Close-to-community providers of health care: increasing evidence of how to bridge community and health systems

Theobald, Sally; Hawkins, Kate; Kok, Maryse; Rashid, Sabina Faiz; Datiko, Daniel Gemechu; Taegtmeyer, Miriam

doi:10.1186/s12960-016-0132-9

Cited by 18 publications

(12 citation statements)

References 14 publications

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“…Q-Corps volunteer programs should be guided and built through sound work regulations and quality improvement frameworks. It is also beneficial for governments to establish collaborative partnership with NGOs, community or professional associations whose members can be trained to oversee the program and provide supportive supervision and input (181). Moreover, while partnering with communities and other NGOs, appropriate coordination should be built at either the regional, district, or community level with delegated responsibilities.…”

Section: Promoting Community Partnerships For the Uptake Of Quality Mmentioning

confidence: 99%

Diagnosis of Human Immunodeficiency Virus Infection

Parekh

Fonjungo

et al. 2018

Clin Microbiol Rev

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SUMMARY HIV diagnostics have played a central role in the remarkable progress in identifying, staging, initiating, and monitoring infected individuals on life-saving antiretroviral therapy. They are also useful in surveillance and outbreak responses, allowing for assessment of disease burden and identification of vulnerable populations and transmission “hot spots,” thus enabling planning, appropriate interventions, and allocation of appropriate funding. HIV diagnostics are critical in achieving epidemic control and require a hybrid of conventional laboratory-based diagnostic tests and new technologies, including point-of-care (POC) testing, to expand coverage, increase access, and positively impact patient management. In this review, we provide (i) a historical perspective on the evolution of HIV diagnostics (serologic and molecular) and their interplay with WHO normative guidelines, (ii) a description of the role of conventional and POC testing within the tiered laboratory diagnostic network, (iii) information on the evaluations and selection of appropriate diagnostics, (iv) a description of the quality management systems needed to ensure reliability of testing, and (v) strategies to increase access while reducing the time to return results to patients. Maintaining the central role of HIV diagnostics in programs requires periodic monitoring and optimization with quality assurance in order to inform adjustments or alignment to achieve epidemic control.

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Section: Promoting Community Partnerships For the Uptake Of Quality Mmentioning

confidence: 99%

Diagnosis of Human Immunodeficiency Virus Infection

Parekh

Fonjungo

et al. 2018

Clin Microbiol Rev

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“…The intermediating role of community health workers is well-documented (Erasmus, 2014;Kok et al, 2017;Nading, 2013), and Standing and Chowdhury noted how, in commercialised healthcare systems, community health workers can assist healthcare users to 'negotiate pluralism and the market, to work out how to locate trusted forms of expertise ' (2008, p. 2105). Some behaviours described in this article have been similarly reported in research on community health work, including the promotion of dependency and extraction of payments (Abuya et al, 2012;Coffey, 2014), and detailed study of healthcare brokerage activities in communities would be a valuable contribution to the growing body of literature on the roles and motivations of community health workers (Kok et al, 2017;Theobald et al, 2016).…”

Section: Discussionmentioning

confidence: 66%

Brokerage in commercialised healthcare systems: A conceptual framework and empirical evidence from Uttar Pradesh

Hunter

2018

Social Science & Medicine

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In many contexts there are a range of individuals and organisations offering healthcare services that differ widely in cost, quality and outcomes. This complexity is exacerbated by processes of healthcare commercialisation. Yet reliable information on healthcare provision is often limited, and progress to and through the healthcare system may depend on knowledge drawn from prior experiences, social networks and the providers themselves. It is in these contexts that healthcare brokerage emerges and third-party actors facilitate access to healthcare. This article presents a novel framework for studying brokerage of access to healthcare, and empirical evidence on healthcare brokerage in urban slums in Lucknow, Uttar Pradesh. The framework comprises six areas of interest that have been derived from sociological and political science literature on brokerage. A framework approach was used to group observational and interview data into six framework charts (one for each area of interest) to facilitate close thematic analysis. A cadre of women in Lucknow's urban slums performed healthcare brokerage by encouraging use of particular healthcare services, organising travel, and mediating communications and fee negotiations with providers. The women emphasised their personal role in facilitating access to care and encouraged dependency on their services by withholding information from users. They received commission payments from healthcare programmes, and sometimes from users and hospitals as well, but were blamed for issues beyond their control. Disruption to their ability to facilitate low-cost healthcare meant some women lost their positions as brokers, while others adapted by leveraging old and new relationships with hospital managers. Brokerage analysis reveals how people capitalise on the complexity of healthcare systems by positioning themselves as intermediaries. Commercialised healthcare systems offer a fertile environment for such behaviours, which can undermine attainment of healthcare entitlements and exacerbate inequities in healthcare access.

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“…The series also explores how building trust in health systems can help eliminate health disparities (4). This recent series adds to a growing body of literature that examines how trusting relationships are essential at all levels of the health system, including influencing community health worker motivation and performance (5,6).…”

Section: Introductionmentioning

confidence: 99%

Trust is the engine of change: A conceptual model for trust building in health systems

Adam

Donelson²

2020

Preprint

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Background: Physicians, health care organizations, governments and communities are increasingly interested in how trust is built throughout the health system. Current science on building trust draws on diverse literature from business and consumer science to healthcare, and theory development has predominately focused on factor based models. We propose a process based theoretical model for trust building which may better reflect the complex and dynamic nature of trust itself. In doing so, we propose a new measurable dimension of the trust building process: reciprocity cycles. Cooperative reciprocal relationships are its building blocks, enabling stakeholders to “try out” their interactions with less risk, and to calibrate their level of effort, time and emotional investment. Reciprocity cycles includes three measurable elements: common goals, self-interests and gratitude/indebtedness.Methods: We applied the model, developing outcomes and measures in close-to-community health partnerships in Kenya. A 3-day workshop designed to stimulate problem solving and collaborative teamwork using human centered design principles was offered in 2 community health units in diverse contexts (rural agrarian and peri-urban flower farm slum), each with about 30 community health volunteers (CHVs) serving a population of approximately 5,000. Each unit formed separate teams representing specific villages; we followed these 9 teams between 18 to 24 months.Results: All 9 volunteer CHV teams delivered on self-directed public health outcomes across the spectrum of social determinants of health over the follow up period, with no funding, only using their own locally available resources. Projects were diverse, including immunization, composting toilets, hygiene, neonatal and reproductive health and public gardening. All 9 teams demonstrated trust building reciprocity cycles with articulation of common goal, self-interest, and gratitude/indebtedness. Conclusion: A process model of trust building, defined by reciprocity cycles, can be stimulated with a short intervention (illustrated here in close-to-community health systems) resulting in trusting relationships that drive agency and co-production of positive outcomes for health systems. In addition, it offers a simpler, more useful framework for trust building and measurement than traditional models of trust in health systems research. Early findings illustrate reciprocity cycles are scalable and adaptable, with potential utility at multiple levels of health systems.

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Close-to-community providers of health care: increasing evidence of how to bridge community and health systems

Cited by 18 publications

References 14 publications

Diagnosis of Human Immunodeficiency Virus Infection

Diagnosis of Human Immunodeficiency Virus Infection

Brokerage in commercialised healthcare systems: A conceptual framework and empirical evidence from Uttar Pradesh

Trust is the engine of change: A conceptual model for trust building in health systems

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