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Msomi NL, Ross AJ. Community service rehabilitation therapists' understanding of social accountability. Afr J Prim Health Care Fam Med 2024; 16:e1-e9. [PMID: 38949437 PMCID: PMC11219558 DOI: 10.4102/phcfm.v16i1.4473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/18/2024] [Accepted: 04/04/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Social accountability is the obligation of health care providers to address the priority health concerns of the community they serve and of universities to ensure that graduates understand these social responsibilities. Although social accountability can combat systemic health inefficiencies, it is not well-understood or practised. AIM The study aimed to explore community service rehabilitation therapists' understanding of social accountability. SETTING The study was conducted in KwaZulu-Natal, South Africa. METHODS This study used an interpretive exploratory design and purposively recruited 27 community service rehabilitation therapists namely, audiologists, speech-language therapists, occupational therapists, and physiotherapists working in public sector health facilities in rural and peri-urban areas. Four focus group discussions and four free attitude interviews were conducted, the results being thematically analysed. RESULTS Despite most of the participants not being instructed in social accountability as part of their formal training or institutional induction, three themes emerged based on their experiences. These themes include describing social accountability, values of social accountability, and values of community-based rehabilitation applicable to social accountability. CONCLUSION Inclusion of instruction on social accountability as part of their formal training and health facility induction would contribute to rehabilitation therapists' understanding of social accountability.Contribution: The study contributes to data on rehabilitation education and community service training regarding social accountability within a South African context and has captured how experiences gained during community service contribute to the rehabilitation therapists' understanding of social accountability.
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Affiliation(s)
- Ntandoyenkosi L Msomi
- Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban.
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de Carvalho Corôa R, Ben Charif A, Robitaille V, G. V. Mochcovitch D, Abdoulaye Samri M, Akpo TG, Gogovor A, Blanchette V, Gomes Souza L, Kastner K, M. Achim A, McLean RKD, Milat A, Légaré F. Strategies for involving patients and the public in scaling initiatives in health and social services: A scoping review. Health Expect 2024; 27:e14086. [PMID: 38837509 PMCID: PMC11150745 DOI: 10.1111/hex.14086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Scaling in health and social services (HSS) aims to increase the intended impact of proven effective interventions. Patient and public involvement (PPI) is critical for ensuring that scaling beneficiaries' interests are served. We aimed to identify PPI strategies and their characteristics in the science and practice of scaling in HSS. METHODS In this scoping review, we included any scaling initiative in HSS that used PPI strategies and reported PPI methods and outcomes. We searched electronic databases (e.g., Medline) from inception to 5 February 2024, and grey literature (e.g., Google). Paired reviewers independently selected and extracted eligible reports. A narrative synthesis was performed and we used the PRISMA for Scoping Reviews and the Guidance for Reporting Involvement of Patients and the Public (GRIPP2). FINDINGS We included 110 unique reports out of 24,579 records. In the past 5 years, the evidence on PPI in scaling has increased faster than in any previous period. We found 236 mutually nonexclusive PPI strategies among 120 scaling initiatives. Twenty-four initiatives did not target a specific country; but most of those that did so (n = 96) occurred in higher-income countries (n = 51). Community-based primary health care was the most frequent level of care (n = 103). Mostly, patients and the public were involved throughout all scaling phases (n = 46) and throughout the continuum of collaboration (n = 45); the most frequently reported ethical lens regarding the rationale for PPI was consequentialist-utilitarian (n = 96). Few papers reported PPI recruitment processes (n = 31) or incentives used (n = 18). PPI strategies occurred mostly in direct care (n = 88). Patient and public education was the PPI strategy most reported (n = 31), followed by population consultations (n = 30). CONCLUSIONS PPI in scaling is increasing in HSS. Further investigation is needed to better document the PPI experience in scaling and ensure that it occurs in a meaningful and equitable way. PATIENT AND PUBLIC CONTRIBUTION Two patients were involved in this review. They shared decisions on review questions, data collection instruments, protocol design, and findings dissemination. REVIEW REGISTRATION Open Science Framework on 19 August 2020 (https://osf.io/zqpx7/).
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Affiliation(s)
- Roberta de Carvalho Corôa
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | | | | | - Diogo G. V. Mochcovitch
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
| | | | - Talagbe Gabin Akpo
- Faculty of Business AdministrationUniversité LavalQuebec CityQuebecCanada
- Institut National de la Recherche ScientifiqueUniversité LavalQuebec CityQuebecCanada
| | - Amédé Gogovor
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | - Virginie Blanchette
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Department of Human Kinetics and Podiatric MedicineUniversité du Québec à Trois‐RivièresTrois‐RivièresQuebecCanada
| | - Lucas Gomes Souza
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
| | | | - Amélie M. Achim
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- CERVO Brain Research CentreQuebec CityQuebecCanada
| | - Robert K. D. McLean
- International Development Research CentreOttawaOntarioCanada
- Faculty of Medicine and Health SciencesStellenbosch UniversityStellenboschWestern CapeSouth Africa
| | - Andrew Milat
- School of Public HealthUniversity of SydneySydneyNew South WalesAustralia
- Sydney Health PartnersSydneyNew South WalesAustralia
| | - France Légaré
- VITAM—Centre de recherche en santé durableCentre intégré universitaire de santé et services sociaux de la Capitale‐NationaleQuebec CityQuebecCanada
- Unité de soutien au système de santé apprenant QuébecQuebec CityQuebecCanada
- Faculty of MedicineUniversité LavalQuebec CityQuebecCanada
- Centre de Recherche du CHU de Québec ‐ Université LavalQuebec CityQuebecCanada
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Mokhachane M, Green-Thompson L, Wyatt TR. Voices of Silence: Experiences in Disseminating Scholarship as a Global South Researcher. TEACHING AND LEARNING IN MEDICINE 2024; 36:235-243. [PMID: 36843331 DOI: 10.1080/10401334.2023.2181815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Issue: There is an unspoken requirement that medical education researchers living in the Global South must disseminate their work using dominant frames constructed by individuals living in the Global North. As such, the published literature in our field is dominated by researchers whose work primarily benefits the Western world, casting the rest of what is published as localized and unhelpful knowledge. In this article, we use Audre Lorde's conception of the Master's house as a metaphor to narrate the experiences of two South African medical education researchers trying to disseminate their work into North American venues. In addition to narrating these stories, we describe the personal and professional consequences they experienced as a result of their efforts. Evidence: For researchers working outside of the Global North, entering the Master's formidable house is daunting, and there is no clear pathway in. These narratives illustrate how reviewers and editorial staff act as gatekeepers, continuously shaping ideas about what it means to do acceptable research, and who is allowed to disseminate it within the field. These narratives also show that those who have been rejected by these gatekeepers are often conflicted about their position within the larger field of medical education. Implications: To begin to address this issue, we have made several suggestions for the research community to consider. First, medical education research journals need to create spaces for researchers publishing from the Global South. One suggestion is for journals to create a submission type that is dedicated to researchers working outside of North America. Second, journals should also include more Global South editors and reviewers to help with knowledge translation when articles are submitted from outside North America. If our collective goal is to improve the training of physicians and the health outcomes of humanity, then we need to renovate the Master's house and begin to break down the barriers that separate us from truly building together.
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Affiliation(s)
- Mantoa Mokhachane
- Unit for Undergraduate Medical Education, University of Witwatersrand, Johannesburg, South Africa
| | | | - Tasha R Wyatt
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Rispel LC, Ditlopo P, White J, Blaauw D. Perspectives of the cohort of health professionals in the WiSDOM study on the learning environment, transformation, and social accountability at a South African University. MEDICAL EDUCATION ONLINE 2023; 28:2185121. [PMID: 36880804 PMCID: PMC10013394 DOI: 10.1080/10872981.2023.2185121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/01/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The dearth of empirical research on transformative health professions education informed this study to examine the factors that influence the perspectives of the cohort of health professionals in the WiSDOM study on the learning environment, transformation, and social accountability at a South African university. METHODS WiSDOM, a prospective longitudinal cohort study, consists of eight health professional groups: clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists, and physiotherapists. At study inception in 2017, participants completed a self-administered questionnaire that included four domains of selection criteria (6 items); the learning environment (5 items); redress and transformation (8 items); and social accountability (5 items). In the analysis, we, rescaled the original Likert scoring of 1 (strongly disagree) to 7 (strongly agree) to a new scale ranging from 0-10. We calculated the mean scores for each item and across items for the four domains, with low scores (0.00-1.99) classified as poor and high scores (8.00-10.00) as excellent. We used multiple linear regression analysis to compare the mean scores, while adjusting for different socio-demographiccharacteristics. RESULTS The mean age of the 501 eligible participants was 24.1 years; the majority female (72.9%), 45.3% self-identified as Black African; and 12.2% were born in a rural area. The domains of selection criteria and redress and transformation obtained mean scores of 5.4 and 5.3 out of 10 respectively, while social accountability and the learning environment obtained mean scores of 6.1 and 7.4 out of 10 respectively. Self-identified race influenced the overall mean scores of selection criteria, redress and transformation, and social accountability (p < 0.001). Rural birth influenced the perceptions on selection criteria, redress and transformation (p < 0.01). CONCLUSION The results suggest the need to create inclusive learning environments that foreground redress, transformation, and social accountability, while advancing the discourse on decolonised health sciences education.
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Affiliation(s)
- Laetitia C. Rispel
- Centre for Health Policy & South African Research Chairs Initiative (SARChI), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Prudence Ditlopo
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Janine White
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Duane Blaauw
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Mauluka C, Stones W, Chiumia IK, Maliwichi L. Exploring a framework for demandable services from antenatal to postnatal care: a deep-dive dialogue with mothers, health workers and psychologists. BMC Pregnancy Childbirth 2023; 23:390. [PMID: 37245010 DOI: 10.1186/s12884-023-05722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/20/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND One of the factors affecting quality of care is that clients do not demand care practises during antenatal, intrapartum and postnatal care. This study aimed to identify care practices that can be demanded by the mother in the continuum of care from antenatal to postnatal. METHODS The study respondents included 122 mothers, 31 health workers and 4 psychologists. The researchers conducted 9 Key Informant Interviews with service providers and psychologists, 8 Focus Group Discussions with 8 mothers per group, and 26 vignettes with mothers and service providers. Data was analysed using Interpretative Phenomenological Analysis (IPA) where themes were identified and categorised. RESULTS During antenatal and postnatal care, mothers demanded all recommended services presented to them. Some services seen as demandable during labour and delivery included 4-hourly assessments of vital signs and blood pressure, emptying of the bladder, swabbing, delivery counselling, administration of oxytocin, post-delivery palpation, and vaginal examination. For the child mothers demanded head to toe assessment, assessment of vital signs, weighing, cord stamp and eye antiseptics, and vaccines. Women observed that they could demand birth registration even though it was not among the recommended services. Respondents proposed empowerment of mothers with cognitive, behavioural and interpersonal skills to demand services e.g., knowledge of service standards and health benefits in addition to improved self-confidence and assertiveness. In addition, efforts have to be made to address perceived or real health worker attitudes, mental health for the client and the service provider, service provider workload, and availability of supplies. CONCLUSION The study found that if a mother is informed in simple language about services that she is supposed to receive, she can demand numerous services in the continuum of care from antenatal to postnatal. However, demand cannot be a standalone solution for improving quality of care. What the mother can ask for is a step in the guidelines, but she cannot probe deeper to influence quality of the procedure. In addition, empowerment of mothers needs to be coupled with services and systems strengthening in support of health workers.
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Affiliation(s)
- Chancy Mauluka
- Kamuzu University of Health Sciences, P.O. Box 360, Blantyre, Malawi.
| | - William Stones
- Kamuzu University of Health Sciences, P.O. Box 360, Blantyre, Malawi
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Lee ST, Yang EB. Factors affecting social accountability of medical schools in the Korean context: exploratory factor and multiple regression analyses. MEDICAL EDUCATION ONLINE 2022; 27:2054049. [PMID: 35313788 PMCID: PMC8942500 DOI: 10.1080/10872981.2022.2054049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/13/2022] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
The concept of social accountability of medical schools is becoming increasingly important worldwide, and numerous frameworks and evaluation tools have been developed. This study examined how global concepts work in a specific context by identifying the factors affecting medical schools' social accountability performance in the Korean context. A survey was conducted with 40 current deans of medical schools and 15 medical education experts in Korea to assess their opinions on the implementation of social accountability of medical schools. A questionnaire survey comprising five key factors, including 39 items, was developed based on a literature review. Exploratory factors were analyzed to derive factors affecting social accountability Multiple regression analysis was conducted to determine the importance of each factor in the implementation of social accountability of medical schools. The exploratory factor analysis revealed that eight factors in three areas influenced the implementation of social accountability by medical schools. The hardware (H) area included the declaration of social accountability and physicians, organizations and systems for implementing social accountability, and physical environment and finance. The software (S) area included curriculum design-related social accountability and monitoring and evaluation system. The partner (P) area included the proximity between partners, building partnerships among stakeholders, and interactions between partners. Multiple regression analysis revealed that 'interactions between partners' had the greatest impact on the implementation of social accountability of medical schools. It is a social accountability implementation model that reflects global principles within the Korean context. The HSP model is significant in that individual medical schools can be used in establishing mandated mechanisms for accreditation. Future studies could adapt this model to study standards and indicators in other contexts.
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Affiliation(s)
- Sangmi T. Lee
- Department of Medical Education, Yonsei University Wonju College of Medicine, Gangwon-do, South Korea
| | - Eunbae B. Yang
- Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea
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Ghaffari R, Taghizadieh A, Behshid M, Somi MH, Mirzazadeh A, Baradaran HR, Huntington M, Emami Razavi SH, Baghban Rezvan F, Salek Ranjbarzadeh F. Accountability in medical education from theory to practice Tabriz 2018 statement: A step towards the implementation of this social necessity. Med J Islam Repub Iran 2020; 34:93. [PMID: 33315967 PMCID: PMC7722974 DOI: 10.34171/mjiri.34.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Indexed: 11/18/2022] Open
Abstract
Background: To implement the education reform package on accountability in medical education, the Education Development Center (EDC) of Tabriz University of Medical Sciences has held the first national conference on accountability in medical education, and the present statement is the result of scientific interactions and exchanges in the conference.
Methods: For implementation of the accountability in medical education, there was a need to inform faculty members and other stakeholders about their responsibility in education and health care needs. The provision of such platform was provided by holding a specialized conference on accountability in medical education by Tabriz University of Medical Sciences. Steps of preparing the draft version of the Tabriz 2018 Statement were as follow: Formation the scientific committee; Division of the responsibility for drafting the statement between various workgroups; and Preparation and primary approval of the draft of Tabriz 2018 Statement.
Results: Steps of preparing the draft version of the Tabriz 2018 Statement were: Formation of the scientific committee, Division of the responsibility for drafting the statement between the various workgroups and Preparation and primary approval of the draft of Tabriz 2018 Statement.
Conclusion: Establishing an educational accreditation model and reviewing accreditation standards based on social accountability can be an effective step to strengthen accountability towards community needs.
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Affiliation(s)
- Reza Ghaffari
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Taghizadieh
- Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozhgan Behshid
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Husein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azim Mirzazadeh
- Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Mark Huntington
- Department of Family Medicine, School of Medicine, University of South Dakota Sanford, 414 E. Clark Street, Vermillion, SD 57069, United States
| | - Seyed Hasan Emami Razavi
- Neuroscience Institute, Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Flora Baghban Rezvan
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Salek Ranjbarzadeh
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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McKimm J, Redvers N, El Omrani O, Parkes MW, Elf M, Woollard R. Education for sustainable healthcare: Leadership to get from here to there. MEDICAL TEACHER 2020; 42:1123-1127. [PMID: 32776858 DOI: 10.1080/0142159x.2020.1795104] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current global crises, including climate, COVID-19, and environmental change, requires global collective action at all scales. These broad socio-ecological challenges require the engagement of diverse perspectives and ways of knowing and the meaningful engagement of all generations and stages of personal and professional development. The combination of systems thinking, change management, quality improvement approaches and models, appreciative/strength-based approaches, narratives, storytelling and the strengths of Indigenous knowledges, offer synergies and potential that can set the stage for transformative, strengths-based education for sustainable healthcare (ESH). The need for strong leadership to enact a vision for ESH is outlined here with the intent to enable and nurture the conditions for change, ultimately improving health and well-being across generations.
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Affiliation(s)
- Judy McKimm
- Swansea University Medical School, Swansea, UK
| | - Nicole Redvers
- University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| | - Omnia El Omrani
- International Federation of Medical Students' Association (IFMSA), Copenhagen, Denmark
| | - Margot W Parkes
- University of Northern British Columbia School of Health Sciences and Northern Medical Program, Prince George, Canada
| | - Marie Elf
- Dalarna University School of Education, Health and Social Studies, Falun, Sweden
| | - Robert Woollard
- Department of Family Practice, University of British Columbia, Vancouver, Canada
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Butler N, Johnson G, Chiweza A, Aung KM, Quinley J, Rogers K, Bedford J. A strategic approach to social accountability: Bwalo forums within the reproductive maternal and child health accountability ecosystem in Malawi. BMC Health Serv Res 2020; 20:568. [PMID: 32571301 PMCID: PMC7310083 DOI: 10.1186/s12913-020-05394-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 06/03/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The majority of documented social accountability initiatives to date have been 'tactical' in nature, employing single-tool, mostly community-based approaches. This article provides lessons from a 'strategic', multi-tool, multi-level social accountability project: UNICEF's 'Social Accountability for Every Woman Every Child' intervention in Malawi. METHODS The project targeted the national, district and community levels. Three Civil Society Organisations (CSOs) were engaged to carry out interventions using various tools to generate evidence and political advocacy at one or more levels. This article focuses on one of the social accountability methods - the bwalo forum (a meeting based on a traditional Malawian method of dialogue). A detailed political economy analysis was conducted by one of the co-authors using qualitative methods including interviews and group discussions. The authors conducted in-country consultations and analysed secondary data provided by the CSOs. RESULTS The political economy analysis highlighted several ways in which CSO partners should modify their work plans to be more compatible with the project context. This included shifting the advocacy and support focus, as well as significantly expanding the bwalo forums. Bwalos were found to be an important platform for allowing citizens to engage with duty bearers at the community and district levels, and enabled a number of reproductive, maternal, newborn, child and adolescent health issues to be resolved at those levels. The project also enabled learning around participant responses as intermediate project outcomes. CONCLUSIONS The project utilised various tools to gather data, elevate community voices, and facilitate engagement between citizen and state actors at the community, district and national levels. This provided the scaffolding for numerous issues to be resolved at the community or district levels, or referred to the national level. Bwalo forums were found to be highly effective as a space for inter-level engagement between citizens and state; however, as they were not embedded in existing local structures, their potential for sustainability and scalability was tenuous. A key strength of the project was the political economy analysis, which provided direction for partners to shape their interventions according to local and national realities and be sensitive to the barriers and drivers to positive action.
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Affiliation(s)
- Nadia Butler
- Anthrologica, Woad Mill, Broughton, Oxfordshire, OX15 6AR UK
| | - Ginger Johnson
- Anthrologica, Woad Mill, Broughton, Oxfordshire, OX15 6AR UK
| | - Asiyati Chiweza
- Department of Political and Administrative Studies, Chancellor College, University of Malawi, PO Box 280, Zomba, Malawi
| | - Kyaw Myint Aung
- UNICEF Malawi, PO Box 30375, Airtel Complex Area 40/31, Lilongwe 3, Malawi
| | - John Quinley
- A Promise Renewed Secretariat, UNICEF, 3 United Nations Plaza, New York, NY 10017 USA
| | - Katherine Rogers
- A Promise Renewed Secretariat, UNICEF, 3 United Nations Plaza, New York, NY 10017 USA
| | - Juliet Bedford
- Anthrologica, Woad Mill, Broughton, Oxfordshire, OX15 6AR UK
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Yue P, Xu T, Greene B, Wang Y, Wang R, Dai G, Xu L. Caring in community nursing practice: Inductive content analysis reveals an inter-dynamic system between patients and nurses. J Clin Nurs 2020; 29:3025-3041. [PMID: 32353918 DOI: 10.1111/jocn.15312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/15/2020] [Accepted: 04/12/2020] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses. BACKGROUND An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person-centred care with their clients. Furthermore, most community nurses-especially in China-lack systematic education and training about caring because the practical meaning of caring in community practice is unknown. DESIGN The qualitative study described herein employed inductive content analysis. METHODS Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty-one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used. RESULTS Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter-dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship-based framework of caring in community nursing practice was constructed. CONCLUSIONS Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care-in China or elsewhere. RELEVANCE TO CLINICAL PRACTICE The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.
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Affiliation(s)
- Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
| | - Tianmeng Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Brian Greene
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yongli Wang
- Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Rongjin Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Guizhi Dai
- Yongdingmenwai Community Health Service Center, Dongcheng District, Beijing, China
| | - Lijie Xu
- School of Nursing, Capital Medical University, Beijing, China
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Clithero-Eridon A, Albright D, Ross A. Conceptualising social accountability as an attribute of medical education. Afr J Prim Health Care Fam Med 2020; 12:e1-e8. [PMID: 32129649 PMCID: PMC7061228 DOI: 10.4102/phcfm.v12i1.2213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 11/22/2022] Open
Abstract
Background Health professionals need to be both person- and community oriented to improve population health. For educators to create socially accountable physicians, they must move learners from understanding social accountability as an expectation to embracing and incorporating it as an aspect of professional identity that informs medical practice. Aim The aim of this article was to assess the degree to which medical students, preceptors and community mentors understand the concept of social accountability. Setting The setting is the KwaZulu-Natal Province in Durban, South Africa. Methods Using an observational design, we surveyed 332 participants, including the first- and sixth-year medical students, physician preceptors and community mentors. Results Whilst most respondents understood social accountability as requiring an action or set of actions, it was defined by some as simply the awareness one must have about the needs of their patients, community or society at large. Some respondents defined social accountability as multi-dimensional, but these definitions were the exception, not the rule. Finally, most respondents did not identify to whom the accountable party should answer. Conclusion Whilst the development of professional identity is seen as a process of ‘becoming’, the ability to define and understand what it means to be socially accountable is not a linear process. Assessment of this progress may start with comprehending how social accountability is understood by students when they begin their education and when they are graduating, as well as in knowing how their educators, both clinical and community, define it.
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Affiliation(s)
- Amy Clithero-Eridon
- Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
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van Schalkwyk S, Couper I, Blitz J, Kent A, de Villiers M. Twelve tips for distributed health professions training. MEDICAL TEACHER 2020; 42:30-35. [PMID: 30696315 DOI: 10.1080/0142159x.2018.1542121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Increasing numbers of health professions students are being trained in healthcare facilities that are geographically removed from central academic hospitals. Consequently, studies have evaluated this distributed training, assessed the impact that it has on student learning as well as on the facilities where the training occurs, and explored factors that enable and constrain successful clinical training at such sites. The 12 tips presented in this article have been developed from a longitudinal project that has focused on developing a framework for effective distributed health professions training through an extensive review of the literature and a national consultative process. These 12 tips should, therefore, have applicability across multiple contexts. The purpose of this article is to assist people in implementing, adapting, upscaling, maintaining, and evaluating the distributed training of students in the health professions.
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Affiliation(s)
- Susan van Schalkwyk
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Stellenbosch University, Cape Town, South Africa
| | - Julia Blitz
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Athol Kent
- Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
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13
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Moodley K, Beyer C. Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking. Biopreserv Biobank 2019; 17:613-624. [PMID: 31603696 PMCID: PMC6921246 DOI: 10.1089/bio.2018.0136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introduction: Community engagement (CE) is an ethical imperative in research, but the knowledge base for what constitutes effective and ethically sound CE is limited. Ubuntu, as a component of responsive communitarianism where communal welfare is valued together with individual autonomy, is useful in furthering our understanding of effective CE and how it could best be achieved. Similarly, a relative solidarity model serves as a compromise between extreme individualism and extreme communalism and is more appropriate in a heterogenous African context. Approaching CE from an Ubuntu philosophical perspective in southern Africa is particularly important in genomic biobanking, given the implications for individuals, families, and communities. Discussion: CE is often implemented in a tokenistic manner as an ancillary component of research. Understanding consent information is challenging where genomic biobanking is concerned due to scientific complexity. We started a process of CE around genomic biobanking and conducted empirical research in an attempt to develop a model to promote effective and ethically sound CE, using relative solidarity to create a nuanced application of Ubuntu. The TRUCE model is an eight-step model that uses social mapping to identify potential communities, establishes the scope of CE, and requires that communities are approached early. Co-creation strategies for CE are encouraged and co-ownership of knowledge production is emphasized. Recruiting and engaging communities at each stage of research is necessary. Evaluation and adaptation of CE strategies are included. Discussion and dissemination of results after the research is completed are encouraged. Conclusions: There is a significant gap between the theory of CE and its authentic application to research in Africa. This Ubuntu-inspired model facilitates bridging that gap and is particularly suited to genomic biobanking. The CE model enhances and complements the consent process and should be integrated into research as a funding and regulatory requirement where applicable.
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Affiliation(s)
- Keymanthri Moodley
- Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, Cape Town, South Africa
- Address correspondence to: Keymanthri Moodley, MBChB, MFamMed, MPhil, FCFP (SA), Executive MBA, DPhil, Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, P.O. Box 241, Cape Town 7505, South Africa
| | - Chad Beyer
- Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, Cape Town, South Africa
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Soteriades ES. A Cardiologist's heart for social responsibility or…. Hellenic J Cardiol 2019; 60:191-193. [PMID: 31039412 DOI: 10.1016/j.hjc.2019.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/16/2019] [Accepted: 04/22/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Elpidoforos S Soteriades
- United Arab Emirates University, College of Medicine and Health Sciences, Institute of Public Health, Al Ain, United Arab Emirates; Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA.
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