Umeå University Library Hosted Journals
Not a member yet
876 research outputs found
Sort by
Media Discourses of a Sustainable Swedish North: Journalism, Places and Practices in Transition
Get PDF[Book review] Jan Rüdiger, All the King’s Women. Polygyny and Politics in Europe, 900–1250
No full textReview of: Jan Rüdiger, All the King’s Women. Polygyny and Politics in Europe, 900–1250 (The Northern world 88), Leiden: Brill 202
[Book review] Anti Selart (ed.), Baltic Crusades and Societal Innovation in Livonia, 1200–1350
No full textReview of: Anti Selart (ed.), Baltic Crusades and Societal Innovation in Livonia, 1200–1350 (The Northern World 93), Leiden: Brill 202
Participación comunitaria a través de la coproducción y la responsabilidad social en Zambia: mapeo de agentes, roles e interfaces en la atención primaria de salud: Participación comunitaria; actores; coproducción; responsabilidad social; atención primaria de salud
No full textIntroduction: Community participation is central to primary health care (PHC). However, there remains limited research on the practices of community involvement in PHC. This study aimed to inform the Zambian PHC agenda, by documenting key actors, their roles, interactions and available spaces or interfaces for engaging in community participation, as well as to identify the enabling conditions/mechanisms, and barriers underpinning community participation.
Methods: We used exploratory qualitative methods consisting semi-structured interviews with Community Health Assistants (CHAs) (n=10), healthcare workers (n=7) and traditional leaders (n=7). Additionally, focus group discussions were conducted with Neighbourhood Health Committees (NHCS) members (n=53) and community members (n=57). Data were analysed using thematic analysis.
Results: The CHAs, health workers and traditional leaders acted as the key intermediaries between health facilities and communities, driving co-production and social accountability processes. Traditional leaders and civil society organizations often served as initial catalysts of community participation, enabling the subsequent roles of the CHAs, while health centres and NHCs provided the spaces and platforms for community members to shape their involvement in participatory activities. Co-production entailed community contributions such as labour and participation in decision-making at health facilities. Social accountability took the form of suggestion boxes and informal feedback from traditional leaders. Several contextual barriers limited participation, including undefined roles for processes of community engagement, the lack of a comprehensive engagement strategy, and the exclusion of CHAs in health facility processes.
Conclusion: The CHAs and their roles, alongside those of other actors, were pivotal in supporting both co-production and social accountability processes. Strengthening community participation in primary health requires clearly defining the roles of various actors through the development of comprehensive community engagement strategies.Introducción: La participación comunitaria constituye un pilar esencial en la atención primaria de salud (APS). No obstante, las investigaciones acerca de las prácticas de participación comunitaria en este ámbito son escasas. Este estudio tiene como objetivo enriquecer la agenda de la APS en Zambia mediante la documentación de actores clave, sus roles, interacciones y los espacios o interfaces disponibles para la participación comunitaria. Además, busca identificar las condiciones y mecanismos que facilitan, así como las barreras que obstaculizan, dicha participación.
Métodos: Se emplearon métodos cualitativos exploratorios, incluyendo entrevistas semiestructuradas a asistentes sanitarios comunitarios (ASC) (n=10), trabajadores sanitarios (n=7) y líderes tradicionales (n=7). Se organizaron también grupos de discusión con miembros de los comités de salud de barrio (CSB) (n=53) y miembros de la comunidad (n=57). Los datos fueron analizados a través del análisis temático.
Resultados: Los ASC, los trabajadores sanitarios y los líderes tradicionales sirvieron como intermediarios clave entre los centros de salud y las comunidades, fomentando los procesos de coproducción y responsabilidad social. Los líderes tradicionales y las organizaciones de la sociedad civil frecuentemente actuaron como catalizadores de la participación comunitaria, facilitando las funciones subsiguientes de los ASC. Por su parte, los centros de salud y los CSB proporcionaron los espacios y plataformas para que los miembros de la comunidad configuraran su involucración en actividades participativas. La coproducción implicó contribuciones comunitarias tales como la mano de obra y la participación en la toma de decisiones dentro de los centros sanitarios. La responsabilidad social se manifestó a través de buzones de sugerencias y retroalimentación informal de los líderes tradicionales. Varias barreras contextuales, como la ambigüedad en las funciones dentro de los procesos de participación comunitaria, la falta de una estrategia de participación integral y la exclusión de los ASC de los procesos de los centros sanitarios, limitaron la participación.
Conclusiones: Las funciones de los ASC, junto con las de otros actores, resultaron fundamentales para apoyar tanto los procesos de coproducción como los de responsabilidad social. Para fortalecer la participación comunitaria en la atención primaria de salud, es imprescindible definir claramente las funciones de los distintos actores mediante el desarrollo de estrategias integrales de participación comunitaria
La perspectiva de la comunidad sobre la responsabilidad social en el sistema de salud: un estudio transversal de Tanzania
No full textIntroduction: Social accountability initiatives are considered a way to address inefficiencies and improve overall health system performance. Tanzania has introduced Health Facility Governing Committees (HFGCs) to improve social accountability of the health system. However, information on how communities perceive these committees is lacking. This study aimed to assess the prevalence and social determinants of the HFGCs accountability from the community perspective in Tanzania.
Methods: The research employed a cross-sectional survey design in two Tanzanian districts (Handeni and Mbarali) selected for their contrasting health performance. Data collection took place from July to October 2022, involving 1184 households in 31 villages/mitaa. The study measured social accountability through a set of six questions, focusing on community support, sensitization, feedback, trust, engagement, and overall accountability of HFGCs. Socio-demographic data such as sex, age, education, occupation, type of health facility and district were also collected and analyzed using linear regression to identify factors influencing perceptions of accountability.
Results: The findings revealed a low prevalence of social accountability as measured by the variables of community awareness and engagement with the HFGCs. Only a small percentage of respondents felt adequately informed or involved in the activities of these committees. Social determinants such as higher education levels and certain occupations, such as business and retirement and those living in Handeni district, correlated positively with a better perception of social accountability.
Conclusion: The study highlights significant challenges in the operational effectiveness of HFGCs in Tanzania, with a notable disconnect between these bodies and the communities they serve. Despite the theoretical framework for social accountability, actual community engagement remains low, impacting the overall efficacy of health governance at the local level. Future research should focus on improving community awareness and participation in these committees to improve their functionality and accountability, thereby aligning with national health objectives and local needs.Introducción: Las iniciativas de responsabilidad social son una estrategia para abordar las ineficiencias y mejorar el desempeño del sistema de salud. Tanzania ha implementado los Comités de Gobierno de los Centros Sanitarios (CGCS) para reforzar esta responsabilidad social. No obstante, falta información sobre la percepción comunitaria de estos Comités. Este estudio buscó evaluar la prevalencia y los factores sociales que influyen en la responsabilidad de los CGCS desde la perspectiva comunitaria en Tanzania.
Métodos: La investigación utilizó una encuesta transversal en dos distritos tanzanos (Handeni y Mbarali) seleccionados por sus diferencias de rendimiento. La recopilación de datos se llevó a cabo entre julio y octubre de 2022, abarcando 1,184 hogares de 31 aldeas/vecindarios. El estudio midió la responsabilidad social a través de seis preguntas que abordan el apoyo comunitario, la sensibilización, la retroalimentación, la confianza, el compromiso y la responsabilidad general de los CGCS. Además, se recogieron datos sociodemográficos (sexo, edad, educación, ocupación, tipo de centro de salud y distrito) que se analizaron mediante regresión lineal para identificar los factores que influyen en la percepción de responsabilidad.
Resultados: Los resultados mostraron una baja prevalencia de responsabilidad social, particularmente en las variables de concienciación y compromiso de la comunidad hacia los CGCS. Solo un pequeño porcentaje de los encuestados se sentía adecuadamente informado o involucrado en las actividades de estos Comités. Factores como un mayor nivel educativo, determinadas ocupaciones (tener un negocio o estar jubilado) y vivir en el distrito de Handeni se correlacionaron positivamente con una percepción más favorable de la responsabilidad social.
Conclusiones: El estudio resalta importantes desafíos en la eficacia operativa de los CGCS en Tanzania, mostrando una desconexión entre estos comités y las comunidades que atienden. A pesar del marco teórico de responsabilidad social, la participación comunitaria sigue siendo limitada, lo que afecta la eficacia de la gobernanza sanitaria a nivel local. Futuros estudios deberían enfocarse en fortalecer la sensibilización y participación comunitaria en estos comités, alineándose con los objetivos de salud nacionales y necesidades locales
Review (English): Christine Quarfood, The Montessori Movement in Interwar Europe: New Perspectives
No full textReview (English): Charlotta Svonni, Utbildning för samer: Ambitioner och praktiker i nomad- och sameskolan från 1950-tal till 2010-tal
No full textThe last smallpox outbreaks in the world – eradication efforts in Somalia – selected memories of a WHO field epidemiologist.
Get PDFSomalia was the last country in the world with smallpox. The government tried to control smallpox through mass vaccination in the 1970s. This was not successful. Contributing to this was a nomadic, highly mobile population and resistance to vaccination. The low vaccination coverage led to importations from neighboring countries, Kenya and Ethiopia and increased transmission inside the country. There was a major outbreak in Mogadishu in August 1976, which continued up to January 1977. It was followed by additional outbreaks in the south of the country, mainly in the area between the Juba and Shabelle rivers, particularly in Baydhabo district. The control method was then shifted to the regular WHO approach of surveillance, containment and ring-vaccination. A reward of 200 Somali shillings was introduced for any new reported smallpox case. Surveillance was intensified. This led to a sharp increase in reported cases in June 1977 – a peak was reached in the middle of July 1977. Then 25 experienced WHO field epidemiologists arrived. I was one of them and was posted to Gedo one of the regions, which still had smallpox. Transmission was gradually brought under control. At the beginning of August, it was clear that transmission mainly consisted of spread between small nomadic groups. These outbreaks were difficult to find and had to be located by temporary searchers sent out on foot. By the end of November there were still five pending outbreaks in Gedo. I give an account of what working in a tough, sometimes hostile area entailed and how we solved the problems encountered there. Those were the last smallpox cases in Gedo. The success was to a large extent dependent on close cooperation with the local people, particularly the camel herders. Without their engagement smallpox would not have been eradicated so quickly in Gedo and thereby not in Somalia