scholarly journals Revitalisation of primary health care governance: an important pillar for the tangible management of COVID-19

2021 ◽  
Vol 13 (4) ◽  
pp. 313
Author(s):  
Ghader Ghanizadeh ◽  
Hossein Masoumbeigi ◽  
Sayyed-Morteza Hosseini-Shokouh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Primary Health ◽  
Health Care Governance

Beyond positive a priori bias: reframing community engagement in LMICs

2019 ◽  
Vol 35 (3) ◽  
pp. 598-609 ◽  
Author(s):  
Seye Abimbola
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Engagement ◽  
A Priori ◽  
Causal Link ◽  
Government Support ◽  
Service Users ◽  
Holy Grail ◽  
Primary Health ◽  
Health Care Governance

Abstract Showing the causal link between community engagement and improved health outcomes is a ‘holy grail’ of health policy. This article argues that this ‘holy grail’ has remained elusive because community engagement in primary health care is under-theorized, having been based on positive a priori assumptions, e.g. that people necessarily want to be engaged in governing their health system. By adopting a theory-driven approach and an agnostic premise, we show that understanding why, how and when community engagement may emerge or function spontaneously is important for informing efforts to support community engagement in primary health care primary health care governance. We draw on empirical research on community engagement in Nigeria and on the literature to identify the ‘why’ (coalition of service users can emerge in response to under-governance); the ‘how’ (five modes: through meetings; reaching out within their community; lobbying governments; augmenting government support; and taking control of service delivery) and the ‘when’ (as geographical, socio-economic and institutional context align, such that the benefits of action outweigh costs). Understanding the broad patterns of mechanisms and of contextual factors that apply across communities is, after all, our ‘holy grail’—and this understanding should inform efforts to tailor support for community engagement in governance in different settings.

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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