The authors investigated community and health-care workers’ perspectives on COVID-19 and on early pandemic responses during the first 2 weeks of national lockdown in Zimbabwe between March and April 2020. Phone interviews were done with with one representative from each of four community-based organizations and 16 health-care workers involved in a trial of community-based services for young people. In addition, information on COVID-19 was collected from social media platforms, news outlets and government announcements. Data were analysed thematically. It emerged that individuals were overloaded with information but lacked trusted sources, which resulted in widespread fear and unanswered questions; communities had limited ability to comply with prevention measures, such as social distancing, because access to long-term food supplies and water at home was limited and because income had to be earned daily; health-care workers perceived themselves to be vulnerable and undervalued because of a shortage of personal protective equipment and inadequate pay and other health conditions were side-lined because resources were redirected, with potentially wide-reaching implications. The authors recommend providing communities with basic needs and reliable information to enable them to follow prevention measures, health-care workers with personal protective equipment and adequate salaries and sustaining health-care services for conditions other than COVID-19.
Governance and participation in health
This research explored communities’ views on the elements of public health services that they find particularly problematic. It aimed to quantify the priority placed on each of these aspects of public service delivery that requires attention. Communities view the routine availability of effective medicines as the greatest priority for improved public sector health services; the least important priority is treatment by doctors. Routine availability of medicines is ten times more important than treatment by doctors. A thorough examination and clear explanation of a patient’s diagnosis and treatment by health professionals are also highly valued community priorities. Communities tolerate poor quality public sector service characteristics such as long waiting times, poor staff attitudes and the lack of direct access to doctors if they receive the medicine they need and a thorough examination and if a clear explanation of their diagnosis and treatment is provided.
Like many other developing countries with forbidding landscapes and isolated communities, radio is to be the most effective way of communication in Nepal, where the majority of population lives in villages and the half of it cannot read and write. This manual draws from both the grassroots experience of community media and from international broadcast practices. It considers the issues that are the real basis for the success of community media: public accountability, community representation, locally relevant programming, diverse funding and acknowledgement of staff, including volunteers. It covers in details many key success factors, such as participation and ownership, content, management, volunteerism and networking. It can be applied across a wide range of contexts, from policy issues to the assessment of a local station.
Delegates attending the Community Working Group on Health (CWGH) 13th National Conference in Harare from 5–6 July 2006 compiled this statement to highlight the key points raised and important conclusions. It covers existing positions on the conditions regarding human resources in health, as well as a number of conditions and policy suggestions to improve both community participation in health and public health performance overall.
This study explored how community-based initiatives address the critical health literacy of older adults and their communities. A systematic literature search was conducted. Two reviewers independently screened titles and abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition, a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included studies. The authors identified two main themes, which are practices that contribute to the critical health literacy of older adults as well as their communities: collaborative learning, and social support. In these practices they identified reciprocity as a key characteristic of both co-learning and social support. This study provides the first overview of community-based initiatives that implicitly address the critical health literacy of adults and their community. The results demonstrate that in the context of one’s own life collaborative learning and social support could contribute to people’s understanding and ability to judge, sift and use health information. The authors therefore suggest to add these two practices to the definition of critical health literacy.
Severe acute malnutrition remains a major killer of children under five years of age. Until recently, treatment has been restricted to facility based approaches, greatly limiting its coverage and impact. New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.
As the population of Africa rapidly urbanizes it may be possible to protect large populations from malaria by controlling aquatic stages of mosquitoes. This report presents a baseline evaluation of the ability of community members to detect mosquito larval habitats with minimal training and supervision in the first weeks of an operational urban malaria control program.
These guidelines aim to assist practitioners and implementing partners to run community-based worker (CBW) systems more effectively, maximising impacts for clients of the service, empowering communities, empowering the CBWs themselves, and assisting governments to ensure that services are provided at scale to enhance livelihoods. They are aimed at practitioners in government, civil society or the private sector already involved or interested in the practical application of community-based worker models. Topics include the generic components of the CBW system, deciding where to use a CBW approach, preparing for implementation and operationalising the CBW system. Descriptions are provided for the different elements of the system, along with step-by-step guidance.
The community-directed intervention (CDI) strategy is an approach in which communities themselves direct the planning and implementation of intervention delivery. This CDI study involved multi-disciplinary research teams from seven sites in three African countries, including Uganda. Integrated delivery of different interventions through the CDI strategy proved feasible and cost-effective where adequate supplies of drugs and other intervention materials were made available. Communities, health workers, policy-makers and other stakeholders were quite supportive and their buy-in to the CDI approach increased significantly over time. Since intervention coverage also increased as more interventions were gradually included in CDI delivery, the results of the study are promising in terms of the sustainability of the CDI approach. Based on its findings, the study recommends that CDI approaches be adopted for integrated, community-level delivery of appropriate health interventions in the 16 African countries with experience in community-directed treatment for onchocerciasis control. This may comprise the interventions tested in this study, especially for malaria, or other intervention packages chosen on the basis of the lessons learnt.
In this study, researchers hypothesised that a participatory learning and action (PLA) family hygiene education approach plus the regular use of hygiene products could result in marked reduction of morbidity in children aged under five years. They sampled 685 households in two separate areas in Cape Town. Two groups received hygiene education only (control) and the other two groups hygiene education plus hygiene products (intervention). Results indicated that children aged under five years in all communities had significant reductions in gastrointestinal and respiratory illnesses and skin infections over time. The first control group with hygiene education only was 2.46 times more likely to experience gastrointestinal illnesses and 4.56 times more likely to experience respiratory illnesses at study follow-up than the corresponding intervention group. The second control group with hygiene education only was 1.64 times more likely to experience gastrointestinal illnesses, 4.62 times more likely to experience respiratory illnesses and 1.29 times more likely to experience skin infections than the intervention group. In conclusion, while hygiene education alone resulted in meaningful reductions in the three conditions, families with hygiene education plus consistent use of provided hygiene products had greater reductions.