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Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews

BACKGROUND: Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of...

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Autores principales: Questa, K., Das, M., King, R., Everitt, M., Rassi, C., Cartwright, C., Ferdous, T., Barua, D., Putnis, N., Snell, A. C., Huque, R., Newell, J., Elsey, H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137248/
https://www.ncbi.nlm.nih.gov/pubmed/32252778
http://dx.doi.org/10.1186/s12939-020-01169-5
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author Questa, K.
Das, M.
King, R.
Everitt, M.
Rassi, C.
Cartwright, C.
Ferdous, T.
Barua, D.
Putnis, N.
Snell, A. C.
Huque, R.
Newell, J.
Elsey, H.
author_facet Questa, K.
Das, M.
King, R.
Everitt, M.
Rassi, C.
Cartwright, C.
Ferdous, T.
Barua, D.
Putnis, N.
Snell, A. C.
Huque, R.
Newell, J.
Elsey, H.
author_sort Questa, K.
collection PubMed
description BACKGROUND: Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of communicable disease control (CDC) in low and lower-middle income countries (LLMIC). We conducted an umbrella review to identify approaches to CE in communicable disease control, effectiveness of these approaches, mechanisms and factors influencing success. METHODS: We included systematic reviews that: i) focussed on CE interventions; ii) involved adult community members; iii) included outcomes relevant to communicable diseases in LLMIC; iv) were written in English. Quantitative results were extracted and synthesised narratively. A qualitative synthesis process enabled identification of mechanisms of effect and influencing factors. We followed guidance from the Joanna Briggs Institute, assessed quality with the DARE tool and reported according to standard systematic review methodology. RESULTS: Thirteen systematic reviews of medium-to-high quality were identified between June and July 2017. Reviews covered the following outcomes: HIV and STIs (6); malaria (2); TB (1); child and maternal health (3) and mixed (1). Approaches included: CE through peer education and community health workers, community empowerment interventions and more general community participation or mobilisation. Techniques included sensitisation with the community and involvement in the identification of resources, intervention development and delivery. Evidence of effectiveness of CE on health outcomes was mixed and quality of primary studies variable. We found: i) significantly reduced neonatal mortality following women’s participatory learning and action groups; ii) significant reductions in HIV and other STIs with empowerment and mobilisation interventions with marginalised groups; iii) significant reductions in malaria incidence or prevalence in a small number of primary studies; iv) significant reductions in infant diarrhoea following community health worker interventions. Mechanisms of impact commonly occurred through social and behavioural processes, particularly: changing social norms, increasing social cohesion and social capacity. Factors influencing effectiveness of CE interventions included extent of population coverage, shared leadership and community control over outcomes. CONCLUSION: Community engagement interventions may be effective in supporting CDC in LLMIC. Careful design of CE interventions appropriate to context, disease and community is vital.
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spelling pubmed-71372482020-04-11 Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews Questa, K. Das, M. King, R. Everitt, M. Rassi, C. Cartwright, C. Ferdous, T. Barua, D. Putnis, N. Snell, A. C. Huque, R. Newell, J. Elsey, H. Int J Equity Health Review BACKGROUND: Community engagement (CE) interventions include a range of approaches to involve communities in the improvement of their health and wellbeing. Working with communities defined by location or some other shared interest, these interventions may be important in assisting equity and reach of communicable disease control (CDC) in low and lower-middle income countries (LLMIC). We conducted an umbrella review to identify approaches to CE in communicable disease control, effectiveness of these approaches, mechanisms and factors influencing success. METHODS: We included systematic reviews that: i) focussed on CE interventions; ii) involved adult community members; iii) included outcomes relevant to communicable diseases in LLMIC; iv) were written in English. Quantitative results were extracted and synthesised narratively. A qualitative synthesis process enabled identification of mechanisms of effect and influencing factors. We followed guidance from the Joanna Briggs Institute, assessed quality with the DARE tool and reported according to standard systematic review methodology. RESULTS: Thirteen systematic reviews of medium-to-high quality were identified between June and July 2017. Reviews covered the following outcomes: HIV and STIs (6); malaria (2); TB (1); child and maternal health (3) and mixed (1). Approaches included: CE through peer education and community health workers, community empowerment interventions and more general community participation or mobilisation. Techniques included sensitisation with the community and involvement in the identification of resources, intervention development and delivery. Evidence of effectiveness of CE on health outcomes was mixed and quality of primary studies variable. We found: i) significantly reduced neonatal mortality following women’s participatory learning and action groups; ii) significant reductions in HIV and other STIs with empowerment and mobilisation interventions with marginalised groups; iii) significant reductions in malaria incidence or prevalence in a small number of primary studies; iv) significant reductions in infant diarrhoea following community health worker interventions. Mechanisms of impact commonly occurred through social and behavioural processes, particularly: changing social norms, increasing social cohesion and social capacity. Factors influencing effectiveness of CE interventions included extent of population coverage, shared leadership and community control over outcomes. CONCLUSION: Community engagement interventions may be effective in supporting CDC in LLMIC. Careful design of CE interventions appropriate to context, disease and community is vital. BioMed Central 2020-04-06 /pmc/articles/PMC7137248/ /pubmed/32252778 http://dx.doi.org/10.1186/s12939-020-01169-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Questa, K.
Das, M.
King, R.
Everitt, M.
Rassi, C.
Cartwright, C.
Ferdous, T.
Barua, D.
Putnis, N.
Snell, A. C.
Huque, R.
Newell, J.
Elsey, H.
Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title_full Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title_fullStr Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title_full_unstemmed Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title_short Community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
title_sort community engagement interventions for communicable disease control in low- and lower- middle-income countries: evidence from a review of systematic reviews
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137248/
https://www.ncbi.nlm.nih.gov/pubmed/32252778
http://dx.doi.org/10.1186/s12939-020-01169-5
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