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超越命令与控制:对有意义的社区参与应对 COVID-19 措施的快速综述。

Beyond command and control: A rapid review of meaningful community-engaged responses to COVID-19.

机构信息

Training and Research Support Centre, Harare, Zimbabwe.

School of Public Health and Family Medicine, University of Cape Town, Cape Town.

出版信息

Glob Public Health. 2021 Aug-Sep;16(8-9):1439-1453. doi: 10.1080/17441692.2021.1900316. Epub 2021 Mar 18.

Abstract

Responses to COVID-19 have included top-down, command-and-control measures, laissez-faire approaches, and bottom-up, community-driven solidarity and support, reflecting long-standing contradictions around how people and populations are imagined in public health-as a 'problem' to be managed, as 'free agents' who make their own choices, or as a potential 'solution' to be engaged and empowered for comprehensive public health. In this rapid review, we examine community-engaged responses that move beyond risk communication and instead meaningfully integrate communities into decision-making and multi-sectoral action on various dimensions of the response to COVID-19. Based on a rapid, global review of 42 case studies of diverse forms of substantive community engagement in response to COVID-19, this paper identifies promising models of effective community-engaged responses and highlights the factors enabling or disabling these responses. The paper reflects on the ways in which these community-engaged responses contribute to comprehensive approaches and address social determinants and rights, within dynamics of relational power and inequality, and how they are sometimes able to take advantage of the ruptures and uncertainties of a new pandemic to refashion some of these dynamics.

摘要

对新冠疫情的应对措施包括自上而下的命令控制措施、放任自流的方法以及自下而上的社区驱动的团结和支持,反映了长期以来在公共卫生领域中人们和人群的想象方式存在的矛盾,即把人们视为需要管理的“问题”,或者是可以自由做出选择的“自由代理人”,或者是可以参与和赋权以实现全面公共卫生的潜在“解决方案”。在这项快速综述中,我们研究了超越风险沟通的社区参与应对措施,而是将社区切实纳入到对新冠疫情各个方面的决策和多部门行动中。基于对 42 项不同形式的实质性社区参与应对新冠疫情的案例研究的快速全球审查,本文确定了有效的社区参与应对措施的有希望的模式,并强调了促进或阻碍这些应对措施的因素。本文反思了这些社区参与应对措施如何在关系权力和不平等的动态中促进全面方法并解决社会决定因素和权利问题,以及它们如何有时能够利用新大流行病的破裂和不确定性来重塑其中的一些动态。

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