scholarly journals The role of community participation in primary health care: practices of South African health committees

2021 ◽  
Vol 22 ◽  
Author(s):  
Hanne Jensen Haricharan ◽  
Maria Stuttaford ◽  
Leslie London
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Human Rights ◽  
Primary Health Care ◽  
Community Participation ◽  
Policy Development ◽  
Primary Role ◽  
Cross Sectional Survey ◽  
Primary Health ◽  
Health Committee

Abstract Background: Community participation is an essential component in a primary health care (PHC) and a human rights approach to health. In South Africa, community participation in PHC is organised through health committees linked to all clinics. Aims: This paper analyses health committees’ roles, their degree of influence in decision-making and factors impacting their participation. Methods: Data were collected through a mixed-methods study consisting of a cross-sectional survey, focus groups, interviews and observations. The findings from the survey were analysed using simple descriptive statistics. The qualitative data were analysed using thematic content analysis. Data on health committees’ roles were analysed according to a conceptual framework adapted from the Arnstein ladder of participation to measure the degree of participation. Findings: The study found that 55 per cent of clinics in Cape Town were linked to a health committee. The existing health committees faced sustainability and functionality challenges and primarily practised a form of limited participation. Their decision-making influence was curtailed, and they mainly functioned as a voluntary workforce assisting clinics with health promotion talks and day-to-day operational tasks. Several factors impacted health committee participation, including lack of clarity on health committees’ roles, health committee members’ skills, attitudes of facility managers and ward councillors, limited resources and support and lack of recognition. Conclusions: To create meaningful participation, health committee roles should be defined in accordance with a PHC and human rights framework. Their primary role should be to function as health governance structures at facility level, but they should also have access to influence policy development. Consideration should be given to their potential involvement in addressing social determinants of health. Effective participation requires an enabling environment, including support, financial resources and training.

scholarly journals Effective and meaningful participation or limited participation? A study of South African health committee legislation

2021 ◽  
Vol 22 ◽  
Author(s):  
Hanne Jensen Haricharan ◽  
Maria Stuttaford ◽  
Leslie London
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Health Facility ◽  
National Policy ◽  
Health Care Facilities ◽  
Western Cape ◽  
Meaningful Participation ◽  
Primary Health ◽  
Health Committee

Abstract Background: Health committees are participatory structures providing community input in health systems. Community participation is a critical tenant in the Alma-Ata Declaration and the Right to Health. In South Africa, national and provincial legislation provides for health committees to be established at all primary health care facilities. Aims: This paper aims to analyze whether the Western Cape Health Facility Boards and Committees Act (2016) is likely to result in effective and meaningful participation consistent with a Primary Health Care (PHC) and human rights approach to participation. The paper also explores whether the provincial Act addresses challenges identified in practice. Methods: The methods consist of an analysis of the Western Cape Health Facility Boards and Committees Act, which is then compared to the international PHC and human rights approach to participation. Findings from an explorative mixed-methods study with health committees in Cape Town are used to discuss whether the Act addresses shortcomings identified in practised participation. Findings and analysis: The paper found that the current legislation is unlikely to lead to effective and meaningful participation. First, the roles prescribed in the Act are narrowly defined. They resemble roles practised and are inconsistent with right-based and PHC frameworks. Second, though the Act provides support, which the empirical research demonstrates is necessary, the support is insufficient, and often contingent. Third, the Act conceptualizes health committees as structures appointed by the Provincial Minister of Health; a formation process likely to lead to structures that do not adequately represent community interests. Conclusions: The paper argues that the Western Cape legislation is unlikely to lead to effective and meaningful participation. It suggests using international PHC and human rights frameworks and national policy documents to restructure health committee participation in the Act and the National Health Insurance Bill.

scholarly journals Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Service Users ◽  
Traditional Health ◽  
Healthcare Needs ◽  
Primary Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

Nursing Profession’s Contribution to Person- and People-Centered Primary Health Care

2015 ◽  
Vol 5 (4) ◽  
pp. 197-203
Author(s):  
Yukiko Kusano ◽  
Erica Ehrhardt
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Policy Development ◽  
Workforce Planning ◽  
Policy Decision ◽  
Well Being ◽  
World Health ◽  
Integration Of Care ◽  
Primary Health ◽  
Strategic Role

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.

scholarly journals Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey

10.2196/11147 ◽  
2018 ◽  
Vol 6 (12) ◽  
pp. e11147 ◽  
Author(s):  
Francesc X Marin-Gomez ◽  
Francesc Garcia Cuyas ◽  
Ramon Reig-Bolano ◽  
Jacobo Mendioroz ◽  
Pere Roura-Poch ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Networking ◽  
Health Care Professionals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Primary Health

Community Participation in the National Development Plan Through Primary Health Care

2019 ◽  
pp. 160-178
Author(s):  
Johannes Ntshilagane Mampane
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Community Participation ◽  
National Development ◽  
Development Plan ◽  
National Development Plan ◽  
Primary Health ◽  
Lgbt Community ◽  
Care Approach

The chapter explores and describes community participation in the National Development Plan through Primary Health Care by using case studies of LGBT organizations in South Africa. Post-Apartheid and democratic South Africa has endorsed community participation as one of the fundamental pillars of the public Primary Health Care approach in its governance structures. This chapter focuses on the current major health issue in South Africa, the HIV epidemic, which is one of the leading causes of death in the country. Particular attention is paid to members of the LGBT community because of their discrimination in public healthcare facilities on grounds of their sexual orientation. The chapter relies on secondary sources of data collection from extant literature, textbooks, journal articles, and internet sources. Challenges to address LGBT community discrimination in HIV testing, prevention, treatment, care, and support were identified and solutions to uphold their human rights were proffered. These solutions are based on the principles of social justice, inclusion, diversity, and equality.

Community Participation in the National Development Plan Through Primary Health Care

2022 ◽  
pp. 657-671
Author(s):  
Johannes Ntshilagane Mampane
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Community Participation ◽  
National Development ◽  
Development Plan ◽  
National Development Plan ◽  
Primary Health ◽  
Lgbt Community ◽  
Care Approach

The chapter explores and describes community participation in the National Development Plan through Primary Health Care by using case studies of LGBT organizations in South Africa. Post-Apartheid and democratic South Africa has endorsed community participation as one of the fundamental pillars of the public Primary Health Care approach in its governance structures. This chapter focuses on the current major health issue in South Africa, the HIV epidemic, which is one of the leading causes of death in the country. Particular attention is paid to members of the LGBT community because of their discrimination in public healthcare facilities on grounds of their sexual orientation. The chapter relies on secondary sources of data collection from extant literature, textbooks, journal articles, and internet sources. Challenges to address LGBT community discrimination in HIV testing, prevention, treatment, care, and support were identified and solutions to uphold their human rights were proffered. These solutions are based on the principles of social justice, inclusion, diversity, and equality.

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