Participation, Health and the Development of Community Resources in Southern Brazil

Guareschi, Pedrinho Arcides; Jovchelovitch, Sandra

doi:10.1177/1359105304040896

Cited by 38 publications

(35 citation statements)

References 18 publications

(21 reference statements)

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“…The first is utilitarian [18], where participation is a discrete, short-term intervention [8], [16], [17], [19] and might involve for instance, “[using] community resources (land, labour and money) to offset the costs of providing services” ([18] p. 221). This approach has been criticised for treating participation as an add on or input to healthcare programmes [12], [20], and for ignoring the underlying context and processes contributing to communities’ health inequalities [10], [19]. It echoes the ‘medical’ and ‘health services’ models of community participation [12] where health is equated with absence of disease, and considered to be best achieved using biomedical approaches and delivery of high quality health services.…”

Section: Introductionmentioning

confidence: 99%

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

et al. 2013

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BackgroundDespite a broad consensus that communities should be actively involved in improving their own health, evidence for the effect of community participation on specific health outcomes is limited. We examine the effectiveness of community participation interventions in maternal and newborn health, asking: did participation improve outcomes? We also look at how the impact of community participation has been assessed, particularly through randomised controlled trials, and make recommendations for future research. We highlight the importance of qualitative investigation, suggesting key areas for qualitative data reporting alongside quantitative work.Methods and findingsSystematic review of published and ‘grey’ literature from 1990. We searched 11 databases, and followed up secondary references. Main outcome measures were the use of skilled care before/during/after birth and maternal/newborn mortality/morbidity. We included qualitative and quantitative studies from any country, and used a community participation theoretical framework to analyse the data. We found 10 interventions. Community participation had largely positive impacts on maternal/newborn health as part of a package of interventions, although not necessarily on uptake of skilled care. Interventions improving mortality or use of skilled care raised awareness, encouraged dialogue and involved communities in designing solutions–but so did those showing no effect.DiscussionThere are few high-quality, quantitative studies. We also lack information about why participation interventions do/do not succeed – an area of obvious interest for programme designers. Qualitative investigation can help fill this information gap and should be at the heart of future quantitative research examining participation interventions – in maternal/newborn health, and more widely. This review illustrates the need for qualitative investigation alongside RCTs and other quantitative studies to understand complex interventions in context, describe predicted and unforeseen impacts, assess potential for generalisability, and capture the less easily measurable social/political effects of encouraging participation.

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Section: Introductionmentioning

confidence: 99%

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

et al. 2013

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“…Wallerstein [40] described empowerment as a social action process that motivates people to achieve goals of increasing political efficacy and social justice. A central strategy of empowerment is the process of conscientization, whereby people become aware of the political, socioeconomic and cultural contradictions that shape their lives and who they are [41]. It is argued that foreign wives who acquired the skills of critical reflexivity from the group of linking social capital are more likely to notice, recall, and report their experiences of racial discrimination.…”

Section: Discussionmentioning

confidence: 99%

Discrimination-related health inequality and role of social capital among marriage migrant women in South Korea

Kim

2016

Int J Equity Health

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BackgroundThis study aimed to evaluate whether social capital could alleviate health inequality against racial discrimination and identify the critical nature of social capital that generates health inequality differences within the social context of South Korea.MethodsUsing the data of the 2009 National Survey of Multicultural Families, a nationally representative sample in which 40,430 foreign wives participated, the concentration index (CI) was used to measure the discrimination-related inequalities in self-rated health and was decomposed into contributing factors.ResultsThe results showed a significant concentration of poor self-rated health unfavorable to foreign wives who were highly discriminated (CI 0.023, standard error [SE] 0.001, p < .001). However, when the CIs were assessed among the subgroups of different social capital, no discrimination-related inequality in health was observed among the group of linking social capital (CI 0.008, SE 0.008, p .332). The total differential decomposition method showed two major factors that generate differences in health inequality between the groups of non-linking and linking social capital: protest against discrimination (35.8 %); experiences of discrimination (28.3 %).ConclusionsThe present results indicated that linking social capital can be a useful resource of health resilience factor that equalizes discrimination-related health inequality among marriage migrant women in South Korea. This study provides additional evidence that social capital needs to be placed in its political context.

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“…24,35 As Wallerstein argues, "empowerment… [is] an important outcome in its own right, and also an intermediate outcome in the pathway to reducing health disparities and social exclusion," 29(p18) -a point reiterated by Hothi, who suggests that "empowerment 'done well'… helps individuals and communities to exert control over the circumstances that affect their lives, thereby improving local well-being." 47(p55) Guareschi and Jovchelovitch 48 have commented that participation for empowerment not only serves a conscientization role, but also "re-shapes the relationship between individuals, community and the political arena, empowering, developing citizenship and forging spaces for the presence of grassroots in the institutional structures of the state." The Phase IV Healthy Cities evaluation identified numerous examples of facilitating access to information, consulting, and enabling participation in decision making by local people.…”

Section: Discussionmentioning

confidence: 99%

Healthy Cities: Facilitating the Active Participation and Empowerment of Local People

Dooris

Héritage

2011

J Urban Health

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Community participation and empowerment are key values underpinning the European WHO Healthy Cities initiative, now in its fifth phase. This paper provides a brief overview of the history, policy context, and theory relating to community participation and empowerment. Drawing on Phase IV evaluation data, it presents the findings in relation to the four quadrants of Davidson's Wheel of Participationinformation, consultation, participation in decision making, and empowerment. The large majority of European Healthy Cities have mechanisms in place to provide information for and to consult with local people. Most also demonstrate a commitment to enabling community participation in decision-making and to empowering citizens. Within this context, the evaluation highlighted a diversity of approaches and revealed varied perspectives on how participation and empowerment can be integrated within city leadership and governance processes. The paper concludes by suggesting that there is a need to strengthen future evaluative research to better understand how and why the Healthy Cities approach makes a difference.

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Participation, Health and the Development of Community Resources in Southern Brazil

Abstract: for the commitment and work they put into the project. Finally we would like to thank three anonymous reviewers for their comments on an earlier version of this article.

Cited by 38 publications

References 18 publications

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

Effects of Community Participation on Improving Uptake of Skilled Care for Maternal and Newborn Health: A Systematic Review

Discrimination-related health inequality and role of social capital among marriage migrant women in South Korea

Healthy Cities: Facilitating the Active Participation and Empowerment of Local People

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