Participatory approach to design social accountability interventions to improve maternal health services

Autor: Eric Mafuta, Patrick K. Kayembe, Paul N. Khomba, Leon Essink, François M. Zioko, Thérèse N. M. Mambu, Tjard de Cock Buning, Marjolein Dieleman
Přispěvatelé: Science Communication, Science and Society
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Maternal mortality
medicine.medical_specialty
Health (social science)
SDG 16 - Peace
Interactive learning and action
Epidemiology
Psychological intervention
03 medical and health sciences
0302 clinical medicine
Health facility
medicine
030212 general & internal medicine
Dialogue Model
Involving users
Social accountability
Facility delivery
Social accounting
business.industry
030503 health policy & services
Health Policy
Public health
Research
SDG 16 - Peace
Justice and Strong Institutions
Public Health
Environmental and Occupational Health
Quality of care
Public relations
Interactive learning and action Involving users Facility delivery Maternal mortality Quality of care Health service responsiveness Dialogue Model Social accountability Voice DR Congo
Focus group
Justice and Strong Institutions
Health service responsiveness
Intervention (law)
Content analysis
Voice
0305 other medical science
business
DR Congo
Situation analysis
Zdroj: Mafuta, E M, Dieleman, M A, L, E, Khomba, PN, Zioko, FM, Mambu, TNM, Kayembe, PK & de Cock Buning, J T 2017, ' Participatory approach to design social accountability interventions to improve maternal health services : a case study from the Democratic Republic of the Congo ', Global Health Research and Policy, vol. 2, no. 1, 4 . https://doi.org/10.1186/s41256-017-0024-0
Global Health Research and Policy
Global Health Research and Policy, 2(1):4. BioMed Central Ltd.
ISSN: 2397-0642
Popis: Background Social accountability (SA) comprises a set of mechanisms aiming to, on the one hand, enable users to raise their concerns about the health services provided to them (voice), and to hold health providers (HPs) accountable for actions and decisions related to the health service provision. On the other hand, they aim to facilitate HPs to take into account users’ needs and expectations in providing care. This article describes the development of a SA intervention that aims to improve health services responsiveness in two health zones in the Democratic Republic of the Congo. Methods Beneficiaries including men, women, community health workers (CHWs), representatives of the health sector and local authorities were purposively selected and involved in an advisory process using the Dialogue Model in the two health zones: (1) Eight focus group discussions (FGDs) were organized separately during consultation aimed at sharing and discussing results from the situation analysis, and collecting suggestions for improvement, (2) Representatives of participants in previous FGDs were involved in dialogue meetings for prioritizing and integrating suggestions from FGDs, and (3) the integrated suggestions were discussed by research partners and set as intervention components. All the processes were audio-taped, transcribed and analysed using inductive content analysis. Results Overall there were 121 participants involved in the process, 51 were female. They provided 48 suggestions. Their suggestions were integrated into six intervention components during dialogue meetings: (1) use CHWs and a health committee for collecting and transmitting community concerns about health services, (2) build the capacity of the community in terms of knowledge and information, (3) involve community leaders through dialogue meetings, (4) improve the attitude of HPs towards voice and the management of voice at health facility level, (5) involve the health service supervisors in community participation and; (6) use other existing interventions. These components were then articulated into three intervention components during programming to: create a formal voice system, introduce dialogue meetings improving enforceability and answerability, and enhance the health providers’ responsiveness. Conclusions The use of the Dialogue Model, a participatory process, allowed beneficiaries to be involved with other community stakeholders having different perspectives and types of knowledge in an advisory process and to articulate their suggestions on a combination of SA intervention components, specific for the two health zones contexts. Electronic supplementary material The online version of this article (doi:10.1186/s41256-017-0024-0) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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