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1 – 10 of over 7000Manoj Kumar, Rekha Bos, Emma Emily de Wit and J.G.F. Bunders-Aelen
This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services…
Abstract
Purpose
This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.
Design/methodology/approach
Four MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.
Findings
The study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.
Originality/value
The current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.
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Larissa Veríssimo, Helen Rainey, Roberta Lindemann and Anne Hendry
This viewpoint piece will highlight the contribution of trained lay community health workers to the integrated workforce in rural, remote and island settings, drawing on…
Abstract
Purpose
This viewpoint piece will highlight the contribution of trained lay community health workers to the integrated workforce in rural, remote and island settings, drawing on experience from a system strengthening project involving community health agents (CHAs) in four municipalities in Litoral Norte, a remote coastal and island region in the state of São Paulo, Brazil.
Design/methodology/approach
This viewpoint reflects on experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care.
Findings
CHAs took forward actions that touched the lives of thousands of vulnerable families with low income and complex needs in communities with high levels of social and health inequalities. They acted as a bridge between patients and families at home, primary healthcare professionals and wider community partners and services. Their valuable insight into the healthcare issues and social challenges experienced by the community informed and supported family centred practice and population health goals. The CHAs rapidly pivoted to became an essential public health workforce during the Covid-19 pandemic.
Practical implications
As the authors establish integrated care systems and embrace proactive care and population health, the conditions are favourable for introducing a similar role in the UK. For psychological safety and avoidance of burnout people in such new roles will require training, supervision and full integration within community teams.
Originality/value
This viewpoint reflects experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care.
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Maria Teresa Ferazzoli and Lily Kpobi
This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved…
Abstract
Purpose
This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK.
Design/methodology/approach
In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK.
Findings
The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community.
Originality/value
This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation.
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Sundeep Sahay and Esther N. Landen
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Abstract
Purpose
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Design/methodology/approach
This paper analyzes the everyday work of CHWs in two low- and middle-income country (LMIC) contexts (Uganda and Malawi) and seeks to understand changes in collective identity and the role of Information and Communication Technologies (ICTs) in mediating this “identity work”. As CHWs conduct their everyday tasks of care giving, data reporting and maintaining social interactions, they play two primary roles. One is the care giving role oriented towards the community, and two, is reporting and administrative work by virtue of them being affiliated with the Ministry of Health, either in formal or voluntary capacity. The ambivalence which they experience as they move back and forth between these two worlds of work is significantly now mediated through ICTs. The paper analyzes these dynamics and identifies three key sets of ambivalence in identity work: (1) role embracing-institutional distancing; (2) conformist-resistant and (3) dramaturgical-transformative. The paper makes unique contributions to information systems (IS) and ICT for development (ICT4D) studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system. This contrasts with dominant research in the field which focuses on professional groups, largely based in Western business organizations.
Findings
The paper identifies identity related tensions that emerge with the mediation of digital technologies in the work world of CHWs. These include tensions of conformist-resistant; and (3) dramaturgical-transformative. These findings are relevant and unique to the field of IS and ICT4D studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system.
Research limitations/implications
While acknowledging identity construction and negotiation is a function of both work and social lives, in this paper we could only focus on the work lives.
Practical implications
As digital interventions in the health sector of low and middle income countries is becoming increasingly widespread, often the focus is more on the supply side (the supply of the technology) rather than on the demand side (users experiences and aspirations). Identity becomes a lens to understand these demand side dynamics, which helps provides practical guidance on implementation approaches to ensure that the technology adds value to user work processes and there is a seamless and not a disruptive transition.
Social implications
CHWs are the most neglected cadre in the health system of low and middle income countries, even though they provide the cutting edge in care provision work to the most marginalized populations, living in rural and underserved areas. By focusing on how technologies can be more effectively implemented to support these care processes, the paper provides important social implications both for practice and research.
Originality/value
Analysis of identity construction and negotiation of informal groups in the unorganized sector of low and middle income countries has not received adequate attention in IS research. The paper seeks to fill this important gap.
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The online health community's success depends on doctors' active participation, so it is essential to understand the factors that affect doctors' knowledge contribution behavior…
Abstract
Purpose
The online health community's success depends on doctors' active participation, so it is essential to understand the factors that affect doctors' knowledge contribution behavior in the online health communities. From the perspective of peer effect, this paper discusses the influence of focal doctors' peers on focal doctors' knowledge contribution behavior and the mechanism behind it. This paper aims to solve these problems.
Design/methodology/approach
Empirical data of 1,938 doctors were collected from a Chinese online health community, and propensity score matching and ordinary least squares were employed to verify the proposed theoretical model.
Findings
The results show that the presence of focal doctors' peers in online health communities has a positive effect on the knowledge contribution behavior of focal doctors, and the economic returns and social returns of focal doctors' peers have a significant mediating effect.
Originality/value
This paper discusses focal doctors' knowledge contribution behavior from the perspective of peer effect. It enhances the understanding of focal doctors' behavior in the online health communities by exploring the mediating role of their peers' economic and social returns. The results of this paper extend the research in the field of peer effect and online health and provide management implications and suggestions for online health platforms and doctors.
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This case study paper aims to explore the complexities and challenges of epidemic response and public health surveillance in Native American and Indigenous American communities…
Abstract
Purpose
This case study paper aims to explore the complexities and challenges of epidemic response and public health surveillance in Native American and Indigenous American communities in the United States and find viable solutions. This paper explores these topics through the emergence and impact of the hantavirus pulmonary syndrome (HPS) within the Navajo Nation in the United States using critical incident analysis and best practices.
Design/methodology/approach
This project is a case study paper based on a topical review of the literature. A topical review of the literature is a comprehensive exploration of the current body of knowledge within a particular research field. It is an important tool used by scholars and practitioners to further the development of existing knowledge as well as to identify potential directions for future research (Fourie, 2020). Such a paper can provide a useful insight into the various aspects of the process that the researcher may have overlooked, as well as highlighting potential areas of improvement (Gall et al., 2020). It can also provide a useful source of ideas and inspiration for the researcher as it can provide an overview of the various approaches used by other researchers in the field (Göpferich, 2009). Case study papers using a topical review of the literature have been used to help frame and inform research topics, problems and best practices for some time. They are typically used to explore a topic in greater depth and to provide an overview of the literature to improve the world of practice to provide a foundation for future comprehensive empirical research. Case study papers can provide research value by helping to identify gaps in the literature and by providing a general direction for further research. They can also be used to provide a starting point for research questions and hypotheses and to help identify potential areas of inquiry.
Findings
This study explores best practices in public health surveillance and epidemic response that can help strengthen public health infrastructure by informing the development of effective surveillance systems and emergency response plans, as well as improving data collection and analysis capabilities within Native American and Indigenous American communities in the United States that also have the option to include new technologies like artificial intelligence (AI) with similar outbreaks in the future.
Research limitations/implications
The literature review did not include any primary data collection, so the existing available research may have limited the findings. The scope of the study was limited to published literature, which may not have reported all relevant findings. For example, unpublished studies, field studies and industry reports may have provided additional insights not included in the literature review. This research has significant value based on the limited amount of studies on how infectious diseases can severely impact Native American communities in the United States, leading to unnecessary and preventable suffering and death. As a result, research on viable best practices is needed on the best practices in public health surveillance and epidemic response in Native American and Indigenous American communities through historical events and critical incident analysis.
Practical implications
Research on public health surveillance and epidemic response in Native American communities can provide insights into the challenges faced by these communities and help identify potential solutions to improve their capacity to detect, respond to and prevent infectious diseases using innovative approaches and new technologies like AI.
Originality/value
More research on public health surveillance and epidemic response can inform policies and interventions to improve access to healthcare for Native American populations, such as increasing availability of healthcare services, providing culturally appropriate health education and improving communication between providers and patients. By providing better public health surveillance and response capacity, research can help reduce the burden of infectious diseases in Native American communities and ultimately lead to improved public health outcomes.
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Tony Zitti, Abdouramane Coulibaly, Idriss Ali Zakaria Gali-Gali, Valery Ridde and Anne-Marie Turcotte-Tremblay
This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina…
Abstract
Purpose
This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina Faso.
Design/methodology/approach
The authors adopted a qualitative approach based on a multiple-case study design. Data were collected from August 10 to 25, 2017, in Mali, and from January to May 2016 in Burkina Faso. In Mali, 191 semi-structured interviews were conducted with investigators (people who collect information from health centre users in the communities, using survey tools), users, users' relatives, and health workers in three of the 10 health districts in the Koulikoro region. In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively.
Findings
In both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country.
Research limitations/implications
CV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results.
Originality/value
There are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent.
Key messages
There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.
In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.
In both countries, there was no feedback on the results of the CV process to health centre staff or users.
Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.
There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.
In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.
In both countries, there was no feedback on the results of the CV process to health centre staff or users.
Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.
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Xuejie Yang, Dongxiao Gu, Honglei Li, Changyong Liang, Hemant K. Jain and Peipei Li
This study aims to investigate the process of developing loyalty in the Chinese mobile health community from the information seeking perspective.
Abstract
Purpose
This study aims to investigate the process of developing loyalty in the Chinese mobile health community from the information seeking perspective.
Design/methodology/approach
A covariance-based structural equation model was developed to explore the mobile health community loyalty development process from information seeking perspective and tested with LISREL 9.30 for the 191 mobile health platform user samples.
Findings
The empirical results demonstrate that the information seeking perspective offers an interesting explanation for the mobile health community loyalty development process. All hypotheses in the proposed research model are supported except the relationship between privacy and trust. The two types of mobile health community loyalty—attitudal loyalty and behavioral loyalty are explained with 58 and 37% variance.
Originality/value
This paper has brought out the information seeking perspective in the loyalty formation process in mobile health community and identified several important constructs for this perspective for the loyalty formation process including information quality, communication with doctors and communication with patients.
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Muhammad Salman Latif, Jian-Jun Wang and Mohsin Shahzad
Online health communities (OHCs) have been recognized as emerging platforms on the Internet used for health purposes. Despite its emergence, developing a successful OHC is still a…
Abstract
Purpose
Online health communities (OHCs) have been recognized as emerging platforms on the Internet used for health purposes. Despite its emergence, developing a successful OHC is still a challenge. Prior studies identified that value co-creation behavior (VCB) of members is an essential factor for sustaining OHCs; however, little is known about how members’ behavior drives to co-create value? Therefore, this study aims to discover the inclusive mechanism for members’ VCB in OHCs.
Design/methodology/approach
The authors develop the study model and hypothesis based on the service-dominant logic of value co-creation theory and social support (SS) literature. The survey data of 608 active OHCs users in China were analyzed using partial least squares structural equation modeling (PLS-SEM).
Findings
The results revealed that SS positively affects members’ VCBs. Ethical aspects; Trust and ethical interaction (EI) partially mediate their relationships. In addition, community members’ current health status (CHS) negatively moderates the relationships between SS and VCB. From the findings, it becomes evident that only SS is not enough; developing an ethical environment in OHCs, i.e. trust and ethically rich interactions among members, significantly helps OHCs to promote co-creation. Also, the negative moderation of CHS findings provides novel insights when cramming health conditions.
Originality/value
Exploring the complex mechanism of co-creation in OHC, the authors illustrate the potential of service-dominant logic to create new theoretical insight for healthcare and provide the framework of co-creation with ethics for the first time. This will extend the application of ethics in healthcare services and offer a robust platform from which the understanding of drivers of members’ VCB can be advanced in the OHC context.
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