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实施患者-公众参与以改善健康:来自加纳三个基于社区的项目的经验教训。

Implementing patient-public engagement for improved health: Lessons from three Ghanaian community-based programmes.

机构信息

Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand.

出版信息

Health Expect. 2023 Dec;26(6):2684-2694. doi: 10.1111/hex.13866. Epub 2023 Sep 11.

Abstract

BACKGROUND

Community-based health interventions have been implemented as a key strategy for achieving improved health outcomes in Ghana. Effectiveness, however, largely depends on the successful implementation of patient-public engagement (PPE). Although several PPE studies have been conducted in Ghana, little research has been done to understand the specific role of PPE in the context of implementing community-based health programmes. This paper, therefore, examines the extent of PPE implementation in three selected community-based health programmes (Community-based Health Planning and Service [CHPS], Community-based Maternal and Child Health and Buruli Ulcer) to understand their specific effects on health outcomes.

METHODS

Three focus groups, involving 26 participants, were held in three districts of the Ashanti region of Ghana. Participants were mainly health service users involving community health committee members/volunteers, residents and health professionals. They were invited to participate based on their roles in the design and implementation of the programmes. Participants focused on each of Rifkin's spider-gram components. Data were transcribed and analysed descriptively using NVIVO 12 Plus.

RESULTS

PPE implementation was found to be extensive across the three programmes in specific areas such as organisation and resource mobilisation. PPE was more restricted in relation to community needs assessment, leadership and management, particularly for the CHPS and Buruli Ulcer programmes.

CONCLUSION

Findings suggest that benefits from community-based health interventions are likely to be greater if PPE can be widely implemented across all dimensions of the spider-gram framework.

摘要

背景

社区卫生干预措施已被作为改善加纳卫生结果的一项关键策略得到实施。然而,其有效性在很大程度上取决于患者公众参与(PPE)的成功实施。尽管加纳已经进行了几项 PPE 研究,但对于理解 PPE 在实施社区卫生项目方面的具体作用,研究还很少。因此,本文考察了三个选定的社区卫生项目(社区卫生规划和服务[CHPS]、社区母婴保健和布鲁里溃疡)中 PPE 实施的程度,以了解它们对健康结果的具体影响。

方法

在加纳阿散蒂地区的三个区举行了三个焦点小组,共有 26 名参与者。参与者主要是卫生服务使用者,包括社区卫生委员会成员/志愿者、居民和卫生专业人员。他们根据其在项目设计和实施中的角色被邀请参加。参与者关注 Rifkin 的蜘蛛图的每个组成部分。使用 NVIVO 12 Plus 对转录的数据进行描述性分析。

结果

在 Rifkin 的蜘蛛图的特定领域,如组织和资源动员,发现三个项目中的 PPE 实施非常广泛。在社区需求评估、领导和管理方面,PPE 的实施更加受限,特别是对于 CHPS 和布鲁里溃疡项目。

结论

研究结果表明,如果 PPE 能够在蜘蛛图框架的所有维度上广泛实施,那么社区卫生干预措施的益处可能更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14fc/10632621/593606ad8d98/HEX-26--g001.jpg

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