Role of innovative institutional structures in integrated governance

Kalita, Anuska; Mondal, Shinjini

doi:10.1108/14777261211277005

Cited by 11 publications

(6 citation statements)

References 26 publications

(18 reference statements)

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“…This study found no significant increase in maternal healthcare utilization, suggesting that income security alone does not reduce barriers to utilization. Additionally, a significant increase in home deliveries was found amongst poorer households, suggesting that Employment Guarantee Schemes (EGS) may introduce unintended barriers that reduce utilization and increase inequity (32).However, advocate for integrated governance potentially improving community participation, service delivery, public system accountability, and human resource rationalization (35). Strategies for innovative institutional structures show improved participation of communities in self-governance, community monitoring of government programs, and, therefore, better services.…”

Section: Governancementioning

confidence: 99%

Primary Healthcare Innovations in India: Synthesis from a systematic review

Chaudhuri,

Yellappa,

Parikh

et al. 2023

Preprint

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TITLE: Primary Healthcare Innovations in India: Synthesis from a systematic review Primary healthcare (PHC) serves as the first point of contact for individuals seeking care. However, the PHC system in India faces significant systemic challenges compounded by multiple disease burdens the population faces. The Astana Declaration highlighted the importance of building a comprehensive and resilient healthcare system, focused on an individual rather than a disease. While Health and Wellness Centers (HWCs) are being developed towards universal health coverage (UHC) as a part of the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), several gaps still exist. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study involved developing a theoretical PHC framework, creating search strategies across databases (like MEDLINE, OVID, and CINAHL), and screening them. The review encompassed health innovations and included studies from 1990 to 2019. Relevant quantitative and geographically focused study designs were included, focusing on innovations that improve the efficiency, effectiveness, quality, sustainability, and economy of primary care services. A total of 239 impact evaluations were included and analyzed. The majority of these evaluations were journal articles (237), with one report and one working paper. The impact evaluations primarily focused on single innovations, although there were also 10 multilayered studies and 7 studies with multiple arms. Out of the 239 innovations, 24 were randomized controlled trials (RCTs) conducted in controlled settings. The studies predominantly took place in rural communities (53%), followed by mixed urban-rural, urban, and tribal communities. Foundations were primary funders (35.6%), with community health worker-delivered interventions, digital service innovations, and supportive mentoring programs being the key supported interventions. This systematic review offers valuable insights into the challenges and opportunities in India's PHC system. The findings can inform policymakers, researchers, and healthcare stakeholders in improving primary healthcare delivery and addressing the evolving healthcare landscape in India.

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Section: Governancementioning

confidence: 99%

Primary Healthcare Innovations in India: Synthesis from a systematic review

Chaudhuri,

Yellappa,

Parikh

et al. 2023

Preprint

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“…Governance generally refers to how organizations are controlled ( Tihanyi et al , 2014 ). Kalita and Mondal (2012) explain governance as “the way resources are allocated, the way decisions are made and the accountability mechanisms which are put in place” (p. 759). The importance of effective governance has reached national priority status such that Australia’s National Safety and Quality Health Service Standards (see Greenfield et al , 2015 ) identify corporate governance (standard 1 – governance for safety and quality in health service organizations) as important to improving the performance of the organization for providing safe and quality services to patients.…”

Section: Statement Of the Problem: Governance And Engagementmentioning

confidence: 99%

“…Statement of the problem: governance and engagement In a complex organization, and particularly in healthcare, the internal decision-making systems are inextricably linked to governance structures (Kalita and Mondal, 2012;Tihanyi et al, 2014). Governance generally refers to how organizations are controlled (Tihanyi et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Voice of the Clinician: the case of an Australian health system

Lock¹,

Stephenson

Branford

et al. 2017

JHOM

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PurposeThe Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue.Design/methodology/approachThe Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members.FindingsThis effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met.Practical implicationsIn response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and – ultimately – clinician engagement.Originality/valueThe breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked.

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“…Among the varying relational community engagement interventions currently being engaged within health spaces, improving accountability and governance as well as promoting social participation are often highlighted as outcomes. More specifically, there are intervention efforts emphasizing the importance of transparency and responsibility through relationships [ 31 ], while recognizing the significance of involving individuals and communities in decision-making processes [ 32 ]. Capacity building among healthcare providers (i.e., aiming to enhance their knowledge and skills), as well as interventions to improve the quality of services while emphasizing the delivery of high-standard care have also been carried out within relational settings [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Relational community engagement within health interventions at varied outcome scales

Redvers,

Odugleh-Kolev,

Paula Cordero

et al. 2024

PLOS Glob Public Health

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Relational community engagement may be a powerful approach with multiple health outcomes. Relational community engagement has the potential to promote health and involves collaborative efforts between multiple stakeholders. The COVID-19 pandemic further highlighted the centrality of community engagement in health crises. Challenges continue to persist, however, in genuinely engaging and empowering communities for better health outcomes. Understanding the multi-level and complex relational nature of community engagement is essential to comprehend its influence on health at micro, meso, and macro scales of influence. The purpose of this narrative review was to synthesize the literature on relational community engagement within varied health interventions at the three major system levels (micro, meso, and macro) to support the development of future research agendas. At the micro level, relational community engagement interventions demonstrated a range of positive outcomes including: increased sense of control, satisfaction, positive behavior, improved knowledge, behavior change, empowerment, and overall positive health and social outcomes. At the meso level, relational community engagement interventions resulted in increased trust between stakeholders and groups/teams, and increased community senses of ownership of interventions, decisions, structures. At the macro level, relational community engagement interventions influenced broader societal factors and had positive impacts on health policy and governance including collaboration between sectors and communities as well as increased access to services. The review highlights the potential versatility and effectiveness of interventions that prioritize relationships, health promotion, and social change while underscoring the significance of holistic and community-centered approaches in addressing diverse health and social challenges.

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Role of innovative institutional structures in integrated governance

Abstract: This paper is one of the few to investigate innovative public institutions of a and community mobilisation to explore this important, and under-researched, topic.

Cited by 11 publications

References 26 publications

Primary Healthcare Innovations in India: Synthesis from a systematic review

Primary Healthcare Innovations in India: Synthesis from a systematic review

Voice of the Clinician: the case of an Australian health system

Relational community engagement within health interventions at varied outcome scales

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