让公民参与地方卫生决策。一个现实主义的探索性案例研究。
Engaging citizens in local health policymaking. A realist explorative case-study.
机构信息
Centre for Nutrition, Prevent and Health Services, Department of Quality of Care and Health Economics, National Institute for Health and the Environment (RIVM), Bilthoven, The Netherlands.
Tilburg University, Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, The Netherlands.
出版信息
PLoS One. 2022 Mar 24;17(3):e0265404. doi: 10.1371/journal.pone.0265404. eCollection 2022.
BACKGROUND
Municipalities have been trying to involve citizens as citizen participation is thought to improve municipalities' accountability, the quality of services, and to align policies and services to communities' needs. This study examined citizens' participation preferences in policymaking by investigating their health policy priorities, expectations of involvement, and required support.
METHODS
For this case-study the realist evaluation approach was applied to focus groups with citizens and to a workshop with a local panel consisting of professionals, citizens and citizen representatives.
RESULTS
This study showed that citizens want to be involved in (health) policymaking with the aim of improving their communities' quality of life and living environment and prioritised local services and amenities (e.g. suitable housing, public transport, health and care services). Instead, professionals' priorities were focussed on singular public health issues related to prevention and lifestyle factors. The results also show that citizens felt responsible for driving citizen participation and representing community needs to the municipality, but needed the municipality to improve their communication and accessibility in order to do so successfully. Furthermore, the professionals on the panel indicated that they needed training on how to reach out to citizens. Such training should highlight how to better align their language to citizens' lived experiences. They also wanted their organisations to provide more space, flexibility and resources to build relationships with citizens in order to provide improved communication and accessibility to citizens.
CONCLUSION
The difference in priorities between citizens and professionals highlights the importance of involving citizens in policymaking. Moreover, citizens' involvement can act as a lever for change to bring a wider range of services and policy sectors together and has the potential to better align policies to citizens' lived experiences and hopefully increase the democratic legitimacy of policymaking. However, to fulfil such potential municipalities will need to invest in improving their accessibility and communication with communities.
背景
市政府一直在努力让市民参与其中，因为公民参与被认为可以提高市政府的问责制、服务质量，并使政策和服务与社区的需求保持一致。本研究通过调查公民的健康政策重点、参与期望和所需支持，考察了公民在决策中的参与偏好。
方法
为了进行这项案例研究，采用了现实主义评价方法，对公民进行了焦点小组讨论，并对由专业人士、公民和公民代表组成的地方小组进行了一次研讨会。
结果
本研究表明，公民希望参与（健康）决策制定，旨在提高社区的生活质量和生活环境，并优先考虑当地的服务和便利设施（如适宜的住房、公共交通、卫生和保健服务）。相比之下，专业人士的重点是与预防和生活方式因素有关的单一公共卫生问题。研究结果还表明，公民感到有责任推动公民参与，并向市政府代表社区需求，但需要市政府改善其沟通和可及性，以便成功推动公民参与。此外，小组中的专业人士表示，他们需要培训如何与公民联系。此类培训应强调如何更好地将他们的语言与公民的生活经验相匹配。他们还希望他们的组织为与公民建立关系提供更多的空间、灵活性和资源，以便为公民提供更好的沟通和可及性。
结论
公民和专业人士之间的优先事项差异突出了让公民参与决策制定的重要性。此外，公民的参与可以作为推动变革的杠杆，将更多的服务和政策领域结合在一起，并有可能更好地使政策与公民的生活经验保持一致，并希望提高决策的民主合法性。然而，要实现这一潜力，市政府需要投资改善与社区的可及性和沟通。
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