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Ankomah SE, Fusheini A, Derrett S. Barriers and facilitators of Patient-Public Engagement for health system improvement in Sub-Saharan Africa: A systematic scoping review. HEALTH POLICY OPEN 2021. [DOI: 10.1016/j.hpopen.2021.100055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ankomah SE, Fusheini A, Ballard C, Kumah E, Gurung G, Derrett S. Patient-public engagement strategies for health system improvement in sub-Saharan Africa: a systematic scoping review. BMC Health Serv Res 2021; 21:1047. [PMID: 34610828 PMCID: PMC8491404 DOI: 10.1186/s12913-021-07085-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/24/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Actively involving patients and communities in health decisions can improve both peoples' health and the health system. One key strategy is Patient-Public Engagement (PPE). This scoping review aims to identify and describe PPE research in Sub-Saharan Africa; systematically map research to theories of PPE; and identify knowledge gaps to inform future research and PPE development. METHODS The review followed guidelines for conducting and reporting scoping reviews. A systematic search of peer-reviewed English language literature published between January 1999 and December 2019 was conducted on Scopus, Medline (Ovid), CINAHL and Embase databases. Independent full text screening by three reviewers followed title and abstract screening. Using a thematic framework synthesis, eligible studies were mapped onto an engagement continuum and health system level matrix to assess the current focus of PPE in Sub-Saharan Africa. RESULTS Initially 1948 articles were identified, but 18 from 10 Sub-Saharan African countries were eligible for the final synthesis. Five PPE strategies implemented were: 1) traditional leadership support, 2) community advisory boards, 3) community education and sensitisation, 4) community health volunteers/workers, and 5) embedding PPE within existing community structures. PPE initiatives were located at either the 'involvement' or 'consultation' stages of the engagement continuum, rather than higher-level engagement. Most PPE studies were at the 'service design' level of the health system or were focused on engagement in health research. No identified studies reported investigating PPE at the 'individual treatment' or 'macro policy/strategic' level. CONCLUSION This review has successfully identified and evaluated key PPE strategies and their focus on improving health systems in Sub-Saharan Africa. PPE in Sub-Saharan Africa was characterised by tokenism rather than participation. PPE implementation activities are currently concentrated at the 'service design' or health research levels. Investigation of PPE at all the health system levels is required, including prioritising patient/community preferences for health system improvement.
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Affiliation(s)
- Samuel Egyakwa Ankomah
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Adam Fusheini
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
- Center for Health Literacy and Rural Health Promotion, Accra, Ghana.
| | - Christy Ballard
- Health Sciences Library, University of Otago, Dunedin, New Zealand
| | - Emmanuel Kumah
- Department of Health Administration and Education, University of Education, Winneba, Ghana
| | - Gagan Gurung
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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Jahun I, Said I, El-Imam I, Ehoche A, Dalhatu I, Yakubu A, Greby S, Bronson M, Brown K, Bamidele M, Boyd AT, Bachanas P, Dirlikov E, Agbakwuru C, Abutu A, Williams-Sherlock M, Onotu D, Odafe S, Williams DB, Bassey O, Ogbanufe O, Onyenuobi C, Adeola A, Meribe C, Efuntoye T, Fagbamigbe OJ, Fagbemi A, Ene U, Nguhemen T, Mgbakor I, Alagi M, Asaolu O, Oladipo A, Amafah J, Nzelu C, Dakum P, Mensah C, Aliyu A, Okonkwo P, Oyeledun B, Oko J, Ikpeazu A, Gambo A, Charurat M, Ellerbrock T, Aliyu S, Swaminathan M. Optimizing community linkage to care and antiretroviral therapy Initiation: Lessons from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) and their adaptation in Nigeria ART Surge. PLoS One 2021; 16:e0257476. [PMID: 34543306 PMCID: PMC8451986 DOI: 10.1371/journal.pone.0257476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/01/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Ineffective linkage to care (LTC) is a known challenge for community HIV testing. To overcome this challenge, a robust linkage to care strategy was adopted by the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). The NAIIS linkage to care strategy was further adapted to improve Nigeria's programmatic efforts to achieve the 1st 90 as part of the Nigeria Antiretroviral Therapy (ART) Surge initiative, which also included targeted community testing. In this paper we provide an overview of the NAIIS LTC strategy and describe the impact of this strategy on both the NAIIS and the Surge initiatives. METHODS The NAIIS collaborated with community-based organizations (CBOs) and deployed mobile health (mHealth) technology with real-time dashboards to manage and optimize community LTC for people living with HIV (PLHIV) diagnosed during the survey. In NAIIS, CBOs' role was to facilitate linkage of identified PLHIV in community to facility of their choice. For the ART Surge, we modified the NAIIS LTC strategy by empowering both CBOs and mobile community teams as responsible for not only active LTC but also for community testing, ART initiation, and retention in care. RESULTS Of the 2,739 PLHIV 15 years and above identified in NAIIS, 1,975 (72.1%) were either unaware of their HIV-positive status (N = 1890) or were aware of their HIV-positive status but not receiving treatment (N = 85). Of these, 1,342 (67.9%) were linked to care, of which 952 (70.9%) were initiated on ART. Among 1,890 newly diagnosed PLHIV, 1,278 (67.6%) were linked to care, 33.7% self-linked and 66.3% were linked by CBOs. Among 85 known PLHIV not on treatment, 64 (75.3%) were linked; 32.8% self-linked and 67.2% were linked by a CBO. In the ART Surge, LTC and treatment initiation rates were 98% and 100%, respectively. Three-month retention for monthly treatment initiation cohorts improved from 76% to 90% over 6 months. CONCLUSIONS Active LTC strategies by local CBOs and mobile community teams improved LTC and ART initiation in the ART Surge initiative. The use of mHealth technology resulted in timely and accurate documentation of results in NAIIS. By deploying mHealth in addition to active LTC, CBOs and mobile community teams could effectively scale up ART with real-time documentation of client-level outcomes.
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Affiliation(s)
- Ibrahim Jahun
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Ishaq Said
- Maryland Global Initiatives (affiliate of the University of Maryland, Baltimore), Abuja, Federal Capital Territory, Nigeria
| | - Ibrahim El-Imam
- Maryland Global Initiatives (affiliate of the University of Maryland, Baltimore), Abuja, Federal Capital Territory, Nigeria
| | - Akipu Ehoche
- Maryland Global Initiatives (affiliate of the University of Maryland, Baltimore), Abuja, Federal Capital Territory, Nigeria
| | - Ibrahim Dalhatu
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Aminu Yakubu
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Stacie Greby
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Megan Bronson
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristin Brown
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Moyosola Bamidele
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Andrew T. Boyd
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pamela Bachanas
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emilio Dirlikov
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Chinedu Agbakwuru
- Maryland Global Initiatives (affiliate of the University of Maryland, Baltimore), Abuja, Federal Capital Territory, Nigeria
| | - Andrew Abutu
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | | | - Denis Onotu
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Solomon Odafe
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Daniel B. Williams
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Orji Bassey
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Obinna Ogbanufe
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Chibuzor Onyenuobi
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Ayo Adeola
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Chidozie Meribe
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Timothy Efuntoye
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Omodele J. Fagbamigbe
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Ayodele Fagbemi
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Uzoma Ene
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Tingir Nguhemen
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Ifunanya Mgbakor
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Matthias Alagi
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Olugbenga Asaolu
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Ademola Oladipo
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | - Joy Amafah
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
| | | | - Patrick Dakum
- Institute of Human Virology (IHVN), Abuja, Federal Capital Territory, Nigeria
| | - Charles Mensah
- Institute of Human Virology (IHVN), Abuja, Federal Capital Territory, Nigeria
| | - Ahmad Aliyu
- Institute of Human Virology (IHVN), Abuja, Federal Capital Territory, Nigeria
| | - Prosper Okonkwo
- AIDS Prevention Initiative Nigeria (APIN), Abuja, Federal Capital Territory, Nigeria
| | - Bolanle Oyeledun
- Center for Integrated Health Program (CIHP), Abuja, Federal Capital Territory, Nigeria
| | - John Oko
- Catholic Caritas Foundation Nigeria (CCFN), Abuja, Federal Capital Territory, Nigeria
| | | | - Aliyu Gambo
- National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria
| | - Manhattan Charurat
- Maryland Global Initiatives (affiliate of the University of Maryland, Baltimore), Abuja, Federal Capital Territory, Nigeria
| | - Tedd Ellerbrock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sani Aliyu
- National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria
| | - Mahesh Swaminathan
- Centers for Disease Control and Prevention-Nigeria Country Office, Abuja, Federal Capital Territory, Nigeria
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Patel SK, Jain A, Battala M, Mahapatra B, Saggurti N. Community Organization Membership, Financial Security, and Social Protection among Female Sex Workers in India. J Int Assoc Provid AIDS Care 2019; 17:2325958218811640. [PMID: 30444156 PMCID: PMC6748518 DOI: 10.1177/2325958218811640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The purpose of this study is to examine the female sex workers’ (FSWs) community organization (CO) membership, their financial and social protection security, and the relationship between these factors among FSWs in India. Data from 4098 FSWs collected under the Avahan-III baseline evaluation survey—2015 in 5 high HIV prevalence states (Maharashtra, Tamil Nadu, Karnataka, Telangana, and Andhra Pradesh) in India were used here. More than three-fifths (77%) were registered CO members, of whom 79% had been CO members for more than 1 year. The likelihood of having high financial security (19% versus 10%; adjusted odds ratio [AOR]: 1.7; 95% confidence interval [CI]: 1.3-2.1) and social protection security (13% versus 6%; AOR: 1.6; 95% CI: 1.2-2.0) was 2 times higher among FSWs who were CO members compared to those who were not. The study offers important insights into furthering CO membership to address financial and social vulnerability as a path to a sustainable reduction of HIV risk.
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Tan RKJ, Wong CS. Mobilizing civil society for the HIV treatment cascade: a global analysis on democracy and its association with people living with HIV who know their status. J Int AIDS Soc 2019; 22:e25374. [PMID: 31379133 PMCID: PMC6680091 DOI: 10.1002/jia2.25374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 07/21/2019] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Civil society organizations (CSOs) play an essential role in the global HIV/AIDS response. Past studies have described the beneficial role of CSOs in meeting the United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, but have not explored how political conditions, which influence the ability of CSOs to organize, have an impact on the cascade. This study explores the relationship between measures of democracy and its association with diagnosis rates among people living with HIV (PLHIV). METHODS This study analyses 2016 data derived from the Economist Intelligence Unit's Democracy Index (EIUDI), UNAIDS country estimates for PLHIV and PLHIV who knew their status in 2016, World Bank's 2016 data on nominal gross domestic product (GDP) per capita and country population, HIV Justice Network's 2016 data on HIV criminalization, and country-level estimates for PLHIV, PLHIV who know their status, and expenditure on HIV prevention from other independent sources. An estimated HIV prevalence variable was constructed by dividing the estimated PLHIV population with the total population of a country. Analyses were limited to countries with available data on PLHIV who know their status (n = 111). RESULTS Of the 111 countries in the analytic sample, the mean democracy index score was 5.93 (of the 10), median estimated HIV prevalence was 0.20% (IQR 0.10-0.65), median GDP per capita (in thousands, US dollar) was 4.88 (IQR 2.11-13.79), and mean PLHIV who know their status is 67.12%. Preliminary analysis on the five component measures of the EIUDI revealed multicollinearity, and thus the composite democracy index score was used as the measure for democracy. Multivariate linear regression analyses revealed that democracy index scores (β = 2.10, SE = 1.02, p = 0.04) and GDP per capita (in thousands; β = 0.34. SE = 0.11, p < 0.01) were positively associated with diagnosis rates among PLHIV, controlling for country-level expenditure on HIV prevention, HIV criminalization laws and estimated HIV prevalence. CONCLUSIONS Results indicate that higher levels of democracy were positively associated with rates of diagnosis among PLHIV. Further analyses following wider implementation of universal testing and treatment is warranted, as well as the need for further research on the mechanisms through which political cultures specifically influence rates of diagnosis among PLHIV.
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Affiliation(s)
- Rayner KJ Tan
- Saw Swee Hock School of Public HealthNational University of SingaporeSingapore
| | - Chen Seong Wong
- National Centre for Infectious DiseasesSingapore
- Department of MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore
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Huang W, Wu D, Pan SW, Li K, Ong JJ, Fu H, Liu C, Mao J, Tucker JD, Tang W. Driving force of condomless sex after online intervention among Chinese men who have sex with men. BMC Public Health 2019; 19:978. [PMID: 31331300 PMCID: PMC6647144 DOI: 10.1186/s12889-019-7307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention. METHODS This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval. RESULTS Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period. CONCLUSION The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.
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Affiliation(s)
- Wenting Huang
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Dan Wu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Stephen W. Pan
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Katherine Li
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Weill Cornell Medical College, New York, USA
| | - Jason J. Ong
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Hongyun Fu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Chuncheng Liu
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Sociology, University of California, San Diego, La Jolla USA
| | - Jessica Mao
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Joseph D. Tucker
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
- Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, UK
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
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Kave S, Khuzwayo NF, Hatcher A, Sikweyiya Y. The role of support groups in linking and retaining newly diagnosed clients in HIV care in a peri-urban location in South Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2019; 18:9-17. [PMID: 30880579 DOI: 10.2989/16085906.2018.1551233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although South Africa has the largest number of people on antiretroviral therapy (ART) in the world, many HIV clients drop out of care immediately after HIV diagnosis. This qualitative study explored the perceptions and experiences of newly diagnosed clients on the role support groups play in linking and retaining newly diagnosed clients in HIV care in Mbandazayo peri-urban location. The data were analysed using the thematic content analysis approach. Data revealed four mechanisms through which support groups appeared to link and retain newly diagnosed clients in the HIV care continuum. First, support groups were a formal link between newly diagnosed clients and health facilities. Second, support groups mitigated the effects of both felt and enacted stigma, thereby facilitating acceptance of HIV diagnosis among newly diagnosed clients. Third, support groups were an advocacy and networking tool for newly diagnosed clients to make their health related needs, challenges, and concerns known to local health clinics, thereby forging and maintaining a close relationship with their local health facilities. Last, support groups were spaces within the community where practical needs of newly diagnosed clients are met, which in turn help in retaining them within support groups, and facilitate their linkage and retention in the HIV continuum of care in Mbandazayo. Our findings suggest that HIV support groups are critical in enhancing linkages and retention of newly diagnosed clients in HIV care. With the introduction of universal test and treat (UTT) in South Africa, our findings suggest that support groups can play a significant role in retaining HIV care clients who are diagnosed and immediately enrolled on ART.
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Affiliation(s)
- Siyabonga Kave
- a Department of Rural Health , University of KwaZulu-Natal , Durban , South Africa
| | - Nelisiwe F Khuzwayo
- a Department of Rural Health , University of KwaZulu-Natal , Durban , South Africa
| | - Abigail Hatcher
- b School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
| | - Yandisa Sikweyiya
- c Gender & Health Research Unit, School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
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Adebayo OW, Salerno JP, Francillon V, Williams JR. A systematic review of components of community-based organisation engagement. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e474-e484. [PMID: 29314373 PMCID: PMC6124309 DOI: 10.1111/hsc.12533] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2017] [Indexed: 05/17/2023]
Abstract
Community-based organisations (CBOs) are important for eliminating health disparities globally and translating research findings to inform interventions. Engagement is an integral part of partnerships between CBOs and community health researchers and impacts the quality and quantity of any desired outcome. Despite the acknowledged benefits of community-based organisation engagement (CBOE), there are variations in its operationalisation and paucity in the understanding of its use in community-scientific partnerships. To further understand CBOE, the aim of this study was to synthesise published literature relevant to the definitions and applications of CBOE and identify its key components. A systematic search was conducted in March 2017, and updated in June 2017. Keywords were varied to account for international differences in spelling and word usage. Five major databases, MEDLINE, PubMed, CINAHL, PsycINFO and Google Scholar, were used to identify potential research studies. A total of 32 studies were included in this review. Following the analysis of the literature, four salient themes emerged as components of CBOE: (1) Need (a consensus between all the parties in a partnership on the importance of a specified project and its proposed benefits to a target community); (2) Partnership Dynamics (the workings of a relationship between a CBO and a scientific/academic stakeholder); (3) Resources (include but are not limited to: personnel, money, work space, expertise and equipment); and (4) Outcomes (products of the partnership). This review provides a foundation for future research in applying CBOE to translational research and interventions. This analysis will assist community health researchers in planning partnerships with CBOs, and make necessary adjustments to improve study outcomes. Appropriate application of the components of CBOE in partnerships will assist researchers in addressing health disparities.
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Affiliation(s)
| | - John P Salerno
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Valerie Francillon
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Jessica R Williams
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
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Li H, Xue L, Tucker JD, Wei C, Durvasula M, Hu W, Kang D, Liao M, Tang W, Ma W. Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men. BMC Public Health 2017; 17:641. [PMID: 28784172 PMCID: PMC5545844 DOI: 10.1186/s12889-017-4662-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 08/01/2017] [Indexed: 12/26/2022] Open
Abstract
Background Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. Methods A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use. Results The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. Conclusion The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4662-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haochu Li
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China. .,UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,SESH Global, Guangzhou, China.
| | - Li Xue
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China
| | - Joseph D Tucker
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,SESH Global, Guangzhou, China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Maya Durvasula
- Department of Economics, Duke University, Durham, NC, USA
| | - Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China
| | - Dianming Kang
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Meizhen Liao
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Weiming Tang
- UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,SESH Global, Guangzhou, China.,Guangdong Provincial Center for Skin Diseases and STI Control, Guangzhou, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road Shandong Province, Jinan, 250012, China.
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Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey. J Int AIDS Soc 2017. [PMID: 28406270 PMCID: PMC5515028 DOI: 10.7448/ias.20.01/21372] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION HIV and syphilis testing rates remain low among men who have sex with men (MSM) in low- and middle-income countries (LMICs). Community engagement has been increasingly used to promote HIV testing among key populations in high-income countries, often in settings with stronger civil society. This study aimed to assess socio-demographic, behavioural, and community engagement factors associated with HIV and syphilis testing among MSM in China. METHODS MSM ≥16 years old who had condomless sex in the past three months were recruited nationwide to complete a cross-sectional online survey in November 2015. Data were collected on socio-demographics, sexual behaviours, HIV testing, syphilis testing, and community engagement in sexual health. We defined community engagement in sexual health using six items assessing awareness and advocacy of sexual health programmes. The underlying factor structure of a 6-item community engagement scale was determined through exploratory factor analysis. Univariate and multivariable logistic regressions identified correlates of HIV and syphilis testing. RESULTS 1189 MSM were recruited. 54% (647/1189) of men had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. Factor analysis suggested three levels of community engagement (minimal, moderate, and substantial) and this model explained 79.5% of observed variance. A quarter (26%, 312/1189) reported none to minimal engagement, over one half (54%, 644/1189) reported moderate engagement, and a fifth (20%, 233/1189) reported substantial engagement. Multivariable logistic regression showed that MSM with greater community engagement in sexual health were more likely to have ever tested for HIV (substantial vs. no engagement: aOR 7.91, 95% CI 4.98-12.57) and for syphilis (substantial vs. no engagement: aOR 5.35, 95% CI 3.16-9.04). CONCLUSION HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting testing in China and should be considered in intervention development and delivery. Further research is needed to better understand the role of LMIC community engagement in HIV interventions.
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Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey. J Int AIDS Soc 2017; 20:21372. [PMID: 28406270 DOI: 10.7448/ias.20.01.21372] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION HIV and syphilis testing rates remain low among men who have sex with men (MSM) in low- and middle-income countries (LMICs). Community engagement has been increasingly used to promote HIV testing among key populations in high-income countries, often in settings with stronger civil society. This study aimed to assess socio-demographic, behavioural, and community engagement factors associated with HIV and syphilis testing among MSM in China. METHODS MSM ≥16 years old who had condomless sex in the past three months were recruited nationwide to complete a cross-sectional online survey in November 2015. Data were collected on socio-demographics, sexual behaviours, HIV testing, syphilis testing, and community engagement in sexual health. We defined community engagement in sexual health using six items assessing awareness and advocacy of sexual health programmes. The underlying factor structure of a 6-item community engagement scale was determined through exploratory factor analysis. Univariate and multivariable logistic regressions identified correlates of HIV and syphilis testing. RESULTS 1189 MSM were recruited. 54% (647/1189) of men had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. Factor analysis suggested three levels of community engagement (minimal, moderate, and substantial) and this model explained 79.5% of observed variance. A quarter (26%, 312/1189) reported none to minimal engagement, over one half (54%, 644/1189) reported moderate engagement, and a fifth (20%, 233/1189) reported substantial engagement. Multivariable logistic regression showed that MSM with greater community engagement in sexual health were more likely to have ever tested for HIV (substantial vs. no engagement: aOR 7.91, 95% CI 4.98-12.57) and for syphilis (substantial vs. no engagement: aOR 5.35, 95% CI 3.16-9.04). CONCLUSION HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting testing in China and should be considered in intervention development and delivery. Further research is needed to better understand the role of LMIC community engagement in HIV interventions.
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Krivelyova A, Kakietek J, Connolly H, Bonnel R, Manteuffel B, Rodriguez-García R, N'Jie N, Berruti A, Gregson S, Agrawal R. Funding and expenditure of a sample of community-based organizations in Kenya, Nigeria, and Zimbabwe. AIDS Care 2013; 25 Suppl 1:S20-9. [PMID: 23745626 PMCID: PMC4003578 DOI: 10.1080/09540121.2013.764390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 11/30/2012] [Indexed: 01/27/2023]
Abstract
Over the last decade, international donors, technical specialists, and governments have come to recognize the potential of community-based organizations (CBOs) in the fight against HIV/AIDS. Recent empirical studies suggest that community engagement, including the involvement of CBOs, adds value to the national response to HIV/AIDS. With the emerging evidence of the effectiveness of engaging communities in the fight against AIDS, it is crucial to understand the economic dimension of community engagement. This article provides an analysis of funding and expenditure data collected from CBOs in three African countries: Kenya, Nigeria, and Zimbabwe. It presents descriptive information regarding CBO funding and expenditure and examines the factors associated with the total amount of funds received and with the proportions of the funds allocated to programmatic activities and program management and administration. An average CBO in the sample received US$29,800 annually or about US$2480 per month. The highest percentage of CBO funding (37%) came from multilateral organizations. CBOs in the sample spent most of their funds (71%) on programmatic activities including provision of treatment, support, care, impact mitigation, and treatment services.
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Kakietek J, Geberselassie T, Manteuffel B, Ogungbemi K, Krivelyova A, Bausch S, Rodriguez-García R, Bonnel R, N'Jie N, Fruh J, Gar S. It takes a village: community-based organizations and the availability and utilization of HIV/AIDS-related services in Nigeria. AIDS Care 2013; 25 Suppl 1:S78-87. [PMID: 23745634 PMCID: PMC4003581 DOI: 10.1080/09540121.2012.740158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 10/11/2012] [Indexed: 11/17/2022]
Abstract
Community-based organizations (CBOs) have emerged as a vital part of the response to HIV/AIDs in Nigeria. The evaluation, on which this article is based, conducted in 28 communities in 6 states and the Federal capital Territory in Nigeria, assessed the effects of the CBO engagement on a set of outcomes related to HIV/AIDS knowledge, attitudes, beliefs, and practices, stigma, service availably and utilization and social capital. It consisted of three components: a household survey conducted in all 28 communities, qualitative data collected from CBO staff and key informants (KIs), and a funding allocation study (qualitative interviews and the funding allocation study were conducted in a subset of 14 communities). This article focuses on the association between CBO engagement and reported availability and utilization of HIV/AIDS-related services. It shows that CBO engagement has a potential to add value to the national response to HIV/AIDS by increasing the awareness, availability, and utilization of HIV/AIDS-related services, especially in the area of prevention, care and support. The CBOs in the evaluation communities focused on prevention activities as well as on providing support for people living with HIV/AIDS (PLWHA) and prevention and care and support were the highest expenditure categories reported by CBOs. Respondents in communities with a stronger CBO engagement were more likely to: (1) be aware of any HIV/AIDs-related services, (2) report that prevention and care services were available in their communities, and (3) have used any HIV/AIDS related services, prevention-related and care-related services than respondents in communities where CBO engagement was weaker. The association between service awareness and service use and CBO engagement was stronger in rural than in urban areas.
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