, and terminal sedation can interfere in patient management. Availability and use of oral morphine for pain relief, spiritual care and availability of palliative care services, the individuals’ autonomy, and family and community participation in care, end of life issues, and preservation of fertility are also big issues that determine the course of care. This review discusses these pertinent factors, discusses how they affect cancer care in women, and proffers ideas for healthcare workers and policy makers on implementation of sustainable models for cancer care in developing countries. Addressing socioeconomic, cultural, and ethical issues affecting gynaecologic cancer care will aid in ensuring development of viable models of cancer care in resource-limited countries.

Brazil: Progress in decentralising health care

In 1988 a law was passed to create a unified decentralized health system in which municipalities have a responsibility for developing health care. Secretaries of health from municipalities met with general practitioners public-health specialists administrators and representatives of UNICEF and PAHO to review the progress of decentralization. Progress has been slow as many smaller municipalities lack the money to plan health care and there are few training programs for general practitioners community nurses and managers. In Icapui Ceara inhabited by 14000 people a local health plan was developed in 1989 with health promotion community participation and primary health care. There was a pronounced fall in infant mortality in 1992 compared with 1991 and appropriate referral of patients to specialist facilities also improved. The general practitioner training program based at the Conceicao hospital group and in the surrounding community in Porto Alegre is now well established. In the state of Para health workers employed by a local nongovernment organization go by boat to villages along the banks of the Amazon and Tapajos rivers to deliver basic health care. The base clinic in the city of Santarem accepts referrals from these outlying villages. The Fundacion Carvajal supports innovative intersectoral work in Cali Colombia based on linking health with development by giving training to small local businesses and individuals to improve their performance. There is emphasis on community health care and much surgery has been devolved from the teaching hospital to small community hospitals. Further reforms include a more integrated approach with emphasis on equal access to care community participation and speeding up of decentralization. Other needs are the development of human resources for health care improved financing a system of referral and discharge and improved collaboration between municipalities. Networks are being set up to encourage the training managers general practitioners and other community health workers.