Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review.

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dc.contributor.authorGeorge, Asha S.
dc.contributor.authorScott, Kerry
dc.contributor.authorMehra, V.
dc.contributor.authorSriram, Veena
dc.date.accessioned2017-06-05T08:29:45Z
dc.date.available2017-06-05T08:29:45Z
dc.date.issued2016
dc.description.abstractBACKGROUND: Community capability is the combined influence of a community's social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs). METHODS: We searched for journal articles published between 2000 and 2012 related to the concepts of "community", "capability/participation", "health systems research" and "LMIC." We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. RESULTS: When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality. CONCLUSIONS: Strengthening community capability is critical to ensuring that community participation leads to genuine empowerment. Our simpler framework to define community capability may help researchers better recognize, support and assess it.en_US
dc.description.accreditationScopusen_US
dc.identifier.citationGeorge, A.S. et al.(2016). Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review. BMC Health Services Research, 16:47 - 59. 1472-6963en_US
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/10566/2921
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-016-1860-1
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherBioMed Centralen_US
dc.rights© The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.
dc.status.ispeerreviewedTRUE
dc.subjectCommunity empowermenten_US
dc.subjectCommunity capabilityen_US
dc.subjectSystematic health systemsen_US
dc.subjectHealth systematic interventionsen_US
dc.titleSynergies, strengths and challenges: findings on community capability from a systematic health systems research literature review.en_US
dc.typeArticleen_US

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