UCL Institute for Global Health, University College London, London, UK
Department of Paediatrics, University of Ibadan, Ibadan, Nigeria.
BMJ Open. 2023 Nov 16;13(11):e069213. doi: 10.1136/bmjopen-2022-069213.
In this study, we used the information generated by community members during an intervention design process to understand the features needed for a successful community participatory intervention to improve child health.
We conducted a concurrent mixed-methods study (November 2019-March 2020) to inform the design and evaluation of a community-facility linkage participatory intervention.
Kiyawa Local Government Area (Jigawa State, Nigeria)-population of 230 000 (n=425 villages).
Qualitative data included 12 community conversations with caregivers of children under-5 (men, older and younger women; n=9 per group), 3 focus group discussions (n=10) with ward development committee members and interviews with facility heads (n=3). Quantitative data comprised household surveys (n=3464) with compound heads (n=1803) and women (n=1661).
We analysed qualitative data with thematic network analysis and the surveys with linear regression-results were triangulated in the interpretation phase. Participants identified the following areas of focus: community health education; facility infrastructure, equipment and staff improvements; raising funds to make these changes. Community involvement, cooperation and empowerment were recognised as a strategy to improve child health, and the presence of intermediate bodies (development committees) was deemed important to improve communication and solve problems between community and facility members. The survey showed functional community relations' dynamics, with high levels of internal cohesion (78%), efficacy in solving problems together (79%) and fairness of the local leaders (82%).
Combining the results from this study and critical theories on successful participation identified community-informed features for a contextually tailored community-facility link intervention. The need to promote a more inclusive approach to future child health interventions was highlighted. In addition to health education campaigns, the relationship between community and healthcare providers needs strengthening, and development committees were identified as an essential feature for successfully linking communities and facilities for child health.
ISRCTN39213655.
本研究利用社区成员在干预设计过程中生成的信息，了解成功实施社区参与式干预以改善儿童健康所需的特征。
我们开展了一项同期混合方法研究（2019 年 11 月至 2020 年 3 月），为社区-机构联系参与式干预的设计和评估提供信息。
吉加瓦地方政府区（尼日利亚，吉加瓦州-人口 230000（n=425 个村庄）。
定性数据包括 12 次与 5 岁以下儿童照顾者的社区对话（男性、年长和年轻女性；每组 9 人）、3 次与病房发展委员会成员的焦点小组讨论（n=10）和对机构负责人的访谈（n=3）。定量数据包括对 3464 个家庭的调查，其中包括负责人（n=1803）和妇女（n=1661）。
我们对定性数据进行了主题网络分析，对调查数据进行了线性回归，在解释阶段对结果进行了三角剖分。参与者确定了以下重点领域：社区健康教育；设施基础设施、设备和人员改进；筹集资金以实现这些变革。社区参与、合作和赋权被认为是改善儿童健康的一项战略，中间机构（发展委员会）的存在被认为对改善社区和机构成员之间的沟通和解决问题很重要。调查显示了功能社区关系的动态，内部凝聚力水平高（78%）、共同解决问题的效力高（79%）和地方领导人的公平性高（82%）。
结合本研究的结果和关于成功参与的关键理论，确定了一个适合具体情况的社区-机构联系干预措施的社区知情特征。强调需要促进对未来儿童健康干预措施采取更具包容性的方法。除了健康教育运动外，还需要加强社区与医疗保健提供者之间的关系，并确定发展委员会是成功联系社区和医疗机构促进儿童健康的一个重要特征。
ISRCTN39213655。
