Patient-public engagement strategies for health system improvement in sub-Saharan Africa: a systematic scoping review.
Community engagement
Health interventions
Health system improvement
Patient-public engagement
Social accountability
Sub-Saharan Africa
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
05 Oct 2021
05 Oct 2021
Historique:
received:
20
08
2021
accepted:
24
09
2021
entrez:
6
10
2021
pubmed:
7
10
2021
medline:
8
10
2021
Statut:
epublish
Résumé
Actively involving patients and communities in health decisions can improve both peoples' health and the health system. One key strategy is Patient-Public Engagement (PPE). This scoping review aims to identify and describe PPE research in Sub-Saharan Africa; systematically map research to theories of PPE; and identify knowledge gaps to inform future research and PPE development. The review followed guidelines for conducting and reporting scoping reviews. A systematic search of peer-reviewed English language literature published between January 1999 and December 2019 was conducted on Scopus, Medline (Ovid), CINAHL and Embase databases. Independent full text screening by three reviewers followed title and abstract screening. Using a thematic framework synthesis, eligible studies were mapped onto an engagement continuum and health system level matrix to assess the current focus of PPE in Sub-Saharan Africa. Initially 1948 articles were identified, but 18 from 10 Sub-Saharan African countries were eligible for the final synthesis. Five PPE strategies implemented were: 1) traditional leadership support, 2) community advisory boards, 3) community education and sensitisation, 4) community health volunteers/workers, and 5) embedding PPE within existing community structures. PPE initiatives were located at either the 'involvement' or 'consultation' stages of the engagement continuum, rather than higher-level engagement. Most PPE studies were at the 'service design' level of the health system or were focused on engagement in health research. No identified studies reported investigating PPE at the 'individual treatment' or 'macro policy/strategic' level. This review has successfully identified and evaluated key PPE strategies and their focus on improving health systems in Sub-Saharan Africa. PPE in Sub-Saharan Africa was characterised by tokenism rather than participation. PPE implementation activities are currently concentrated at the 'service design' or health research levels. Investigation of PPE at all the health system levels is required, including prioritising patient/community preferences for health system improvement.
Sections du résumé
BACKGROUND
BACKGROUND
Actively involving patients and communities in health decisions can improve both peoples' health and the health system. One key strategy is Patient-Public Engagement (PPE). This scoping review aims to identify and describe PPE research in Sub-Saharan Africa; systematically map research to theories of PPE; and identify knowledge gaps to inform future research and PPE development.
METHODS
METHODS
The review followed guidelines for conducting and reporting scoping reviews. A systematic search of peer-reviewed English language literature published between January 1999 and December 2019 was conducted on Scopus, Medline (Ovid), CINAHL and Embase databases. Independent full text screening by three reviewers followed title and abstract screening. Using a thematic framework synthesis, eligible studies were mapped onto an engagement continuum and health system level matrix to assess the current focus of PPE in Sub-Saharan Africa.
RESULTS
RESULTS
Initially 1948 articles were identified, but 18 from 10 Sub-Saharan African countries were eligible for the final synthesis. Five PPE strategies implemented were: 1) traditional leadership support, 2) community advisory boards, 3) community education and sensitisation, 4) community health volunteers/workers, and 5) embedding PPE within existing community structures. PPE initiatives were located at either the 'involvement' or 'consultation' stages of the engagement continuum, rather than higher-level engagement. Most PPE studies were at the 'service design' level of the health system or were focused on engagement in health research. No identified studies reported investigating PPE at the 'individual treatment' or 'macro policy/strategic' level.
CONCLUSION
CONCLUSIONS
This review has successfully identified and evaluated key PPE strategies and their focus on improving health systems in Sub-Saharan Africa. PPE in Sub-Saharan Africa was characterised by tokenism rather than participation. PPE implementation activities are currently concentrated at the 'service design' or health research levels. Investigation of PPE at all the health system levels is required, including prioritising patient/community preferences for health system improvement.
Identifiants
pubmed: 34610828
doi: 10.1186/s12913-021-07085-w
pii: 10.1186/s12913-021-07085-w
pmc: PMC8491404
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1047Informations de copyright
© 2021. The Author(s).
Références
Health Policy Plan. 2012 Oct;27(7):541-54
pubmed: 22279082
J Biosoc Sci. 2016 Sep;48 Suppl 1:S56-73
pubmed: 27428066
Health Policy. 2010 May;95(2-3):211-5
pubmed: 20036434
AIDS. 2015 Jul;29 Suppl 2:S155-64
pubmed: 26102626
Health Expect. 2020 Apr;23(2):261-273
pubmed: 31981295
Acta Trop. 2003 Mar;85(3):325-38
pubmed: 12659970
AIDS Care. 2013;25 Suppl 1:S67-77
pubmed: 23745632
Reprod Health. 2013 Jul 26;10:36
pubmed: 23890362
Public Health. 2005 Nov;119(11):987-94
pubmed: 16188287
Health Promot Int. 2018 Aug 1;33(4):723-733
pubmed: 28334951
Health Policy Plan. 2014 Sep;29 Suppl 2:ii98-106
pubmed: 25274645
Med J Aust. 2003 Jan 6;178(1):17-20
pubmed: 12492384
BMC Med Ethics. 2014 Feb 17;15:12
pubmed: 24533875
J Eval Clin Pract. 2018 Feb;24(1):240-253
pubmed: 29076631
Acta Trop. 1996 Apr;61(2):79-92
pubmed: 8740887
Qual Health Res. 2017 Apr;27(5):738-749
pubmed: 27022034
PLoS One. 2018 Mar 2;13(3):e0193579
pubmed: 29499043
Prim Health Care Res Dev. 2018 Sep;19(5):492-502
pubmed: 29374506
Trials. 2014 Feb 25;15:65
pubmed: 24565019
BMC Health Serv Res. 2015 Nov 23;15:514
pubmed: 26593716
BMJ Glob Health. 2019 Aug 16;4(Suppl 8):e001489
pubmed: 31478027
BMJ Qual Saf. 2016 Aug;25(8):626-32
pubmed: 26993640
BMC Pregnancy Childbirth. 2010 Mar 19;10:13
pubmed: 20302625
Syst Rev. 2019 Apr 18;8(1):97
pubmed: 30999950
Hum Resour Health. 2018 Oct 4;16(1):53
pubmed: 30286763
Health Policy. 2009 Aug;91(3):219-28
pubmed: 19261347
Health Hum Rights. 2008;10(1):81-92
pubmed: 20845831
Int J Health Plann Manage. 2021 Mar;36(2):273-281
pubmed: 33051932
Int J Evid Based Healthc. 2015 Sep;13(3):141-6
pubmed: 26134548
PLoS Med. 2013 Aug;10(8):e1001495
pubmed: 23940462
Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S146-S153
pubmed: 30845322
Eval Program Plann. 2019 Feb;72:170-178
pubmed: 30368104
BMC Health Serv Res. 2013 Jun 26;13:233
pubmed: 23803140
AIDS Behav. 2012 Jul;16(5):1217-26
pubmed: 21822627
Health Policy Plan. 2018 Dec 1;33(10):1128-1143
pubmed: 30590543
Health Econ Rev. 2016 Dec;6(1):49
pubmed: 27785769
J Health Commun. 2018;23(1):80-90
pubmed: 29265915
Health Policy Plan. 2005 Jan;20(1):25-34
pubmed: 15689427
Ann Intern Med. 2018 Oct 2;169(7):467-473
pubmed: 30178033
Am J Public Health. 2011 Oct;101(10):1857-67
pubmed: 21852635
Implement Sci. 2010 Sep 20;5:69
pubmed: 20854677
Int J Qual Health Care. 2011 Oct;23(5):510-5
pubmed: 21586433
Malar J. 2011 Aug 04;10:225
pubmed: 21816085
BMJ Open. 2018 Jan 30;8(1):e018263
pubmed: 29382676
BMC Public Health. 2019 Jun 21;19(1):791
pubmed: 31226977
AIDS. 2013 Jun 19;27(10):1657-66
pubmed: 24047764
Dev World Bioeth. 2015 Apr;15(1):18-26
pubmed: 23725206
J Health Polit Policy Law. 1993 Winter;18(4):881-904
pubmed: 8120350
BMC Health Serv Res. 2014 Aug 11;14:340
pubmed: 25113017
SAHARA J. 2008 Dec;5(4):162-77
pubmed: 19194598
Implement Sci. 2018 Jul 26;13(1):98
pubmed: 30045735
BMC Health Serv Res. 2013 Aug 16;13:320
pubmed: 23953492
BMC Med Ethics. 2017 Dec 13;18(1):76
pubmed: 29237440
PLoS One. 2015 Oct 23;10(10):e0141091
pubmed: 26496124
Qual Saf Health Care. 2006 Oct;15(5):307-10
pubmed: 17074863
Health Expect. 2015 Apr;18(2):153-65
pubmed: 23252574
Health Policy Plan. 2018 Oct 1;33(8):879-887
pubmed: 30084938
BMC Public Health. 2013 Jan 31;13:91
pubmed: 23368931
PLoS Negl Trop Dis. 2009 Aug 25;3(8):e412
pubmed: 19707588
Stud Fam Plann. 2015 Sep;46(3):241-61
pubmed: 26347089