Abstract
Abstract
Background
Social and community participation is a fundamental component of the development of renewed primary healthcare (PHC). With the recognition of health as a right, such participation is a significant part of the design of public policies aimed at this sector. These policies contribute not only to overcoming inequity in the provision of this type of services but also to a reduction in social inequalities as a whole. Through a comparative analysis, this study aimed to explain the conditions through which ethnic-rural territories of the Colombian Pacific coast participate in health to contribute to the generation of policies and programs in territories with similar conditions.
Methods
The work was developed through the use of multiple techniques and strategies for information collection and analysis. These include several semi-structured interviews, multiple observation exercises and analysis based on a set theory, i.e., qualitative comparative analysis (QCA). The latter aims to develop a model that provides a count of the main causal combinations that allow high community participation in health.
Results
Key findings include how the trajectory of social mobilization and existence of a robust community social fabric became two critical conditions for community participation in the context of social exclusion. The presence of variables such as the implementation of PHC, guarantee of social rights, and trust in institutions, is underestimated as sufficient causal conditions for obtaining this result. Therefore, it is essential to recognize the existence, validity, and importance of processes, experiences, and resourcefulness of political natures, which aim at transforming the daily reality of the inhabitants of these communities. These also set a potential space and scenario for managing the communities’ main problems, including health, in the absence of institutionality that guarantees access to their social rights.
Conclusion
This study points out the importance of understanding community participation as a political activity, expanding exchange dynamics and dialogs between institutions, rulers, and communities to provide social responses in health and well-being to communities and to understand local realities and their own community dynamics.
Funder
Universidad ICESI
Departamento Administrativo de Ciencia, Tecnología e Innovación
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference44 articles.
1. Putnam R. Bowling Alone: America’s Declining Social Capital. J Democr. 1995;6(1):65–78.
2. World Health Organization, The United Nations Children’s Fund (UNICEF). Declaración de Astaná. Conferencia Mundial sobre Atención Primaria en Salud. In: Desde Alma-Ata hacia la cobertura sanitaria universal y los Objetivos de Desarrollo Sostenible. [Internet]. 2018. Available from: https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration-sp.pdf.
3. Mulumba M, London L, Nantaba J, Ngwena C. Using Health Committees to Promote Community Participation as a Social Determinant of the Right to Health. Health Hum Rights. 2018;20(2):11–7.
4. George AS, Mehra V, Scott K, Sriram V. Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities. PloS One. 2015;10(10):e0141091.
5. Sobeck J, Agius E. Organizational capacity building: addressing a research and practice gap. Eval Program Plann. 2007;30(3):237–46.