The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Susan B. Rifkin - One of the best experts on this subject based on the ideXlab platform.
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chasing the dragon developing indicators for the assessment of Community Participation in health programmes
Social Science & Medicine, 2010Co-Authors: Alizon Draper, Susan B. Rifkin, Gillian HewittAbstract:Community Participation was identified as one of the key components of Primary Health Care as articulated in the Alma Ata declaration of 1978 and is enjoying a renewal of interest in both low and high income countries. There remains, however, an on-going challenge in how to assess its role in achieving health improvements. This is largely due to the multiplicity of definitions of Community Participation, which has made it difficult to evaluate its impact on desired programme outcomes, such as uptake and sustainability, as well as broader health improvements. This paper addresses this challenge by first defining a continuum of Community Participation that captures its many forms, and then incorporates this into an evaluation framework that enables an analysis of the process of Participation and links this with health and programme outcomes. The continuum of Participation and framework is based upon the spidergram of Rifkin, Muller, and Bichmann (1988), but modified in the light of the growing literature on Community Participation and also in relation to our original requirements to evaluate the role of Community Participation in nutrition-related child survival programmes. A case-study is presented to provide a worked example of the evaluation framework and its utility in the evaluation of Community Participation. While this is a literature-based and retrospective analysis, it demonstrates how the evaluation tool enables a nuanced analysis of the different ways in which communities can participate in the delivery of health-related interventions. It could be used prospectively by those involved in programme design and implementation to further our understanding of Community Participation and its relationship with health outcomes, as well as key programme outcomes, such as sustainability.
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lessons from Community Participation in health programmes a review of the post alma ata experience
International Health, 2009Co-Authors: Susan B. RifkinAbstract:Summary The year 2008 marked the 30 year anniversary of Primary Health Care, the health policy of all member nations of the WHO. Community Participation was one of the key principles of this policy. This article reviews the experiences of and lessons learned by policy makers, planners and programme managers in attempting to integrate Community Participation into their health programmes. The lessons, identified in an earlier article by the author, are still relevant today. They help to identify three reasons why integrating Community Participation into health programmes is so difficult. These reasons are: (1) the dominance of the bio-medical paradigm as the main planning tool for programmes, leading to the view of Community Participation as an intervention; (2) the lack of in-depth analysis of the perceptions of Community members regarding the use of Community health workers; and (3) the propensity to use a framework that limits investigation into what works, why and how in Community Participation in health programmes. Despite these challenges, evidence suggests that Community Participation has contributed to health improvements at the local level, particularly in poor communities, and will continue to be relevant to programme professionals.
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paradigms lost toward a new understanding of Community Participation in health programmes
Acta Tropica, 1996Co-Authors: Susan B. RifkinAbstract:Abstract Community Participation has been a critical part of health programmes, particularly since the acceptance of primary health care as the health policy of the member states of the World Health Organisation. However, it has rarely met the expectations of health planners/professionals. This paper argues that the reason for this failure is that Community Participation has been conceived in a paradigm which views Community Participation as a magic bullet to solve problems rooted booth in health and political power. For this reason, it is necessary to use a different paradigm which views Community Participation as an iterative learning process allowing for a more electric approach to be taken. Viewing Community Participation in this way will enable more realistic expectations to be made. Community Participation in disease control programmes focusing on Community health workers is used as an example to show the limitations of the old paradigm. Participatory rapid appraisal is used to illustrate the new.
Jane Farmer - One of the best experts on this subject based on the ideXlab platform.
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Community Participation for rural health: a review of challenges.
Health Expectations, 2014Co-Authors: Amanda Kenny, Jane Farmer, Virginia Dickson-swift, Nerida HyettAbstract:Context Internationally, Community Participation is highlighted in health policy reform as good for rural communities. Implicit in this policy is the message that the complexities of the rural environment are too difficult for easy solutions and that Community Participation will somehow build resilient, self-determining communities capable of dealing with complex rural access and equity issues and poorer health outcomes. The underpinning proposition is that by giving decision-making powers to Community members, health care will be locally responsive, costs will be contained, and health outcomes will improve. What happens in the practice of enacting Community Participation in health-care decision making is less clear. Objective Despite the growing body of work that documents different levels and models of Community Participation, significant gaps that outline the practical challenges inherent in rural Community Participation remain. In this article, we draw on a body of literature to outline the practical considerations in implementing Community Participation policy in health settings in rural areas. Through a critical review, we aim to stimulate debate, progress ideas and provide a conceptual representation of the somewhat ‘messy’ nature of rural Community Participation at a grass-roots organizational level. Discussion and conclusion Based on our analysis of the current literature, we provide a summary of challenges and practical strategies that might mitigate some of these challenges. Our review highlights that despite policymakers suggesting that Community Participation is good for rural communities, policy enactment must move beyond mandated tokenism for there to be a recognition that meaningful Participation is neither easy nor linear.
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Community Participation to design rural primary healthcare services.
BMC Health Services Research, 2014Co-Authors: Jane Farmer, Amy NimegeerAbstract:Background This paper explores how Community Participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community Participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many Community Participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates Community Participation. This paper addresses an evidence gap about the outcomes of using Community Participation in (re)designing rural Community health services.
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Community Participation in rural health a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dicksonswift, Peter OmearaAbstract:Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
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Community Participation in rural health: a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dickson-swift, Peter O'mearaAbstract:Background: Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. Methods: A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results: We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. Conclusions: In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
Judy Taylor - One of the best experts on this subject based on the ideXlab platform.
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Community Participation in rural primary health care intervention or approach
Australian Journal of Primary Health, 2010Co-Authors: Robyn Preston, Hilary Waugh, Sarah Larkins, Judy TaylorAbstract:Community Participation is considered important in primary health care development and there is some evidence to suggest it results in positive health outcomes. Through a process of synthesising existing evidence for the effectiveness of Community Participation in terms of health outcomes we identified several conceptual areas of confusion. This paper builds on earlier work to disentangle the conceptual gaps in this area, and clarify our common understanding of Community Participation. We conducted a research synthesis of 689 empirical studies in the literature linking rural Community Participation and health outcomes. The 37 final papers were grouped and analysed according to: contextual factors; the conceptual approach to Community Participation (using a modification of an existing typology); Community Participation process; level of evidence; and outcomes reported. Although there is some evidence of benefit of Community Participation in terms of health outcomes, we found only a few studies demonstrating higher levels of evidence. However, it is clear that absence of evidence of effect is not necessarily the same as absence of an effect. We focus on areas of debate and lack of clarity in the literature. Improving our understanding of Community Participation and its role in rural primary health care service design and delivery will increase the likelihood of genuine Community–health sector partnerships and more responsive health services for rural communities.
Amanda Kenny - One of the best experts on this subject based on the ideXlab platform.
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Community Participation for rural health: a review of challenges.
Health Expectations, 2014Co-Authors: Amanda Kenny, Jane Farmer, Virginia Dickson-swift, Nerida HyettAbstract:Context Internationally, Community Participation is highlighted in health policy reform as good for rural communities. Implicit in this policy is the message that the complexities of the rural environment are too difficult for easy solutions and that Community Participation will somehow build resilient, self-determining communities capable of dealing with complex rural access and equity issues and poorer health outcomes. The underpinning proposition is that by giving decision-making powers to Community members, health care will be locally responsive, costs will be contained, and health outcomes will improve. What happens in the practice of enacting Community Participation in health-care decision making is less clear. Objective Despite the growing body of work that documents different levels and models of Community Participation, significant gaps that outline the practical challenges inherent in rural Community Participation remain. In this article, we draw on a body of literature to outline the practical considerations in implementing Community Participation policy in health settings in rural areas. Through a critical review, we aim to stimulate debate, progress ideas and provide a conceptual representation of the somewhat ‘messy’ nature of rural Community Participation at a grass-roots organizational level. Discussion and conclusion Based on our analysis of the current literature, we provide a summary of challenges and practical strategies that might mitigate some of these challenges. Our review highlights that despite policymakers suggesting that Community Participation is good for rural communities, policy enactment must move beyond mandated tokenism for there to be a recognition that meaningful Participation is neither easy nor linear.
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Community Participation in rural health a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dicksonswift, Peter OmearaAbstract:Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
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Community Participation in rural health: a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dickson-swift, Peter O'mearaAbstract:Background: Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. Methods: A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results: We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. Conclusions: In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
Nerida Hyett - One of the best experts on this subject based on the ideXlab platform.
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Community Participation for rural health: a review of challenges.
Health Expectations, 2014Co-Authors: Amanda Kenny, Jane Farmer, Virginia Dickson-swift, Nerida HyettAbstract:Context Internationally, Community Participation is highlighted in health policy reform as good for rural communities. Implicit in this policy is the message that the complexities of the rural environment are too difficult for easy solutions and that Community Participation will somehow build resilient, self-determining communities capable of dealing with complex rural access and equity issues and poorer health outcomes. The underpinning proposition is that by giving decision-making powers to Community members, health care will be locally responsive, costs will be contained, and health outcomes will improve. What happens in the practice of enacting Community Participation in health-care decision making is less clear. Objective Despite the growing body of work that documents different levels and models of Community Participation, significant gaps that outline the practical challenges inherent in rural Community Participation remain. In this article, we draw on a body of literature to outline the practical considerations in implementing Community Participation policy in health settings in rural areas. Through a critical review, we aim to stimulate debate, progress ideas and provide a conceptual representation of the somewhat ‘messy’ nature of rural Community Participation at a grass-roots organizational level. Discussion and conclusion Based on our analysis of the current literature, we provide a summary of challenges and practical strategies that might mitigate some of these challenges. Our review highlights that despite policymakers suggesting that Community Participation is good for rural communities, policy enactment must move beyond mandated tokenism for there to be a recognition that meaningful Participation is neither easy nor linear.
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Community Participation in rural health a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dicksonswift, Peter OmearaAbstract:Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
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Community Participation in rural health: a scoping review
BMC Health Services Research, 2013Co-Authors: Amanda Kenny, Jane Farmer, Nerida Hyett, John Sawtell, Virginia Dickson-swift, Peter O'mearaAbstract:Background: Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community Participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level Community Participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level Community Participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level Community Participation in rural healthcare. Methods: A scoping review was designed to map the existing evidence base on higher level Community Participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results: We identified six articles that most closely demonstrated higher level Community Participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level Participation, little detail was provided about how groups were established and how the Community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from Community Participation were not rigorously measured. Conclusions: In an environment characterised by increasing interest in Community Participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.
