Centre for Development Support, University of Free State, Bloemfontein 9300, South Africa.
School of Governance, University of the Witwatersrand, Johannesburg 2050, South Africa.
Int J Environ Res Public Health. 2024 Jun 23;21(7):820. doi: 10.3390/ijerph21070820.
Citizen participation is a crucial aspect of the national health system, empowering individuals to contribute to improving local health services through Health Committees (HCs). HCs promote the participation of citizens in the delivery of primary healthcare services. The study explores the perceptions of citizen participation in the context of the Ruhama County Ntungamo local government area, Uganda. This study aims to understand the impact of HCs on healthcare service delivery. Using a qualitative approach of inquiry grounded in thematic analysis and rooted in principal-agent theory in a single case study, this study examined citizens' participation in the delivery of a local healthcare service. The study is based on interviews with 66 participants comprising health workers, patients, residents, health administrators, local councillors, and HC members. The findings reveal a notable absence of a health committee in healthcare delivery in Ruhama County. The absence is attributed to a need for a formalised citizen participation structure in managing health facilities and service delivery. It raises concerns about the limited influence of citizens in shaping healthcare policies and decision-making processes. The study recommends the incorporation of health committees into the local health systems to enhance participation and grant communities greater influence over the management of health facilities and service delivery. Incorporating health committees into local health systems strengthens citizen participation and leads to more effective and sustainable healthcare services aligned with people's needs and preferences. Integrating health committees within Itojo Hospital and similar facilities can grant citizens a meaningful role in shaping the future of their healthcare.
公民参与是国家卫生系统的一个关键方面，通过健康委员会（HCs）使个人能够为改善当地卫生服务做出贡献。HCs 促进公民参与提供初级保健服务。本研究探讨了在乌干达 Ntungamo 地方政府区 Ruhama 县背景下公民参与的看法。本研究旨在了解 HCs 对医疗服务提供的影响。本研究采用扎根于主题分析的定性探究方法，并基于单一案例研究中的委托代理理论，考察了公民在提供当地医疗服务方面的参与情况。该研究基于对 66 名参与者的访谈，包括卫生工作者、患者、居民、卫生管理人员、地方议员和 HC 成员。研究结果表明，Ruhama 县的医疗服务提供中明显没有健康委员会。这种缺失归因于在管理卫生设施和服务提供方面需要一个正式的公民参与结构。这引发了人们对公民在塑造医疗政策和决策过程方面影响力有限的担忧。研究建议将卫生委员会纳入地方卫生系统，以加强参与，并使社区对卫生设施和服务提供的管理拥有更大的影响力。将卫生委员会纳入地方卫生系统可加强公民参与，并使医疗服务更有效和可持续，符合人民的需求和偏好。将卫生委员会纳入 Itojo 医院和类似设施可以赋予公民在塑造其医疗保健未来方面的有意义的角色。
