Sharma Nandini, Palo Subrata Kumar, Bhimarasetty Devi Madhavi, Kandipudi Kesava Lakshmi Prasad, Purty Anil J, Kumar Tivendra, Basu Saurav, Alice Alice, Velavan A, Madhavan Sathish, Rongsen-Chandola Temsunaro, Arora Narendra Kumar, Dixit Shikha, Pati Sanghamitra, Taneja Malik Shikha
Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India.
Regional Medical Research Centre, Bhubaneshwar 751023, India.
Healthcare (Basel). 2023 Jan 31;11(3):411. doi: 10.3390/healthcare11030411.
Six diverse Demographic Development and Environmental Surveillance System (DDESS) sites were established in urban slum, urban resettlement, peri-urban, rural, and tribal areas located in Northern, North-East, Eastern, and Southern regions of India from June 2020 to March 2022. Understanding the community dynamics and engaging people in the community is critically important in the process of establishing DDESS. We ascertained the barriers, challenges, and facilitators during the establishment of multiple DDESS sites across India.
This was a cross-sectional descriptive mixed-methods study.
Multiple barriers and challenges encountered were reported in the process of community engagement (CE), such as geographical inaccessibility, language barriers, adverse weather, non-responsiveness due to perceived lack of individual benefit or financial gain, fear of contracting COVID-19, COVID-19 vaccine hesitancy, etc. Facilitators in the CE process were pre-existing links with the community, constitution of community advisory boards, community need assessment, concomitant delivery of outreach health services, and skill-building facilities.
Most community barriers in the development of DDESS sites in resource-limited settings can be overcome through a multipronged approach, including effective community engagement by focusing on demonstrating trust at the local level, enlisting community mobilization and support, utilizing pre-existing community linkages, initiating community diagnosis, and meeting perceived community health needs.
2020年6月至2022年3月期间，在印度北部、东北部、东部和南部地区的城市贫民窟、城市安置区、城郊、农村和部落地区设立了六个不同的人口发展与环境监测系统（DDESS）站点。在建立DDESS的过程中，了解社区动态并让社区居民参与其中至关重要。我们确定了在印度各地建立多个DDESS站点过程中的障碍、挑战和促进因素。
这是一项横断面描述性混合方法研究。
在社区参与（CE）过程中报告了遇到的多种障碍和挑战，例如地理位置偏远、语言障碍、恶劣天气、因认为缺乏个人利益或经济收益而无响应、担心感染新冠病毒、对新冠疫苗犹豫不决等。CE过程中的促进因素包括与社区的既有联系、社区咨询委员会的组建、社区需求评估、同步提供外展卫生服务以及技能建设设施。
在资源有限的环境中，通过多管齐下的方法可以克服DDESS站点发展中的大多数社区障碍，包括通过在地方层面展现信任、争取社区动员和支持、利用既有社区联系、开展社区诊断以及满足社区感知到的卫生需求来进行有效的社区参与。
