Ouagadougou declaration on primary health care and health systems in Africa: achieving better health for Africa in the new millennium

The International Conference on Primary Health Care and Health Systems in Africa, meeting in Ouagadougou, Burkina Faso, from 28 to 30 April 2008, reaffirms the principles of the Declaration of Alma-Ata of September 1978, particularly in regard to health as a fundamental human right and the responsibility that governments have for the health of their people. Having analysed the experience of Primary Health Care implementation in the countries of Africa in the last 30 years, the Conference expresses the need for accelerated action by African governments, partners and communities to improve health; the Conference, also reaffirming the importance of the involvement, participation and empowerment of communities in health development in order to improve their well-being; and recognizing the importance of a concerted partnership, in particular, civil society, private sector and development partners to translate commitments into action; hereby makes the following Declaration.

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

BACKGROUND:

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research.

OBJECTIVE:

To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.

METHODOLOGY:

We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out ...

How stakeholder participation can contribute to systematic reviews of complex interventions

Although patient and public involvement in research is a requirement for research funding in many countries, the knowledge base for how to effectively involve people —and evidence of the effectiveness of involvement—is weak. This article describes how methods used in participatory health research were used to involve patients, clients, providers and community health workers across all stages of a realist review. Sustained involvement enabled better identification of the components of the complex intervention of communitybased peer support. It also challenged assumptions of how peer support is constructed, leading the review team to question whether the process of designing and implementing interventions has more influence on effectiveness than previously recognised in empirical studies. We conclude with a discussion on when sustained involvement should be used, and the challenges of incorporating it into the traditional researcher-led approach to systematic reviews.

Reaching the poor with health interventions: programme-incidence analysis of seven randomised trials of women’s groups to reduce newborn mortality in Asia and Africa

Background Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa.

Methods We conducted a secondary analysis of seven randomised trials of participatory women’s groups to reduce newborn mortality in India, Bangladesh, Nepal and Malawi. We analysed data on 70 574 pregnancies. Socioeconomic and sociodemographic differences in group attendance were tested using logistic regression. Qualitative data were collected at each trial site (225 focus groups, 20 interviews) to understand our results.

Results Socioeconomic differences in women’s group attendance were small, except for occasional lower attendance by elites. Sociodemographic differences were large, with lower attendance by young primigravid women in African as well as in South Asian sites. The intervention was considered relevant ...

Diversity Conceptual Model for aged care: Person-centred and difference-oriented and connective with a focus on benefit, disadvantage and equity

AIM:

This project aimed to develop a Diversity Conceptual Model to support the aged care sector to identify diversity characteristics and associated benefits and disadvantages in order to consider greater equity in policy and practice.

METHODS:

A multi-method approach was used to develop the Diversity Conceptual Model using a literature review, organisation-wide consultation using a questionnaire, focus groups and interviews with key stakeholders.

RESULTS:

A Diversity Conceptual Model was developed as a visual 'tool', made up of numerous components, with a focus on diversity characteristics that may be creating benefits and disadvantages for a consumer to participate in their health care. Continuous quality improvements and equity are presented as essential overarching components of the Model.

CONCLUSION:

The Diversity Conceptual Model has many potential applications for aged care. The author proposes that its wider adoption would increase confidence, skills and knowledge, enabling the aged care sector to influence greater equity in ...

What can a participatory approach to evaluation contribute to the field of integrated care?

Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground.

We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms.

While there is still much to learn about the benefits ...

European Forum for Primary Care 2017 Conference: The Citizen Voice in Primary Care

The main themes of this conference are,

1 - Promoting participative citizenship in healthcare 

Sub-themes:

Citizen oriented healthcare

Health literacy

Citizen participation in health research

Procedures to listen to the public voice

IT to citizen participation in health

Patients and communities’ leagues and commissions and their relevance for health organizations.

Parallel themes

2 - Informal Care

3 - Mediterranean Health

Primary health services at district level in South Africa: a critique of the primary health care approach

The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite, South Africa´s progress and attempts at implementing primary health care, various factors still limit its success.

Asia-Pacific Patients Congress: Harmonisation for Patient-Centred Universal Health Coverage in Asia

IAPO’s Asia-Pacific Patients Congress is the 2019 regional event which will bring together the patient movement in the Asia-Pacific region. The Congress aims to bring together around 150 patient advocates from the region to share their insights, perspectives, experiences and best practices on the pressing healthcare issues in the region.

It is also an opportunity for IAPO to promote its mission to help build patient-centered healthcare across the region and to encourage the formation of national alliances of patient groups.

The Congress is organized by IAPO and co-delivered by its regional members the Psoriasis Association of Taiwan (PAT) and the Taiwan Alliance of Patient Organizations (TAPO).

Comparison of family centered care with family integrated care and mobile technology (mFICare) on preterm infant and family outcomes: a multi-site quasi-experimental clinical trial protocol

Family Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes.

Integrated people-centred health services (IPCHS) in Ireland: lessons learnt

Following presentation of Dr. Áine Carroll, Consultant at The National Rehabilitation Hospital (NRH) and Professor of Healthcare Integration and Improvement at UCD describes current lessons learnt in the design and delivering of integrated people-centred health services in Ireland.

In the context of challenging emerging demands and system constraints, a clinical strategy and over 30 national programs have been developed to improve clinician and patient experience at the lower cost. Dr. Carroll, addresses the challenges of implementing integrated care programs and highlights the most recent achievements of national policy “Sláintecare Action Plan” that contributes to make integrated care a reality. Several elements as patient narratives, partnership and leadership make up the health system’s capacities for building integration at micro, meso and macro level.

Please check out the video: https://pro.panopto.com/Panopto/Pages/Viewer.aspx?tid=5e8a430a-519d-45ad-88ad-ac7100d48a92

Lessons in the Design and Initial Implementation of the System on Prevention, Early Identification, Referral, and Intervention for Delays, Disorders, and Disabilities in Early Childhood in the Philippines

Approximately 1 in every 10 children has a disability and in developing countries, fewer than one out of 10 of them go to school (1) (2). Persons with disabilities experience overlapping deprivations that contribute to marginalization, significant discrimination, and ultimately, exclusion in societal participation, perpetrating the vicious cycle of disability and poverty (3) (4).

Early childhood is the time when the impact of disability into adulthood can be maximally mitigated. It is, therefore, crucial for identification to be carried out at the earliest possible instance and appropriate intervention is provided.

In the Philippines, efforts are underway to implement a system on prevention, early identification, referral, and intervention for delays, disorders, and disabilities in early childhood in select subnational areas. This is a project that is being implemented through the national Early Childhood Care and Development Council and the Department of Health with support from UNICEF and Humanity and Inclusion.

Important ...

Citizen Leadership & Integrated Care Report

Integrated care is at its heart about health, social care and wider services being better coordinated around people, families, and communities. This requires those who plan, design, and deliver services to understand what is important to people on an individual and collective basis. People’s circumstances and aspirations may change with their health conditions and social situations and through new challenges arising in wider society. It is therefore important that opportunities to influence and co-produce services are not a one-off exercise, but rather are ongoing and responsive to people’s interests and perspectives.

Professor Robin Miller and Dr Caroline Jackson (Social Care theme) have been collaborating with research partners in Europe and Canada to understand how people with lived experience of health and/or social care can influence the development of integrated care.

The first report from the research is now available for download: Citizen Leadership & Integrated Care Report.

Civil society feedback on the Zero Draft of the 2023 Political Declaration on UHC

The 2023 UN High-Level (HLM) Meeting on Universal Health Coverage (UHC) provides countries and all stakeholders with the opportunity to not just recommit to UHC but take concrete actions toward building resilient and equitable health systems. While some progress has been made since the 2019 HLM on UHC that resulted in a comprehensive Political Declaration, more than half of the world’s population still lacks access to essential health services. The situation was further exacerbated by the COVID-19 pandemic.

As the UHC2030 Co-Chairs recently stated in their reflection on the UHC Political Declaration 2023 Zero Draft, Member States must show political leadership and “move from commitment to action”. Following the release of the zero draft of the political declaration, the Civil Society Engagement Mechanism (CSEM) launched a survey to collect feedback from civil society to identify priorities for strengthening the zero draft, and ultimately, the Political Declaration. Over the span ...