Impact of Community Participation on Sustainable Primary Healthcare Service Delivery in Akobo County
Keywords:
Community participation, improved service uptake and access, quality of care, community ownership, resilience.Abstract
This study assessed the impact of community participation on sustainable primary healthcare service delivery in Akobo County. Employing a mixed methods approach, the study was guided by the Arnstein’s Ladder of Participation Theory which provided a comprehensive framework in assessing the impact of community participation in PHC service delivery. The findings revealed that community participation facilitated the improvement of service uptake and access through health information dissemination, encouragement of early health-seeking behaviour, and heightened disease surveillance. The findings additionally revealed the critical role played by community representation in ensuring that services were more responsive to local priorities, increased accountability of resource allocation and allowed for timely interventions that were more contextually appropriate and met emerging health needs. The findings further revealed that community ownership had a strong impact on the resilience and sustainability of the primary healthcare services in Akobo County by strengthening accountability, promoting equity and encouraging self-reliance. The study concluded that community participation is a structural condition that is a pre-requisite for sustainability in contexts in which states' capacity is low, support is uncertain, and communities need to be primary actors in their own health and wellbeing.
References
1. Arnstein, S. R. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35(4), 216-224.
2. Baghirov, R., Ah-Ching, J., & Bollars, C. (2019). Achieving UHC in Samoa through revitalizing PHC and reinvigorating the role of Village Women Groups. Health Systems & Reform, 5(1), 78–82.
3. Bispo, J. P., & Serapioni, M. (2021). Community participation: Lessons and challenges of the 30 years of Health Councils in Brazil. Journal of Global Health, 11(1), 1–3.
4. Braun, V., & Clarke, V. (2022). Thematic analysis: A practical guide. SAGE.
5. Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). SAGE.
6. Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for aboriginal Australians through effective engagement between community and Health Services. BMC Health Services Research, 16(1), 1–13.
7. Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013). Achieving integration in mixed methods designs: Principles and practices. Health Services Research, 48(6, Pt 2), 2134–2156.
https://doi.org/10.1111/1475-6773.12117
8. George, A. S., Mehra, V., Scott, K., & Sriram, V. (2015). 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, 10(10), 1–25.
9. Gizaw, Z., Astale, T., & Kassie, G. M. (2022). What improves access to primary healthcare services in rural communities? A systematic review. BMC Primary Care, 23(1), 1–16.
10. Haldane, V., Chuah, F. L., Srivastava, A., Singh, S. R., Koh, G. C., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLOS ONE, 14(5), 1–25.
11. Haricharan, H. J., Stuttaford, M., & London, L. (2021). The role of community participation in primary health care: Practices of South African Health Committees. Primary Health Care Research & Development, 22, 1–15. https://doi.org/10.1017/s146342362100027x
12. Hothersall, S. J. (2019). Epistemology and social work: Enhancing the integration of theory, practice and research through philosophical pragmatism. European Journal of Social Work, 22(5), 860–870. https://doi.org/10.1080/13691457.2018.1499613
13. Karuga, R., Dieleman, M., Mbindyo, P., Ozano, K., Wairiuko, J., Broerse, J. E., & Kok, M. (2023). Community participation in the health system: analyzing the implementation of community health committee policies in Kenya. Primary health care research & development, 24, e33.
14. Kilewo, E. G., & Frumence, G. (2015). Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania. Global Health Action, 8(1), 1–10.
15. Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30(3), 607–610. https://doi.org/10.1177/001316447003000308
16. Naidoo, C. (2020). Report on the national colloquium on health committees in South Africa. Report). Cape Town: University of Cape Town.
17. National Bureau of Statistics. (2017). [Title of the 2017 population estimates for Akobo County]. [Publisher or URL].
18. Olusola, O., Sharif, M., Omer, M., & Robins, A. (2022). A case study on Participatory Health Planning and Budgeting in Somali Region of Ethiopia. Archives of Current Research International, 22(1), 45-52.
19. Ranjan, R. K., Kumar, V., & Saeed, A. (2026). Community engagement and participation in health programs: Assessing the role of community engagement in improving health program uptake. International Journal of Pharmaceutical Quality Assurance, 17(2), 60–65.
20. Ratnayake, R., Tammaro, M., Tiffany, A., Kongelf, A., Polonsky, J. A., & McClelland, A. (2020). People-centred surveillance: a narrative review of community-based surveillance among crisis-affected populations. The Lancet Planetary Health, 4(10), e483-e495.
21. Warren, C. E., Bellows, B., Marcus, R., Downey, J., Kennedy, S., & Kureshy, N. (2021). Strength in diversity: Integrating community in primary health care to advance Universal Health Coverage. Global Health: Science and Practice, 9(Supplement 1), 1–5.
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