Key issues for stakeholder engagement in the development of health and healthcare guidelines

Established in 2015, the Multi-Stakeholder Engagement (MuSE) Consortium is an international network of over 120 individuals interested in stakeholder engagement in research and guidelines. The MuSE group is developing guidance for stakeholder engagement in the development of health and healthcare guideline development. The development of this guidance has included multiple meetings with stakeholders, including patients, payers/purchasers of health services, peer review editors, policymakers, program managers, providers, principal investigators, product makers, the public, and purchasers of health services and has identified a number of key issues. These include: (1) Definitions, roles, and settings (2) Stakeholder identification and selection (3) Levels of engagement, (4) Evaluation of engagement, (5) Documentation and transparency, and (6) Conflict of interest management. In this paper, we discuss these issues and our plan to develop guidance to facilitate stakeholder engagement in all stages of the development of health and healthcare guideline development.

Potential barriers to and facilitators of civil society organization engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria: an implementation research

BACKGROUND

Civil society organizations (CSOs) are important in health care delivery. They have the potential to play significant roles in immunization-related services, such as advocacy, health education, demand creation and resource mobilization. Their roles are often indispensable, diverse and beneficial in reducing infant morbidity and mortality due to vaccine-preventable diseases. This study explored the potential barriers to and facilitators of CSO engagement in increasing immunization coverage in Odukpani Local Government Area of Cross River State, Nigeria.

METHODS

The study adopted qualitative data collection methods. Twenty-two focus group discussion (FGD) sessions, three in-depth interviews (IDIs) and 26 key informant interviews (KIIs) were conducted. Appropriate guides (FGD guide, IDI guide and KII guide) were used to conduct face-to-face interviews and the discussions. The FGDs, KIIs and IDIs were audio-recorded and transcribed. A framework analysis approach involving five key stages of analysis (familiarization with data, identification of thematic framework, indexing, charting, mapping/interpretation) was used for data analyses and presentation.

RESULTS

CSOs encounter barriers in the course of their immunization advocacy, communication and social mobilization due to male child preference, leading to shielding of male children and not allowing them to be given immunization, as well as patriarchy, safety concerns, religious concerns, anti-vaccine misinformation and rumours, low perception of effectiveness and efficacy of vaccines, inaccessibility of localities, low health literacy and superstitious beliefs. Various community structures, such as the institution of the village head, elders' council and town crier (announcer), and the existence of change agents, act as facilitators of immunization advocacy and uptake. Factors such as traditional control mechanisms including masquerades and religion act as either barriers or facilitators depending on the community and the mode of deployment. CSO members are willing to overcome these barriers and leverage the facilitators.

CONCLUSIONS

For successful engagement in immunization-related services, there are barriers in the study area that CSOs should overcome, such as male child preference and geographic inaccessibility, as well as facilitators that they should leverage such as traditional information dissemination systems and enforcement of compliance by the chiefs and elders' council.

Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of Civil Society Organisations for Immunisation in a Nigerian Rural Community

BACKGROUND AND OBJECTIVE

Immunisation coverage remains sub-optimal, especially in rural hard-to-reach communities in Nigeria. Nigeria's immunisation program suffered set-backs in recent years due to socio-cultural, religious and health system barriers. Grassroots Civil Society Organisations could play a role in addressing some of these barriers with resultant increase in demand for and uptake of immunisation services. The objective of this study was to carry out strengths, weaknesses, opportunities and threats (SWOT) analysis of grassroots civil society organisations regarding engagement for increasing demand for and uptake of immunisation services.

SUBJECTS, MATERIALS AND METHODS

This was a qualitative study. A pre-tested SWOT analysis template was used to collect data from 26 grassroots CSOs in Odukpani local government area (LGA) of Cross River State of Nigeria. The data were manually entered into a matrix made up of four quadrants. The results were presented as tables of frequencies and percentages.

RESULTS

The CSOs have the numerical strength to carry out immunisation advocacy, communication and social mobilization. There is pool of non-CSO community members who are willing to volunteer. However, some of the CSOs are not good in record keeping. There are also several security threats due to communal clashes.

CONCLUSION

There are several strengths and opportunities that the CSOs can leverage on while dealing with identified weaknesses and threats in order to contribute towards increasing the demand for and uptake of immunisation services in this community.