Power, data and social accountability: defining a community-led monitoring model for strengthened health service delivery

IF 4.6 1区 医学 Q2 IMMUNOLOGY Journal of the International AIDS Society Pub Date : 2024-10-24 DOI:10.1002/jia2.26374
Ndivhuwo Rambau, Soeurette Policar, Alana R. Sharp, Elise Lankiewicz, Allan Nsubuga, Luke Chimhanda, Anele Yawa, Kenneth Mwehonge, Donald Denis Tobaiwa, Gérald Marie Alfred, Matthew M. Kavanagh, Asia Russell, Solange Baptiste, Onesmus Mlewa Kalama, Rodelyn M. Marte, Naïké Ledan, Brian Honermann, Krista Lauer, Nadia Rafif, Susan Perez, Gang Sun, Anna Grimsrud, Laurel Sprague, Keith Mienies
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Abstract

Introduction

Despite international commitment to achieving the end of HIV as a public health threat, progress is off-track and existing gaps have been exacerbated by COVID-19's collision with existing pandemics. Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community-led monitoring (CLM) of health service delivery holds potential as a social accountability model to increase the accessibility and quality of health systems. However, the effectiveness of the CLM model in strengthening accountability and improving service delivery relies on its alignment with evidence-based principles for social accountability mechanisms. We propose a set of unifying principles for CLM to support the impact on the quality and availability of health services.

Discussion

Building on the social accountability literature, core CLM implementation principles are defined. CLM programmes include a community-led and independent data collection effort, in which the data tools and methodology are designed by service users and communities most vulnerable to, and most impacted by, service quality. Data are collected routinely, with an emphasis on prioritizing and protecting respondents, and are then be used to conduct routine and community-led advocacy, with the aim of increasing duty-bearer accountability to service users. CLM efforts should represent a broad and collective community response, led independently by impacted communities, incorporating both data collection and advocacy, and should be understood as a long-term approach to building meaningful engagement in systems-wide improvements rather than discrete interventions.

Conclusions

The CLM model is an important social accountability mechanism for improving the responsiveness of critical health services and systems to communities. By establishing a collective understanding of CLM principles, this model paves the way for improved proliferation of CLM with fidelity of implementation approaches to core principles, rigorous examinations of CLM implementation approaches, impact assessments and evaluations of CLM's influence on service quality improvement.

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权力、数据和社会问责制:确定社区主导的监测模式以加强医疗服务的提供。
导言:尽管国际社会承诺要终结艾滋病毒对公共卫生的威胁,但进展却偏离了轨道,COVID-19 与现有流行病的碰撞加剧了现有的差距。由艾滋病毒感染者领导的政治问责和历史性医疗保健宣传模式催生了由社区主导的医疗服务提供监测(CLM),它作为一种社会问责模式,具有提高医疗系统可及性和质量的潜力。然而,社区主导监测模式在加强问责制和改善服务提供方面的有效性取决于它是否符合社会问责机制的循证原则。我们为 CLM 提出了一套统一原则,以支持其对医疗服务质量和可获得性的影响:讨论:在社会问责文献的基础上,界定了社区语言管理的核心实施原则。社区语言管理计划包括社区主导的独立数据收集工作,其中的数据工具和方法由最容易受到服务质量影响的服务用户和社区设计。数据的收集是常规性的,重点是优先考虑和保护受访者,然后用于开展常规的、由社区主导的宣传活动,目的是加强义务承担者对服务使用者的责任。社区联络机制应代表一种广泛的、集体的社区响应,由受影响社区独立领导,包括数据收集和宣传,并应被理解为一种长期方法,以建立对全系统改进的有意义的参与,而不是孤立的干预:CLM 模式是一种重要的社会问责机制,可提高关键医疗服务和系统对社区的响应能力。通过建立对 CLM 原则的集体理解,该模式为更好地推广 CLM 铺平了道路,使实施方法忠实于核心原则,对 CLM 实施方法进行严格审查,对 CLM 对服务质量改善的影响进行评估和评价。
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来源期刊
Journal of the International AIDS Society
Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
8.60
自引率
10.00%
发文量
186
审稿时长
>12 weeks
期刊介绍: The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.
期刊最新文献
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