Young Researcher Minciencias, Department of Organizational Management, Faculty of Economic and Administrative Sciences, Universidad icesi., Cali, Colombia.
Full-Time Professor, Department of Organizational Management, Faculty of Economic and Administrative Sciences, Universidad Icesi., Cali, Colombia.
Int J Equity Health. 2020 Oct 26;19(1):129. doi: 10.1186/s12939-020-01239-8.
Social and community participation is a fundamental component of the development of renewed primary healthcare (PHC). With the recognition of health as a right, such participation is a significant part of the design of public policies aimed at this sector. These policies contribute not only to overcoming inequity in the provision of this type of services but also to a reduction in social inequalities as a whole. Through a comparative analysis, this study aimed to explain the conditions through which ethnic-rural territories of the Colombian Pacific coast participate in health to contribute to the generation of policies and programs in territories with similar conditions.
The work was developed through the use of multiple techniques and strategies for information collection and analysis. These include several semi-structured interviews, multiple observation exercises and analysis based on a set theory, i.e., qualitative comparative analysis (QCA). The latter aims to develop a model that provides a count of the main causal combinations that allow high community participation in health.
Key findings include how the trajectory of social mobilization and existence of a robust community social fabric became two critical conditions for community participation in the context of social exclusion. The presence of variables such as the implementation of PHC, guarantee of social rights, and trust in institutions, is underestimated as sufficient causal conditions for obtaining this result. Therefore, it is essential to recognize the existence, validity, and importance of processes, experiences, and resourcefulness of political natures, which aim at transforming the daily reality of the inhabitants of these communities. These also set a potential space and scenario for managing the communities' main problems, including health, in the absence of institutionality that guarantees access to their social rights.
This study points out the importance of understanding community participation as a political activity, expanding exchange dynamics and dialogs between institutions, rulers, and communities to provide social responses in health and well-being to communities and to understand local realities and their own community dynamics.
社会和社区参与是更新初级卫生保健（PHC）发展的基本组成部分。随着健康被视为一项权利，这种参与是旨在针对该部门的公共政策设计的重要组成部分。这些政策不仅有助于克服提供此类服务方面的不平等，而且有助于减少整个社会的不平等。通过比较分析，本研究旨在解释哥伦比亚太平洋沿岸的种族农村地区参与卫生保健的条件，以为具有类似条件的地区制定政策和方案做出贡献。
这项工作是通过使用多种技术和信息收集与分析策略来开展的。这些包括多次半结构化访谈、多次观察练习以及基于集合理论的分析，即定性比较分析（QCA）。后者旨在开发一个模型，该模型提供了一个主要因果组合的计数，这些组合允许社区高度参与卫生保健。
主要发现包括社会动员的轨迹和强大的社区社会结构的存在如何成为社会排斥背景下社区参与的两个关键条件。变量的存在，如 PHC 的实施、社会权利的保障和对机构的信任，被低估为获得这一结果的充分因果条件。因此，必须认识到存在、有效性和政治性质的过程、经验和机智的重要性，这些过程、经验和机智旨在改变这些社区居民的日常生活现实。这些也为在没有保障其社会权利的体制的情况下管理社区的主要问题，包括卫生问题，提供了一个潜在的空间和场景。
本研究指出，理解社区参与作为一种政治活动的重要性，扩大机构、统治者和社区之间的交流动态和对话，以提供社区在健康和福祉方面的社会反应，并理解当地现实及其自身社区的动态。
