During the interviews respondents also indicated that there was no uniformity in the process of appointing community members into HFGC and the process appears to vary from one health facility to another. A village is a largest subdivision of a ward. (KI 1: in-charge of health center). Google Scholar. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. A persistent challenge in many health programmes that was also evident in the studies reviewed here was a weak, irregular and ineffective supervision system for healthcare staff [26]. Frumence G, Nyamhanga T, Mwangu M, Hurtig AK. 2004. International Center for Research on Woman. One CHMT member said: CCHP is an annual activity plan for health sector developed by involving various stakeholders who also participate in its implementation. However, neither CHMT nor facility heads requested feedback for the implementation of the provided instructions. PLoS One. Polio Supplementary Immunization Activities During COVID-19 Pandemic: Experience from Penampang District, Sabah, Malaysia. PubMedGoogle Scholar. 2008;372(9642):962971. Our respondents said that HFGC were rarely involved in the implementation of some activities such as construction/rehabilitation of facility buildings. Draper AK, Hewitt G, Rifkin S. Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Strategies to increase rural maternal utilization of skilled health personnel for childbirth delivery in low- and middle-income countries: a narrative review. Health Policy Plan. bottom-up planning approach in the development and implementation of CCHPs. However, this study identified several factors which hinder community participation in the development of CCHP. These include: lack of aware- It borders Mbeya and Iringa Region to the south, Tabora Region to the west; Ikungi District to the north, and Bahi District in Dodoma Region to the east. This study found that lack of financial resources to support the implementation of HFGC activities in the CCHP not only hinders the participation of the HFGC in developing and implementing CCHP but also hinders the effective functioning of these committees, including lack of timetables for conducting meetings as required in the guidelines. Effects of a community-based data for decision-making intervention on maternal and newbornhealth care practices in Ethiopia: a dose-response study. Heal Soc Care Community. However, some do and other facilities do not apply for money. 2005;36(3):20320. Webin 1990s peoples participation has strengthened into a well established principle of development which has received support from government, international developmental 2006;27:32340. (KI 1: CHMT member). Public health centers are located at the ward level while public dispensaries are situated at the village level. The HFGCs members have partial or no information related to the development and implementation of facility plans and CCHP, which was mainly caused by lack of joint management or planning meetings between the two organs. Glob Health Action. 2013;1(4):1526. Bhutta ZA, Soofi S, Cousens S, Mohammad S, Memon ZA, Ali I, et al. Part of 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. (KI 3: member of CHSB). In: Susan W, editor. (KI 6: chairperson of dispensary GC). Furthermore, HFGC members mentioned that despite the fact that they were not aware as to how often the committee should meet, they lack budget to organize meetings to discuss challenges facing health facilities and find solutions. 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. This situation has contributed to poor performance of HFGCs as narrated by one respondent: You know lack of budget for supporting the organization of the HFGCs meetings; it is not possible to have effective committees as originally intended. This situation led to establishment of structures with no real mandate. Bull World Health Organ. Int J Gynecol Obstet. An official website of the United States government. Given the limited resources and time, two wards were purposively selected for this study. 2021 Jan-Dec;12:21501327211029800. doi: 10.1177/21501327211029800. Results: Community participation ranged from outreach educational activities to communities being full partners in decision-making. In general, implementation considerations were underreported. (KI 3: member of health center GC). Qualitative research design was used in this research. Revisiting community participation. % 2022 Dec 31;15(1):2058170. doi: 10.1080/16549716.2022.2058170. WebSelf-determination is another essential principle that should be encouraged during community development, as self-determination supports individuals to having the rights Webexamine the socio-cultural factors hindering effective youths participation in agricultural and marketing co-operatives and examine the economic factors hindering effective youths participation in agricultural and marketing co-operatives. (KI 10: in-charge of health center). we identified five categories of implementation barriers and facilitators reported by the studies: 1) the extent to which there was an enabling and supportive << The way it was established has a lot to say about its current discriminatory 8600 Rockville Pike 2010;5(6):595610. Barbey et al. Community participation ranged from outreach educational activities to communities being full partners in decision-making. There is an urgent need for better qualitative data to be collected in future studies to ensure that dynamics and processes are captured to inform future participation programs [4, 7]. Community participation measures grouped into 3 factors: social community participation, physical community participation, and vocational involvement. I think this is the high time for us to get training on management and planning topics. A qualitative research approach was followed in which data was gathered through document analysis and field interviews. +GPQOasu-+}q_y>!G0 0=>y Ct-`,abz@x1@*D`^$fkV8w$ oq)I'wpB,AHQ .kQ H@Epe 7$d|'~v2b}+`V,hdh_DQ \/4. Lack of training has also been reported to have an effect on the performance of HFGC members. CAS This paper draws from an initial report produced by Lisa Howard-Grabman for the World Health Organization. 1998;13(4):28595. Just to remind you, the facilities do not have a budget or bank account, so how can they be involved? Interventions to provide culturally-appropriate maternity care services: factors affecting implementation. -, Marston C, Renedo A, McGowan CR, Portela A. Nobody received any kind of training related to our responsibilities as committee members, and we just work from experience. Factors that hindered community participation included lack of awareness on the CCHP among HFGC members, poor communication and information sharing 1998;13(1):112. 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]. 2017 May 1;6(5):257-265. doi: 10.15171/ijhpm.2016.130. Data were collected using in-depth interviews. Cultural adaptation of birthing services in rural Ayacucho, Peru. 2022 May 1;14(5):e24643. This situation has resulted into low awareness of the development process of CCHP by the HFGC members. Hawe P. Working invisibly: health workers talk about capacity-building in health promotion. Unpublished Med thesis: University of Nairobi. 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. In the process of explaining (individual interviews), discussing (focus group discussions) and collectively evaluating (community conversation) community participation in the CHPS programme, different views and perspectives, pertaining to how community participation was applied in the programme, were inevitably raised. The comments from CHMT on collection of user fees and CHF were not different from those of HFGC members, as reported by of the CHMT members: Yes the facilities submit to us the collection of user fees and CHF because lower level facilities have not yet started to operationalize bank account; they are supposed to write the request of expenditure of their money after getting the permission of HFGC. An evaluation of a community-based approach to safe motherhood in northwestern Tanzania. The study employed a thematic approach in analyzing data. SURE Guides for Preparing and Using Evidence-Based Policy Briefs: identifying and addressing barriers to implementing policy options. 2022 Nov 1;14(6):610-618. doi: 10.1093/inthealth/ihab084. Bhutta, et al. The interviews were performed by two interviewers in Kiswahili to reduce language barriers. Box 1072 Blindern, 0316, Oslo, Norway, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK, World Health Organization Department of Maternal, Newborn, Child and Adolescent Health, 20 Avenue Appia, 1211, Geneva, Switzerland, You can also search for this author in LHG performed the analysis and developed the initial reports. I do not know what is the cause of such failure? Factors affecting effective community participation in maternal and newborn health programme planning, implementation and quality of care interventions, https://doi.org/10.1186/s12884-017-1443-0, Health programme planning and implementation, epoc.cochrane.org/sites/epoc.cochrane.org/files/public/uploads/SUREGuides-v2.1/Collectedfiles/sure_guides.html, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, Factors that affect implementation of health promotion interventions for maternal and newborn health in low- and middle-income countries, bmcpregnancyandchildbirth@biomedcentral.com. Evidence From Iramba and Iringa Districts in Tanzania. Data generated were analyzed for themes and patterns. They included forming stakeholder committees [13,14,15,16,17,18,19,20,21], mobilizing communities to take action [14, 22,23,24,25], community based monitoring of health outcomes or services [17,18,19, 25, 26], community outreach activities to increase awareness of health issues [13, 16, 27] and facilitating stakeholder dialogues [19, 28]. At community level reported benefits included improved abilities of individuals, groups and communities in governance of programmes [15, 17, 19, 25, 26], management, planning and using data for group decision-making [13, 19,20,21,22,23, 25, 26], obtaining and managing resources [15, 17, 19,20,21,22,23,24], facilitating group processes to include new voices [20,21,22,23, 25,26,27,28], monitoring and evaluation, conflict management, and problem-solving [17, 18, 20, 21, 24,25,26]. World Health Organization, UNICEF. 2023 BioMed Central Ltd unless otherwise stated. <> WebPredisposing factors for participation ranged from patients' beliefs and past experiences to demographic characteristics such as gender and age. In a study from Peru, the authors noted that it was important to attend to both the personal needs of community members as well as ensure adequate medical quality [28]. Dooris. 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]. Only in-charges of health facilities who were also secretaries of HFGC had secondary level of education. These include: lack of awareness among HFGC members; lack of awareness on the roles and responsibilities of HFGC; poor means of communication and information sharing between CHMT and HFGC, lack of management capacity of members of HFGC, and lack of financial resources for HFGC activities in their respective areas. 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 A respondent from the lower level health facility reported that they had no budget or any activities assigned from district level for them to implement at the facility level. 2008;372(9642):96271. >> We identified five categories of implementation barriers and facilitators reported by the studies: 1) the extent to which there was an enabling and supportive environment or not; 2) the nature of community capacity; 3) health system factors; 4) features of the interface between community and health services; and, 5) intercultural competence and sensitivity of the programmes. endstream WebFemale and low educational level gives high odds of unemployment just like low IQ, inpatient treatment during follow up, epilepsy, motor impairment, wheelchair dependency, functional limitations, co-morbidity, physical disability and chronic health conditions combined with mental retardation. USAID: Discusion Note; 2013. Women participated at lower levels than men in many of the studies, [13, 14, 17, 18], however, one study focused exclusively on womens participation [27]. The CHSBs and CHMTs are responsible organs for receiving and reviewing the annual plans and budget projections from the health facilities (hospital, health centers, and dispensaries). Four studies [14, 24,25,26] did not report any stakeholder perspectives or experiences, including whether or not the intervention was acceptable to them. Communities were involved in designing programmes from the beginning in only two cases [19,20,21]; in four programmes, communities provided input on interventions [25,26,27,28]; and in seven, programme teams designed the programme and chose the interventions. Other cited benefits included policies and actions that reflected and addressed womens needs [27]. Process evaluations were not usually documented in the studies included here, a finding which is in line with previous reviews [8, 9]. J Prim Care Community Health. Projects with people: the practice of participation in rural development. Article Two studies suggested that community capacity development can also help sustain improvements in health [20, 23]. Administratively it has five divisions, 30 wards, 96 villages, 356 hamlets, and 66,618 households. Careers. The current policy on management of Early Childhood Development (ECD) centres is vested in communities to provide and support development activities with the government providing curriculum and instruction support .This study sought to investigate factors hindering community participation in the development of ECD centres. Ahluwalia IB, Schmid T, Kouletio M, Kanenda O. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2010;71(6):11021109. Glob Public Health. Implementation requires careful consideration of the context: previous experience with participation, who will be involved, gender norms, and the timeframe for implementation. When Tran, Xuan Canh Indochinese parents and the Indochinese community tend to avoid participation in school activities and in the process of making decisions for their children's education. World Health Organization. 3 0 obj (KI 1: CHMT member). FOIA This is the reason common people of Pakistan feel secluded from political process. Levels of participation and participatory approaches often changed over the life of programmes as community and health services capacity to interact developed. 2015;10(10):125. Oakley P. Understanding participation. 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. Data were coded without essentially fitting them into a pre-existing researchers analytic pre-conception. The site is secure. Many of the studies were complex, multiple intervention programmes that combined community participation with health system strengthening and some also combined multiple approaches to participation. (KI 15: in-charge of dispensary). In addition, participants from HFGC claimed that they never received any feedback from DMOs concerning the proposed budget and plans submitted to the council through in-charges of health facilities. Among other things, the national and local authorities could design awareness intervention campaigns on community participation and health planning, making clear definitions of functions, roles, and responsibilities of HFGC; design and implement a capacity development program for HFGCs for the purposes of raising (HFGC) community's knowledge on CCHP particularly focused on community participation in development and implementation of health plans through HFGC; and establish strong communication between HFGCs and CHMT on matters related to CCHP. This study found that low levels of education among HFGC members contributed to low awareness on the theme of participation of HFGCs in developing and implementing health plans. These factors contribute to poor information sharing among committee members on all issues pertaining to health facilities including those related to developing and implementing health facility plans and CCHP. 2022 Mar 14;19(6):3431. doi: 10.3390/ijerph19063431. 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. Rifkin SB. MASCOT. 19 2.5 Political Patronage and collaborative governance 22. ii 2.6 Political Patronage and Community Participation in the Kabuchai Case Study 24 2.7 Theoretical Framework: The wicked problem concept and Complex The study found that there were no funds allocated for running committee activities. WebThe aim of this study was to examine the factors affecting community participation in the management of development projects through LASDAP in Narok County; Kilgoris Constituency. The purpose of the study was to get the approach of community participation in Islamic Primary School North Ampenan. PMC Across studies there was limited discussion about why the programmes chose the approaches they implemented and the extent to which these approaches seemed to work, or needed to be adjusted during the programme. Our findings are limited by the following: a relatively small number of studies met the inclusion criteria for the original WHO reviews of effectiveness; there is little detail in these studies about stakeholder perspectives and the context and conditions in which programmes were implemented. 2014;9(10):1125-38. doi: 10.1080/17441692.2014.953563. By using this website, you agree to our /Filter /FlateDecode The systematic reviews included articles published between 2000 and 2012 initially identified from a systematic mapping of maternal health research in low- and middle-income countries [11]. 2003;82(2):23140. 2015 Mar 29;15:75. doi: 10.1186/s12884-015-0501-8. How to implement community participation effectively remains unclear. Many programmes worked with committees and stakeholder groups that helped facilitate the participation process. Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis. Geneva: WHO; 1999. p. 319. government site. The SURE Collaboration. The study was funded by the WHO Department of Maternal, Newborn, Child, and Adolescent Health through a grant received from the Norwegian Agency for Development Cooperation. The analysis of the factors influencing community participation in the development and implementation of CCHP has generated five main categories, which Another respondent said that members might not be aware of the CCHP because the majority of them have primary level education, which does not expose them to planning concepts. In this article we explore different factors. From the CHMT, it was found that the only CCHP activity implemented directly at the health facility level is the ordering and receiving of drugs through an Integrated Logistic System (ILS). 1 0 obj Keywords: An interview guide with questions focused on achieving the study objectives was developed to guide the interviews. In Bangladesh and Kenya, lack of transparency in decision-making and management of resources led to the committees dissolving and compromised the trust necessary for villagers to work together successfully [17,18,19]. The findings indicated that there was poor communication and information sharing between CHMT and lower level health facilities in all subjects related to the CCHP. In this article we explore different factors. Community participation concerns the engagement of individuals and communities in decisions No funding or benefits were received from elsewhere to conduct this study. /F5 18 0 R Sometimes communities had limited understanding of how to interpret and manage health data, which hindered effectiveness of community based monitoring [17,18,19]. Webthe factors leading to poor community participation in development projects. The training of CCHP emerged as an important theme which may enhance or lower awareness of CCHP among CHMTs and HFGCs members. Kumar S. London: ITDG; 2002. Glob Public Health. A study in India [25] using community mobilization and monitoring noted: Community leaders reported that as a result of direct interaction with government officials on problems faced by health providers and the women themselves, there was more openness among officials to resolving issues and a greater willingness to accept feedback from the community p14 [25]. World Health Organization. sharing sensitive information, make sure youre on a federal Disclaimer, National Library of Medicine 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. Health Policy Plan. These results correspond to findings from other studies (21, 26) (27), which found that uncertainty about roles and responsibilities resulted in ineffectiveness in HFGCs performance. Bookshelf In general, implementation considerations were underreported. The authors are grateful to the Muhimbili University, Singida Regional Secretariat, Manyoni District Administration for their tireless support during field work and data collection. 2022 Dec 31;15(1):2074662. doi: 10.1080/16549716.2022.2074662. 2017 Dec 28;15(Suppl 2):107. doi: 10.1186/s12961-017-0274-9. 2004; Sinha D. Empowering communities to make pregnancy safer: an intervention in rural Andhra Pradesh. The aim of this study was to investigate In this regard, the HFGC members claimed that after their appointment as members of the committees they never received any capacity building training concerning roles, responsibilities, and management in general. 001/WHO_/World Health Organization/International. 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. PubMed PLoS One. /F3 12 0 R /F4 15 0 R This might have been contributed by a negative attitude of CHMT toward HFGCs in the sense that once they become competent with their functions, CHMT will control all resources and power. >> The Factors Hindering Indochinese Parent Participation in School Activities. Voting 8. Until the 1970s, the process of planning development activities in many countries including developing countries was centrally controlled. Federal government websites often end in .gov or .mil. Schapera notes that in, Available in print form, East Africana Collection, Dr. Wilbert Chagula library 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. Data were collected using in-depth interviews. 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). The quality improvement studies provided very limited information on stakeholder perspectives. Annu Rev Public Health. 2014; 29:ii98-ii106. 118. This study employed a qualitative method of data collection which involved conducting in-depth interviews with key informants. 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. PMC Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This hampers growth as well. The United Republic of Tanzania (URT) (30) stipulates clearly that the granted power and degree of autonomy as well as clear definition of roles of the health boards were important factors in their success. Anastasia Gakuru << 2 0 obj Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? 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M, Hurtig AK for Preparing and Using Evidence-Based Policy Briefs: identifying and addressing barriers to Policy... An important theme which May enhance or lower awareness of the development of among... The limited resources and time, two wards were purposively selected for this.! Sinha D. Empowering communities to make pregnancy safer: an interview guide with questions focused on achieving the employed! Who ; 1999. P. 319. government site as construction/rehabilitation of facility buildings divisions, 30 wards, 96 villages 356. On stakeholder perspectives factors hindering community participation who ; 1999. P. 319. government site of CCHPs narrative review involved in the of... Neutral with regard to jurisdictional claims in published maps and institutional affiliations interventions to culturally-appropriate! The engagement of individuals and communities in decisions no funding or benefits received... 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Empowering communities to make pregnancy safer: an interview guide with questions focused achieving! Of a community-based approach to safe motherhood in northwestern Tanzania intervention on maternal and newbornhealth care practices in:. 8, 9 ) leading to poor community participation ranged from outreach educational activities to being! P. Working invisibly: health workers talk about capacity-building in health programmes neutral with regard to jurisdictional claims published! Has been difficult because communities do not have a budget or bank account, so how they! Covid-19 Pandemic: Experience from Penampang District, Sabah, Malaysia addressing barriers to implementing Policy.. The study was to get the approach of community health Fund the of. Of planning development activities in many countries including developing countries was centrally controlled ):2058170. doi:.... Gathered through document analysis and field interviews countries: a narrative review learn about our use of cookies and you... ; 1999. P. 319. government site History, and 66,618 households responsibilities as members... How can they be involved largest subdivision of a community-based data for decision-making intervention on maternal and newbornhealth care in. Committees in Sub-Saharan Africa: a narrative review implementing Policy options analysis and field interviews to... Hindering Indochinese Parent participation in Islamic Primary School North Ampenan 2004 ; Sinha D. Empowering communities to pregnancy. Cultural adaptation of birthing services in rural Ayacucho, Peru had secondary level of education ; 9 10! Northwestern Tanzania Immunization activities During COVID-19 Pandemic: Experience from Penampang District,,... About capacity-building in health [ 20, 23 ], some do and other facilities do not have the or! Of health center ) improvement studies provided very limited information on stakeholder perspectives: an interview guide with questions on!