Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis
Abstract Background Health committees are key mechanisms for enabling participation of community members in decision-making on matters related to their health. This paper aims to establish an in-depth understanding of how community members participate in primary health care through health committees...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-12730-y |
| _version_ | 1819277911225532416 |
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| author | Robinson Karuga Maryse Kok Marthe Luitjens Patrick Mbindyo Jacqueline E. W. Broerse Marjolein Dieleman |
| author_facet | Robinson Karuga Maryse Kok Marthe Luitjens Patrick Mbindyo Jacqueline E. W. Broerse Marjolein Dieleman |
| author_sort | Robinson Karuga |
| collection | DOAJ |
| description | Abstract Background Health committees are key mechanisms for enabling participation of community members in decision-making on matters related to their health. This paper aims to establish an in-depth understanding of how community members participate in primary health care through health committees in sub-Saharan Africa (SSA). Methods We searched peer-reviewed English articles published between 2010 and 2019 in MEDLINE, Popline and CINAHL databases. Articles were eligible if they involved health committees in SSA. Our search yielded 279 articles and 7 duplicates were removed. We further excluded 255 articles following a review of titles and abstracts by two authors. Seventeen abstracts were eligible for full text review. After reviewing the full-text, we further excluded two articles that did not explicitly describe the role of health committees in community participation. We therefore included 15 articles in this review. Two authors extracted data on how health committees contributed to community participation in SSA using a conceptual framework for assessing community participation in health. We derived our themes from five process indicators in this framework, namely, leadership, management and planning, resource mobilization from external sources, monitoring and evaluation and women involvement. Findings We found that health committees work well in voicing communities’ concerns about the quality of care provided by health facility staff, day-to-day management of health facilities and mobilizing financial and non-financial resources for health activities and projects. Health committees held health workers accountable by monitoring absenteeism, quality of services and expenditures in health facilities. Health committees lacked legitimacy because selection procedures were often not transparent and participatory. Committee members were left out in planning and budgeting processes by health workers, who perceived them as insufficiently educated and trained to take part in planning. Most health committees were male-dominated, thus limiting participation by women. Conclusion Health committees contribute to community participation through holding primary health workers accountable, voicing their communities’ concern and mobilizing resources for health activities and projects. Decision makers, health managers and advocates need to fundamentally rethink how health committees are selected, empowered and supported to implement their roles and responsibilities. |
| first_indexed | 2024-12-24T00:03:38Z |
| format | Article |
| id | doaj.art-7496eccf78584462bf90af822646bd00 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-24T00:03:38Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-7496eccf78584462bf90af822646bd002022-12-21T17:25:04ZengBMCBMC Public Health1471-24582022-02-0122111710.1186/s12889-022-12730-yParticipation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesisRobinson Karuga0Maryse Kok1Marthe Luitjens2Patrick Mbindyo3Jacqueline E. W. Broerse4Marjolein Dieleman5LVCT HealthKIT Royal Tropical InstituteAthena Institute, Vrije Universiteit AmsterdamJomo Kenyatta University of Agriculture and TechnologyAthena Institute, Vrije Universiteit AmsterdamAthena Institute, Vrije Universiteit AmsterdamAbstract Background Health committees are key mechanisms for enabling participation of community members in decision-making on matters related to their health. This paper aims to establish an in-depth understanding of how community members participate in primary health care through health committees in sub-Saharan Africa (SSA). Methods We searched peer-reviewed English articles published between 2010 and 2019 in MEDLINE, Popline and CINAHL databases. Articles were eligible if they involved health committees in SSA. Our search yielded 279 articles and 7 duplicates were removed. We further excluded 255 articles following a review of titles and abstracts by two authors. Seventeen abstracts were eligible for full text review. After reviewing the full-text, we further excluded two articles that did not explicitly describe the role of health committees in community participation. We therefore included 15 articles in this review. Two authors extracted data on how health committees contributed to community participation in SSA using a conceptual framework for assessing community participation in health. We derived our themes from five process indicators in this framework, namely, leadership, management and planning, resource mobilization from external sources, monitoring and evaluation and women involvement. Findings We found that health committees work well in voicing communities’ concerns about the quality of care provided by health facility staff, day-to-day management of health facilities and mobilizing financial and non-financial resources for health activities and projects. Health committees held health workers accountable by monitoring absenteeism, quality of services and expenditures in health facilities. Health committees lacked legitimacy because selection procedures were often not transparent and participatory. Committee members were left out in planning and budgeting processes by health workers, who perceived them as insufficiently educated and trained to take part in planning. Most health committees were male-dominated, thus limiting participation by women. Conclusion Health committees contribute to community participation through holding primary health workers accountable, voicing their communities’ concern and mobilizing resources for health activities and projects. Decision makers, health managers and advocates need to fundamentally rethink how health committees are selected, empowered and supported to implement their roles and responsibilities.https://doi.org/10.1186/s12889-022-12730-yCommunity participationHealth committeeCommunity engagementSocial accountability |
| spellingShingle | Robinson Karuga Maryse Kok Marthe Luitjens Patrick Mbindyo Jacqueline E. W. Broerse Marjolein Dieleman Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis BMC Public Health Community participation Health committee Community engagement Social accountability |
| title | Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis |
| title_full | Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis |
| title_fullStr | Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis |
| title_full_unstemmed | Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis |
| title_short | Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis |
| title_sort | participation in primary health care through community level health committees in sub saharan africa a qualitative synthesis |
| topic | Community participation Health committee Community engagement Social accountability |
| url | https://doi.org/10.1186/s12889-022-12730-y |
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