Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review

George, Asha; Scott, Kerry; Mehra, Vrinda; Sriram, Veena

doi:10.1186/s12913-016-1860-1

Cited by 49 publications

(45 citation statements)

References 90 publications

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“…[9][10][11] Furthermore, there is a concern that CE in health research is rarely community directed, often tokenistic in practice, and may not amount to genuine engagement, empowerment, or consideration for the diverse, heterogeneous concerns and priorities of these communities. 1,5,[12][13][14][15][16][17][18] The spectrum of engagement can vary from community acknowledgment at a superficial level to community-based action research (CBAR). The focus of this article is on CE, which is a more flexible approach that is not so prescriptive in its intention and outcome.…”

Section: Introductionmentioning

confidence: 99%

Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking

Moodley

Beyer

2019

Biopreservation and Biobanking

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Introduction: Community engagement (CE) is an ethical imperative in research, but the knowledge base for what constitutes effective and ethically sound CE is limited. Ubuntu, as a component of responsive communitarianism where communal welfare is valued together with individual autonomy, is useful in furthering our understanding of effective CE and how it could best be achieved. Similarly, a relative solidarity model serves as a compromise between extreme individualism and extreme communalism and is more appropriate in a heterogenous African context. Approaching CE from an Ubuntu philosophical perspective in southern Africa is particularly important in genomic biobanking, given the implications for individuals, families, and communities. Discussion: CE is often implemented in a tokenistic manner as an ancillary component of research. Understanding consent information is challenging where genomic biobanking is concerned due to scientific complexity. We started a process of CE around genomic biobanking and conducted empirical research in an attempt to develop a model to promote effective and ethically sound CE, using relative solidarity to create a nuanced application of Ubuntu. The TRUCE model is an eight-step model that uses social mapping to identify potential communities, establishes the scope of CE, and requires that communities are approached early. Co-creation strategies for CE are encouraged and co-ownership of knowledge production is emphasized. Recruiting and engaging communities at each stage of research is necessary. Evaluation and adaptation of CE strategies are included. Discussion and dissemination of results after the research is completed are encouraged. Conclusions: There is a significant gap between the theory of CE and its authentic application to research in Africa. This Ubuntu-inspired model facilitates bridging that gap and is particularly suited to genomic biobanking. The CE model enhances and complements the consent process and should be integrated into research as a funding and regulatory requirement where applicable.

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Section: Introductionmentioning

confidence: 99%

Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking

Moodley

Beyer

2019

Biopreservation and Biobanking

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“…Approaches like community organising or community-based participatory research activities may also act on community capacities, as well as help build relationships with other stakeholders. Together, these may help people living in more disadvantaged circumstances advocate for changes that can improve health and wellbeing (21)(22)(23). In contrast, forms of participation such as local government or other statutory organisations inviting people to participate, listen and respond, may function in a different way; by demonstrating to people that their competences/views are valued, reinforcing motivations to participate, and a sense that people can make a difference to living conditions (19,27).…”

Section: Discussionmentioning

confidence: 99%

“…2), with the greatest proportion of qualitative or case study design (see Table 1). We supplemented the European empirical literature (35 studies) with nine non-European papers containing theoretical models or frameworks (19)(20)(21)(22)(23)(24)(25)(26)(27). These models included the participation chain model (19), social innovation theory (20), a community capacity model (21), community capability model (22), decision process model (25), and the biographical approach (26).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The next was a 2012 review of involvement strategies in environmental projects (29). Two 2016 reviews explored evidence on pathways from control to health inequalities, (10) and community capability (22). A review in 2017 explored evidence regarding public and stakeholder engagement in the built environment (30), and another in the same year focused on community engagement (11).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Increasing Public Participation and Influence in Local Decision-making to Address Social Determinants of Health During Times of Resource Constraint: A Systematic Review Examining Initiatives and Theories

Baxter¹,

Barnes²,

Lee³

et al. 2020

Preprint

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Background: Creating conditions for people to exert influence and control within their lives is an important determinant of health, and crucial in addressing health inequity. Globally, governments, communities, and other partners are experimenting with initiatives to support public participation at a local level. Little is known about how different approaches work, and how changing economic circumstances including the worldwide financial crisis and COVID-19 pandemic create challenging circumstances for implementation. This review examined evidence on initiatives to increase peoples’ involvement in local decision-making, with a focus on how this may be affected by resource constraints. Methods: We carried out a mixed-method systematic review of European empirical literature published since 2008, on initiatives aiming to increase public participation in local decision-making/action which could affect public health outcomes. We supplemented this with worldwide literature outlining theories and frameworks to explore potential change pathways. We used narrative synthesis to analyse the literature identified, and a summary diagram to provide a reporting structure.Results: We included 42 documents. Much literature was from the United Kingdom, and of qualitative or case study design. There was limited reporting of the forms and intended/actual functions of initiatives to enhance public participation and influence. Diverse factors (organisational and community-related factors, features of the participatory process) were noted to shape pathways to potential outcomes. Positive and adverse outcomes were reported for communities, individuals, relationships, and the decision-making process. The review highlights how initiatives may be at risk during times of limited resourcing; undermining individual and community capacities to participate, and requiring organisational leaders to think/act differently. Conclusions: Areas to prioritise for action within local governance systems include: supporting community capabilities; relationships between organisations and communities; creating spaces for safe/equitable interaction and knowledge-sharing; and changing institutional culture. If investment is to be made by local governments or communities themselves in times of resource-constraint, there is an urgent need to clarify the functions of different activities and pathways to improvements in determinants of health and inequity. Support to enable change is needed, particularly in response to deep-seated issues within local governance systems, and more explicit engagement with concepts of politics and power.

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“…This study is part of the Future Health Systems Research Programme Consortium, which defined community capability as the combined influence of a community’s social systems and collective resources that can be applied to address community problems and broaden community opportunities [26]. In the present, article we focus on two specific dimensions of community capacity: household head’s membership in community organizations and perceived community cohesion and explore its association with children’s nutritional adequacy.…”

Section: Introductionmentioning

confidence: 99%

How is perceived community cohesion and membership in community groups associated with children’s dietary adequacy in disadvantaged communities? A case of the Indian Sundarbans

Barman

Vadrevu

2016

BMC Health Serv Res

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BackgroundMembership in community groups and a sense of community cohesion may facilitate collective action in mobilizing resources towards better health outcomes. This paper explores the relationship of these factors, along with individual level socio-economic variables, to dietary adequacy among children below 6 years of age, a proximate determinant of child malnutrition.MethodsWe conducted a cross-sectional survey in Patharpratima block of the Sundarbans in West Bengal, India, using a two-stage, 30 cluster random sampling design. In 1200 sampled households, we used a structured questionnaire to interview mothers of children below 6 years of age on their child’s nutritional intake. We also interviewed household heads to assess perceived community cohesion using a nine item scale, membership in any community self-help organization, and other socio-economic determinants. We used a logistic regression model to assess their association with a minimum acceptable diet among children between 6 months to 6 years.ResultsOnly 9.33 % children between 6 and 71 months of age received a minimum acceptable diet. With each increase in the perceived community cohesion score (scale 0-9), a child is 1.31 times more likely to have minimum acceptable diet (95 % CI 1.14, 1.50). The odds of minimum acceptable diet were also higher among children whose mothers had primary education (2.09, 95 % CI 1.03, 2.94) as compared to illiterate mothers and in households with surplus food resources (2.72, 95 % CI 1.32, 5.58) as compared to those without surplus or deficit. In contrast, registering at an Anganwadi (government early child development) centre (odds ratio 1.34 95 % CI 0.69, 2.60) and community membership (odds ratio 0.93, 95 % CI 0.59, 1.46) were not associated with minimum acceptable diet.ConclusionThe results are consistent with what is known about the importance of maternal education and access to food resources in ensuring that children have a minimum acceptable diet. Perceived community cohesion seems to play a positive role in children’s diets. Further research needs to clarify which community characteristics and services are the most relevant, how they can better support children’s diets, and how interventions can strengthen these community characteristics and services.

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Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review

Cited by 49 publications

References 90 publications

Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking

Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking

Increasing Public Participation and Influence in Local Decision-making to Address Social Determinants of Health During Times of Resource Constraint: A Systematic Review Examining Initiatives and Theories

How is perceived community cohesion and membership in community groups associated with children’s dietary adequacy in disadvantaged communities? A case of the Indian Sundarbans

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