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Bemme D, Roberts T, Ae-Ngibise KA, Gumbonzvanda N, Joag K, Kagee A, Machisa M, van der Westhuizen C, van Rensburg A, Willan S, Wuerth M, Aoun M, Jain S, Lund C, Mathias K, Read U, Taylor Salisbury T, Burgess RA. Mutuality as a method: advancing a social paradigm for global mental health through mutual learning. Soc Psychiatry Psychiatr Epidemiol 2024; 59:545-553. [PMID: 37393204 PMCID: PMC10944435 DOI: 10.1007/s00127-023-02493-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/23/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE Calls for "mutuality" in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. METHODS We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. RESULTS Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained responsive to all collaborators' needs and critiques. This resulted in a social paradigm that calls for GMH to (1) move from a deficit to a strength-based view of community mental health, (2) include local and experiential knowledge in scaling processes, (3) direct funding to community organizations, and (4) challenge concepts, such as trauma and resilience, through the lens of lived experience of communities in the global South. CONCLUSION Under the current institutional arrangements in GMH, mutuality can only be imperfectly achieved. We present key ingredients of our partial success at mutual learning and conclude that challenging existing structural constraints is crucial to prevent a tokenistic use of the concept.
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Affiliation(s)
| | | | | | | | | | - Ashraf Kagee
- Stellenbosch University, Stellenbosch, South Africa
| | | | | | - André van Rensburg
- University of Kwazulu-Natal, Centre for Rural Health, Durban, South Africa
| | - Samantha Willan
- South African Medical Research Council, Cape Town, South Africa
| | | | - May Aoun
- Save the Children, New York, USA
| | | | - Crick Lund
- King's College London, London, UK
- University of Cape Town, Cape Town, South Africa
| | - Kaaren Mathias
- University of Canterbury, Christchurch, New Zealand
- Burans, Herbertpur Christian Hospital, Atten Bagh, India
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2
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Accoe K, Criel B, Ag Ahmed MA, Buitrago VT, Marchal B. Conditions for health system resilience in the response to the COVID-19 pandemic in Mauritania. BMJ Glob Health 2023; 8:e013943. [PMID: 38050409 PMCID: PMC10693853 DOI: 10.1136/bmjgh-2023-013943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION A country's ability to manage a crisis depends on its level of resilience. Efforts are made to clarify the concept of health system resilience, but its operationalisation remains little studied. In the present research, we described the capacity of the local healthcare system in the Islamic Republic of Mauritania, in West Africa, to cope with the COVID-19 pandemic. METHODS We used a single case study with two health districts as units of analysis. A context analysis, a literature review and 33 semi-structured interviews were conducted. The data were analysed using a resilience conceptual framework. RESULTS The analysis indicates a certain capacity to manage the crisis, but significant gaps and challenges remain. The management of many uncertainties is largely dependent on the quality of the alignment of decision-makers at district level with the national level. Local management of COVID-19 in the context of Mauritania's fragile healthcare system has been skewed to awareness-raising and a surveillance system. Three other elements appear to be particularly important in building a resilient healthcare system: leadership capacity, community dynamics and the existence of a learning culture. CONCLUSION The COVID-19 pandemic has put a great deal of pressure on healthcare systems. Our study has shown the relevance of an in-depth contextual analysis to better identify the enabling environment and the capacities required to develop a certain level of resilience. The translation into practice of the skills required to build a resilient healthcare system remains to be further developed.
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Affiliation(s)
- Kirsten Accoe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Mothupi M, Dasgupta J, Hosseini Jebeli SS, Stevenson J, Berdichevsky K, Vong S, Barasa E, George A. Using an intersectionality approach to transform health services for overlooked healthcare users and workers after covid-19. BMJ 2023; 381:e072243. [PMID: 37286226 DOI: 10.1136/bmj-2022-072243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Mamothena Mothupi
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | | | - Jacqui Stevenson
- United Nations University International Institute of Global Health, Kuala Lumpur, Malaysia
| | - Karla Berdichevsky
- National Center for Gender Equity and Reproductive Health, Ministry of Health, Mexico City, Mexico
| | | | - Edwine Barasa
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Asha George
- Complexity and Social Change, School of Public Health, University of the Western Cape, Cape Town, South Africa
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4
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Mayers PM, Olckers L, Prinsloo EL, Raine J, Zweigenthal V. Reflections of volunteer counselors working remotely during the COVID-19 pandemic-Implications for policy and practice. J Nurs Scholarsh 2023; 55:239-252. [PMID: 36510097 PMCID: PMC9877706 DOI: 10.1111/jnu.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE We reflect on our experience of running a remote volunteer counseling service, known as the Counseling Collective, to support patients and their families during the second wave of the COVID-19 pandemic in Cape Town, South Africa, and the learning and implications for practice and policy regarding the effective utilization of volunteers during a crisis or disaster context. BACKGROUND The Beta SARS-Co-2 variant dominated the second COVID-19 wave which gained momentum in December 2020, as public sector health teams prepared to deescalate services over the South African summer season. The ferocity with which the wave hit the city soon made it clear that volunteers would be needed to assist with counseling services as the Beta variant caused serious disease, resulting in a significant upswing in hospitalisations and deaths. METHODS Four counselors and a colleague with oversight responsibilities of the volunteers reflected on the service we provided. This was done with the benefit of hindsight a year after the activities of the Counseling Collective were wrapped up. LESSONS LEARNED Virtual volunteers are a largely untapped resource in the South African health care system. Much is to be gained by using this underutilized resource to deliver patient-centred services, especially in times of crisis. CONCLUSION Networks of retired and self-employed health professionals, particularly nurses,-skilled volunteers-are a valuable resource and can be deployed for critical work using their versatile skillsets, in public health emergencies. Telephonic consultations are a useful modality for providing quality care and need to be built into the business of health services. Skills to conduct such consultations and for the provision of palliative care services need to be mainstreamed into the skillsets of health professionals. POLICY AND CLINICAL RELEVANCE Public health disaster plans should include a blueprint for the rapid recruitment and deployment of volunteer counselors to assist permanent staff in providing crucial patient-centred care.
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Affiliation(s)
- Pat M. Mayers
- University of Western CapeCape TownSouth Africa,University of Cape TownCape TownSouth Africa
| | | | | | - Joy Raine
- Private PracticeCape TownSouth Africa
| | - Virginia Zweigenthal
- School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa,Western Cape Department of HealthCape TownSouth Africa
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Rendall J, Curtin M, Roy MJ, Teasdale S. Relationships between community-led mutual aid groups and the state during the COVID-19 pandemic: complementary, supplementary, or adversarial? PUBLIC MANAGEMENT REVIEW 2022; 26:313-333. [PMID: 38818046 PMCID: PMC11138323 DOI: 10.1080/14719037.2022.2084769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
This research explores ways public service ecosystems developed during the COVID-19 pandemic, focusing on relationships between community-led mutual aid groups and the state. Data were collected through in-depth interviews, focus groups, and mobile ethnographic methods with 30 participants from the public sector and three mutual aid groups across Scotland. We show how relationships between mutual aid groups and the state - whether complementary, supplementary, or adversarial - shifted over the course of the pandemic. Our findings add nuance to understandings that presuppose mutual aid as antagonistic, highlighting ways that mutual aid groups may be brought into existing public service ecosystems.
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Affiliation(s)
- Jack Rendall
- The Yunus Centre for Social Business & Health, Glasgow Caledonian University, Scotland
| | - Maeve Curtin
- The Yunus Centre for Social Business & Health, Glasgow Caledonian University, Scotland
| | - Michael J. Roy
- The Yunus Centre for Social Business & Health, Glasgow Caledonian University, Scotland
| | - Simon Teasdale
- The Yunus Centre for Social Business & Health, Glasgow Caledonian University, Scotland
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Ayala G, Sprague L, van der Merwe LLA, Thomas RM, Chang J, Arreola S, Davis SLM, Taslim A, Mienies K, Nilo A, Mworeko L, Hikuam F, de Leon Moreno CG, Izazola-Licea JA. Peer- and community-led responses to HIV: A scoping review. PLoS One 2021; 16:e0260555. [PMID: 34852001 PMCID: PMC8635382 DOI: 10.1371/journal.pone.0260555] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/18/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In June 2021, United Nations (UN) Member States committed to ambitious targets for scaling up community-led responses by 2025 toward meeting the goals of ending the AIDS epidemic by 2030. These targets build on UN Member States 2016 commitments to ensure that 30% of HIV testing and treatment programmes are community-led by 2030. At its current pace, the world is not likely to meet these nor other global HIV targets, as evidenced by current epidemiologic trends. The COVID-19 pandemic threatens to further slow momentum made to date. The purpose of this paper is to review available evidence on the comparative advantages of community-led HIV responses that can better inform policy making towards getting the world back on track. METHODS We conducted a scoping review to gather available evidence on peer- and community-led HIV responses. Using UNAIDS' definition of 'community-led' and following PRISMA guidelines, we searched peer-reviewed literature published from January 1982 through September 2020. We limited our search to articles reporting findings from randomized controlled trials as well as from quasi-experimental, prospective, pre/post-test evaluation, and cross-sectional study designs. The overall goals of this scoping review were to gather available evidence on community-led responses and their impact on HIV outcomes, and to identify key concepts that can be used to quickly inform policy, practice, and research. FINDINGS Our initial search yielded 279 records. After screening for relevance and conducting cross-validation, 48 articles were selected. Most studies took place in the global south (n = 27) and a third (n = 17) involved youth. Sixty-five percent of articles (n = 31) described the comparative advantage of peer- and community-led direct services, e.g., prevention and education (n = 23) testing, care, and treatment programs (n = 8). We identified more than 40 beneficial outcomes linked to a range of peer- and community-led HIV activities. They include improved HIV-related knowledge, attitudes, intentions, self-efficacy, risk behaviours, risk appraisals, health literacy, adherence, and viral suppression. Ten studies reported improvements in HIV service access, quality, linkage, utilization, and retention resulting from peer- or community-led programs or initiatives. Three studies reported structural level changes, including positive influences on clinic wait times, treatment stockouts, service coverage, and exclusionary practices. CONCLUSIONS AND RECOMMENDATIONS Findings from our scoping review underscore the comparative advantage of peer- and community-led HIV responses. Specifically, the evidence from the published literature leads us to recommend, where possible, that prevention programs, especially those intended for people living with and disproportionately affected by HIV, be peer- and community-led. In addition, treatment services should strive to integrate specific peer- and community-led components informed by differentiated care models. Future research is needed and should focus on generating additional quantitative evidence on cost effectiveness and on the synergistic effects of bundling two or more peer- and community-led interventions.
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Affiliation(s)
- George Ayala
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Alameda County Department of Public Health, Oakland, CA, United States of America
- * E-mail:
| | - Laurel Sprague
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - L. Leigh-Ann van der Merwe
- Social, Health and Empowerment Feminist Collective of Transgender Women in Africa, East London, South Africa
- Innovative Response Globally to Transgender Women and HIV (IRGT), Oakland, CA, United States of America
| | | | - Judy Chang
- International Network of People Who Use Drugs, London, United Kingdom
| | - Sonya Arreola
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Arreola Research, San Francisco, CA, United States of America
| | | | | | - Keith Mienies
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | | | - Lillian Mworeko
- International Community of Women Living with HIV Eastern Africa, Kampala, Uganda
| | - Felicita Hikuam
- AIDS and Rights Alliance for Southern Africa, Windhoek, Namibia
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Ottemöller FG, Matenga TFL, Corbin JH, Nakhuda H, Delobelle P, Ayele C, Boston-Fisher N, Leitch S, Wicker J, Mweemba O. Re-envisioning health promotion: Thinking and acting salutogenically towards equity for historically resilient communities. Glob Health Promot 2021; 28:88-96. [PMID: 34474605 PMCID: PMC8821975 DOI: 10.1177/17579759211035089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper explores how the salutogenic theory can enable us to re-envision health promotion work with marginalized communities, towards an approach that acknowledges and honours their resilience. We use the three core concepts in Antonovsky’s salutogenic model of health – sense of coherence, generalized resistance resources and specific resistance resources – to explore the theory’s relevance to health equity, thus presenting new opportunities for how we might radically re-evaluate current health promotion approaches. We conclude that a more equitable health promotion requires increased participation of marginalized communities in shaping their futures and suggest a new model for historically grounded salutogenic health promotion.
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Affiliation(s)
| | | | - J Hope Corbin
- Western Washington University, Bellingham, Washington, USA
| | - Humaira Nakhuda
- IUHPE Student and Early Career Network, Toronto, Ontario, Canada
| | - Peter Delobelle
- University of Cape Town, South Africa; Vrije Universiteit Brussel, Brussels, Belgium
| | - Christa Ayele
- IUHPE Student and Early Career Network, Philadelphia, Pennsylvania, USA
| | | | - Stephanie Leitch
- IUHPE Trustee for Partnerships, NARO; University of Suffolk, United Kingdom; WOMANTRA, Trinidad and Tobago
| | - Josette Wicker
- IUHPE Student and Early Career Network, Seattle, Washington, USA
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8
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Mutual aid organisations and their role in reducing food insecurity in Chicago's urban communities during COVID-19. Public Health Nutr 2021; 25:119-122. [PMID: 34462038 PMCID: PMC8458839 DOI: 10.1017/s1368980021003736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has disproportionately impacted food security and food access in urban communities of colour. Loss of income, often associated with food insecurity, has affected Hispanic, Black, low-wage workers, single mothers and women of colour more than other groups of individuals. Mutual aid organisations have proliferated in response to the COVID-19 pandemic, yet a description of the contributions of these organisations in addressing food insecurity has yet to be described in the literature to date. This article aims to describe the unique role and contributions of mutual aid organisations in addressing food insecurity and food access disparities in Chicago’s communities of colour during the COVID-19 pandemic. Local mutual aid organisations can function as hubs to feed urban communities while reducing food waste and building community. During the pandemic, mutual aid organisations in Chicago have distributed thousands of pounds of food to families and individuals. Mutual aid organisations provide short-term food security while engaging with community members to create a more equitable and sustainable food system. The development of robust mutual aid hubs facilitated unique opportunities for collaboration and expansion of infrastructure that may allow mutual aid organisations to address food access in their communities well into the future.
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9
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Bayingana AU, Binagwaho A, Mathewos K. What will we choose to learn from the COVID-19 pandemic? BMJ Glob Health 2021; 6:e007005. [PMID: 34385164 PMCID: PMC8361680 DOI: 10.1136/bmjgh-2021-007005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alice Uwase Bayingana
- London School of Hygiene & Tropical Medicine, London, UK
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Agnes Binagwaho
- Office of the Vice Chancellor, University of Global Health Equity, Kigali, Rwanda
| | - Kedest Mathewos
- Office of the Vice Chancellor, University of Global Health Equity, Kigali, Rwanda
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10
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Doherty T, Kroon M, Reynolds L, Fawcus S, Lake L, Solanki G. Building back from the ground up: the vital role of communities. BMJ Glob Health 2021; 5:bmjgh-2020-003928. [PMID: 33028703 PMCID: PMC7542619 DOI: 10.1136/bmjgh-2020-003928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/13/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tanya Doherty
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa .,Paediatrics and Child Health, University of Cape Town Faculty of Health Sciences, Observatory, South Africa.,School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Max Kroon
- Neonatology, University of Cape Town Faculty of Health Sciences and Mowbray Maternity Hospital, Observatory, South Africa
| | - Louis Reynolds
- Paediatrics and Child Health, University of Cape Town Faculty of Health Sciences, Observatory, South Africa.,People's Health Movement, Cape Town, South Africa
| | - Sue Fawcus
- Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lori Lake
- Children's Institute, University of Cape Town, Cape Town, South Africa
| | - Geetesh Solanki
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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11
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Tang W, Wu D, Yang F, Wang C, Gong W, Gray K, Tucker JD. How kindness can be contagious in healthcare. Nat Med 2021; 27:1142-1144. [PMID: 34127853 DOI: 10.1038/s41591-021-01401-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Weiming Tang
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,University of North Carolina Project-China, Guangzhou, Guangdong, China.,SESH Global, Guangzhou, China
| | - Dan Wu
- SESH Global, Guangzhou, China.,Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Fan Yang
- University of North Carolina Project-China, Guangzhou, Guangdong, China.,SESH Global, Guangzhou, China.,Institute of Population Research, Peking University, Beijing, China
| | - Cheng Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Wenfeng Gong
- Bill and Melinda Gates Foundation, Beijing, China
| | - Kurt Gray
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D Tucker
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,University of North Carolina Project-China, Guangzhou, Guangdong, China. .,SESH Global, Guangzhou, China. .,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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12
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van der Merwe M, D'Ambruoso L, Witter S, Twine R, Mabetha D, Hove J, Byass P, Tollman S, Kahn K. Collective reflections on the first cycle of a collaborative learning platform to strengthen rural primary healthcare in Mpumalanga, South Africa. Health Res Policy Syst 2021; 19:66. [PMID: 33874951 PMCID: PMC8054125 DOI: 10.1186/s12961-021-00716-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Frontline managers and health service providers are constrained in many contexts from responding to community priorities due to organizational cultures focused on centrally defined outputs and targets. This paper presents an evaluation of the Verbal Autopsy with Participatory Action Research (VAPAR) programme-a collaborative learning platform embedded in the local health system in Mpumalanga, South Africa-for strengthening of rural primary healthcare (PHC) systems. The programme aims to address exclusion from access to health services by generating and acting on research evidence of practical, local relevance. METHODS Drawing on existing links in the provincial and national health systems and applying rapid, participatory evaluation techniques, we evaluated the first action-learning cycle of the VAPAR programme (2017-19). We collected data in three phases: (1) 10 individual interviews with programme stakeholders, including from government departments and parastatals, nongovernmental organizations and local communities; (2) an evaluative/exploratory workshop with provincial and district Department of Health managers; and (3) feedback and discussion of findings during an interactive workshop with national child health experts. RESULTS Individual programme stakeholders described early outcomes relating to effective research and stakeholder engagement, and organization and delivery of services, with potential further contributions to the establishment of an evidence base for local policy and planning, and improved health outcomes. These outcomes were verified with provincial managers. Provincial and national stakeholders identified the potential for VAPAR to support engagement between communities and health authorities for collective planning and implementation of services. Provincial stakeholders proposed that this could be achieved through a two-way integration, with VAPAR stakeholders participating in routine health planning and review activities and frontline health officials being involved in the VAPAR process. Findings were collated into a revised theory of change. CONCLUSIONS The VAPAR learning platform was regarded as a feasible, acceptable and relevant approach to facilitate cooperative learning and community participation in health systems. The evaluation provides support for a collaborative learning platform within routine health system processes and contributes to the limited evaluative evidence base on embedded health systems research.
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Affiliation(s)
- Maria van der Merwe
- , White River, South Africa.
- Centre for Global Development, School of Education, University of Aberdeen, Aberdeen, Scotland.
| | - Lucia D'Ambruoso
- Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- National Health Service (NHS) Grampian, Aberdeen, Scotland
| | - Sophie Witter
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Denny Mabetha
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Hove
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Byass
- Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Kathleen Kahn
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
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D'Ambruoso L, Abbott P, Binagwaho A. Building back fairer in public health policy requires collective action with and for the most vulnerable in society. BMJ Glob Health 2021; 6:e005555. [PMID: 33727282 PMCID: PMC7970266 DOI: 10.1136/bmjgh-2021-005555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Lucia D'Ambruoso
- Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Pamela Abbott
- Centre for Global Development, School of Education, University of Aberdeen, Aberdeen, UK
| | - Agnes Binagwaho
- Office of the Vice Chancellor, University of Global Health Equity, Kigali, Rwanda
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