scholarly journals ‘They need to ask me first’. Community engagement with low‐income citizens. A realist qualitative case‐study

2022 ◽  
Author(s):  
Esther De Weger ◽  
Caroline Baan ◽  
Cheryl Bos ◽  
Katrien Luijkx ◽  
Hanneke Drewes
2020 ◽  
Vol 35 (4) ◽  
pp. 440-451
Author(s):  
Jennifer A Callaghan-Koru ◽  
Munia Islam ◽  
Marufa Khan ◽  
Ardy Sowe ◽  
Jahrul Islam ◽  
...  

Abstract There is a well-recognized need for empirical study of processes and factors that influence scale up of evidence-based interventions in low-income countries to address the ‘know-do’ gap. We undertook a qualitative case study of the scale up of chlorhexidine cleansing of the umbilical cord (CHX) in Bangladesh to identify and compare facilitators and barriers for the institutionalization and expansion stages of scale up. Data collection and analysis for this case study were informed by the Consolidated Framework for Implementation Research (CFIR) and the WHO/ExpandNet model of scale up. At the national level, we interviewed 20 stakeholders involved in CHX policy or implementation. At the district level, we conducted interviews with 31 facility-based healthcare providers in five districts and focus group discussions (FGDs) with eight community-based providers and eight programme managers. At the community level, we conducted 7 FGDs with 53 mothers who had a baby within the past year. Expanded interview notes were thematically coded and analysed following an adapted Framework approach. National stakeholders identified external policy and incentives, and the engagement of stakeholders in policy development through the National Technical Working Committee for Newborn Health, as key facilitators for policy and health systems changes. Stakeholders, providers and families perceived the intervention to be simple, safe and effective, and more consistent with family preferences than the prior policy of dry cord care. The major barriers that delayed or decreased the public health impact of the scale up of CHX in Bangladesh’s public health system related to commodity production, procurement and distribution. Bangladesh’s experience scaling up CHX suggests that scale up should involve early needs assessments and planning for institutionalizing new drugs and commodities into the supply chain. While the five CFIR domains were useful for categorizing barriers and facilitators, additional constructs are needed for common health systems barriers in low-income settings.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045624
Author(s):  
Tuba Saygın Avşar ◽  
Louise Jackson ◽  
Hugh McLeod

IntroductionTobacco control during pregnancy is a policy priority in high-income countries (HICs) because of the significant health and inequality consequences. However, little evidence exists on interventions to reduce tobacco use in low-income and middle-income countries (LMICs), especially for pregnant women. This study aimed to assess how health economics evidence, which is mainly produced in HICs, could be adopted for tobacco cessation policies for pregnant women in LMICs.MethodsA qualitative case study was conducted in an international public health organisation. The organisation was chosen due to its capacity to influence health policies around the world. Tobacco control experts working in the organisation were identified through purposeful sampling and snowballing. Semistructured interviews were conducted with 18 informants with relevant experience of countries from all of the regions covered by the organisation. Data were analysed using the framework method.ResultsIn practice, tobacco cessation during pregnancy was not viewed as a priority in LMICs despite international recognition of the issue. In LMICs, factors including the recorded country-specific prevalence of tobacco use during pregnancy, availability of healthcare resources and the characteristics of potential interventions all affected the use of health economics evidence for policy making.ConclusionThe scale of tobacco use among pregnant women might be greater than reported in LMICs. Health economics evidence produced in HICs has the potential to inform health policies in LMICs around tobacco cessation interventions if the country-specific circumstances are addressed. Economic evaluations of cessation interventions integrated into antenatal care with a household perspective would be especially relevant in LMICs.


2021 ◽  
Author(s):  
Daniel de Vries ◽  
John Kinsman ◽  
Anne Cremers ◽  
John Angrén ◽  
Svetla Tsolova ◽  
...  

Abstract BackgroundCommunities affected by infectious disease outbreaks are increasingly recognised as partners with a significant role to play during public health emergencies. This paper reports on a qualitative case study of the interactions between affected communities and public health institutions prior to, during, and after two emerging tick-borne disease events in 2016: Crimean-Congo Haemorrhagic Fever in Spain, and Tick-Borne Encephalitis in the Netherlands. The aim of the paper is to identify pre-existing and emergent synergies between communities and authorities, and to highlight areas where synergies could be facilitated and enhanced in future outbreaks.MethodsDocumentary material provided background for a set of semi-structured interviews with experts working in both health and relevant non-health official institutions (13 and 21 individuals respectively in Spain and the Netherlands), and focus group discussions with representatives of affected communities (15 and 10 individuals respectively). Data from all sources were combined and analysed thematically, initially independently for each country and then for both countries together.ResultsStrong synergies were identified in tick surveillance activities in both countries, and the value of pre-existing networks of interest groups for preparedness and response activities was recognised. However, authorities also noted that there were hard-to-reach and potentially vulnerable groups, such as hikers, foreign tourists, and volunteers working in green areas. While the general population received preventive information about the two events, risk communication or other community engagement efforts were not seen as necessary specifically for these sub-groups. Post-event evaluations of community engagement activities during the two events were limited, so lessons learned were not well documented.ConclusionsA set of good practices emerged from this study, that could be applied in these and other settings. They included the potential value of conducting stakeholder analyses of community actors with a stake in tick-borne or other zoonotic diseases; of utilising pre-existing stakeholder networks for information dissemination; and of monitoring community perceptions of any public health incident, including through social media. Efforts in the two countries to build on the community engagement activities that are already in place could contribute to better preparedness planning and more efficient and timely responses in future outbreaks.


2017 ◽  
Vol 2 (2) ◽  
pp. 63-88
Author(s):  
Froilan Tuccat Malit Jr ◽  
Mouawiya Alawad ◽  
George Naufal

This paper examines how and why migrants remit through unauthorized remittance channels (namely the hawala or hundi) and investigates the hawala's developmental roles and effects on migrants’ socioeconomic status. Applying a qualitative case study of 30 low-income Pakistani migrants in Dubai, we argue that the thriving yet unauthorized status of the hawala system is a unique product of global migration process. In contrast to the dominant literature on the nexus between the hawala and terrorist and criminal-related financing, we assert that the sustainability of the hawala is the result of an ongoing effort of low-income migrants to increase their remitting power, providing money that is crucial to their families’ socioeconomic status within the con-text of rapidly globalizing forces. This study provides both important empirical and theoretical insights into the hawala's complex relevance for low-income migrants, governments, and international organizations in global migration context.


2015 ◽  
Vol 47 (6) ◽  
pp. 661-671
Author(s):  
Joanna Lucio ◽  
Erica McFadden

Although public and private management approaches have been frequently analyzed for their outcomes along the lines of efficiency and equity, their relationship to fostering community resilience has been understudied. Public housing has undergone a market-based transition, devolving management and operations of its sites or tenants to private management companies. This multi-site case study evaluates different management contexts to understand how management processes encourage or discourage community resilience. Findings include that management can play an integral role in developing community resilience by providing spaces and opportunities for community engagement and resident empowerment. To better navigate in an era of austerity measures, this article recommends practitioners actively leverage and invest in citizen strengths to build more resilient programs.


Author(s):  
Sara Dorow ◽  
Nicole Smith-Acu

Engaged scholarship is increasingly concerned with how community engagement might be institutionalized in the contemporary university. At the same time, it must be attentive to diverse academic approaches to knowledge and to the forms of engagement associated with them. Attention to this plurality is especially important in the humanities, arts, and social sciences (HASS). Based on a multi-method study conducted in the Faculty of Arts at a large western Canadian research university, this paper maps the demographic positions (gender, rank, and discipline) and scholarly dispositions (stances adopted toward the production of knowledge and the role of the academic) of HASS faculty and contract instructors onto the range of ways they perceive and practice engagement. Against this backdrop, we present a qualitative case study of two pairs of faculty that fleshes out the complexities and possibilities of divergent dispositions and the forms and experiences of engagement with which they are associated. We assert that understanding differentiated starting points to knowledge production among HASS academics is an important pathway to the fuller recognition and flexible institutionalization of engagement in research universities.  


2019 ◽  
Vol 12 (2) ◽  
pp. 265-280 ◽  
Author(s):  
S. Sunarti ◽  
Joesron Alie Syahbana ◽  
Asnawi Manaf

PurposeWithin low-income communities in urban slums, access to housing is limited because individuals in these communities cannot afford to purchase homes. One area of Indonesia with these conditions is Kampung Kajen, Danukusuman, Surakarta, where, oftentimes, a single house is inhabited by several families and is passed down from generation to generation. This causes a change in space, a narrowing of that which is inhabited by the next generation. This paper aims to examine the transformation of space within low-income homes in Kampong Kajen.Design/methodology/approachThe research method was a qualitative case study approach, and data were collected through direct interviews and field observation. Informants in this study were classified into three groups: residents, non-residents and government agencies.FindingsThe space transformation that occurred in the studied samples was partial. The transformation continued to occur as the new families grew, and the area of space used by the new families experienced a narrowing for future generations.Originality/valueThe novelty of this research is in regard to the findings about the partial transformation of the house from generation to generation, which details changes in the layout and the extent of the house interior, the narrowing of the house, the change of owners and the changing behaviour of the house inhabitants. Partial transformation continues to occur in line with the addition of new families living in one house.


2021 ◽  
Vol 15 (2) ◽  
pp. 155798832110055
Author(s):  
Joseph B. Richardson ◽  
William Wical ◽  
Nipun Kottage ◽  
Mihir Chaudhary ◽  
Nicholas Galloway ◽  
...  

Low-income young Black men experience a disproportionate burden of violent injury in the United States. These men face significant disparities in healthcare insurance coverage and access to care. The Affordable Care Act (ACA) created a new healthcare workforce, Navigators and In-Person Assisters (IPAs), to support low-income minority populations with insurance enrollment. Using a longitudinal qualitative case study approach with Navigators and IPAs at the two busiest urban trauma centers in Maryland, this study identifies the culturally and structurally responsive enrollment strategies used by three Navigators/IPAs as they enrolled violently injured young Black men in healthcare insurance coverage. These approaches included gaining their trust and building rapport and engaging female caregivers during enrollment. Navigators and IPAs faced significant barriers, including identity verification, health literacy, privacy and confidentiality, and technological issues. These findings offer novel insight into the vital work performed by Navigators and IPAs, as they attempt to decrease health disparities for young Black male survivors of violence. Despite high rates of victimization due to violent firearm injury, little is known about how this population gains access to healthcare insurance. Although the generalizability of this research may be limited due to the small sample size of participants, the qualitative case study approach offers critical exploratory data suggesting the importance of trauma-informed care in insurance enrollment by Navigators and IPAs. They also emphasize the need to further address structural issues, which affect insurance enrollment and thus undermine the well-being of young Black men who have survived violent injury.


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