SSM - Health Systems最新文献

{"title":"Kenya’s path to Universal Health Coverage: Insights from policy and practice","authors":"Evaline Langat ,&nbsp;Paul R. Ward ,&nbsp;Hailay Abrha Gesesew ,&nbsp;Lillian Mwanri","doi":"10.1016/j.ssmhs.2025.100141","DOIUrl":"10.1016/j.ssmhs.2025.100141","url":null,"abstract":"<div><h3>Background</h3><div>Universal health coverage (UHC) is a globally endorsed commitment aimed at ensuring equitable access to affordable healthcare services. Kenya's journey toward UHC has been marked by significant reforms, including the 2018 pilot phase and ongoing implementation phase (2020–2030). Using qualitative insights from policymakers and practitioners, this study explored Kenya’s progress, challenges, and opportunities to achieve UHC.</div></div><div><h3>Methods</h3><div>Key informant interviews were conducted with 44 stakeholders across seven counties in Kenya. Data were collected in English using a semi-structured interview guide, audio-recorded with consent, and transcribed verbatim. Thematic analysis, guided by the WHO health system framework, identified achievements, challenges, and areas for improvement across six health system building blocks.</div></div><div><h3>Results</h3><div>The pilot phase improved healthcare access for vulnerable populations by eliminating user fees in public health facilities but faced challenges such as staff shortages, inadequate supplies, financial constraints, and limited stakeholder engagement. The implementation phase introduced structural reforms, including Primary Care Networks (PCNs) to strengthen primary healthcare, mandatory social health insurance for financial protection, and legal frameworks to support service delivery and facility autonomy. Despite these advancements, challenges remain, including workforce shortages, financial barriers, and limited stakeholder participation. Sustaining UHC requires strengthened health systems, reduced out-of-pocket costs, and inclusive stakeholder engagement, with political commitment as a key enabler.</div></div><div><h3>Conclusion</h3><div>Achieving equitable, efficient, and sustainable UHC in Kenya demands more than political commitment. It requires strengthened workforce capacity, equitable financing, efficient supply chains, stakeholder engagement, reduced out-of-pocket costs, and strategic private sector involvement within inclusive policies.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating power in policy adoption: The political economy of noncommunicable diseases in Sierra Leone","authors":"Giulia Loffreda ,&nbsp;Reynold Senesi ,&nbsp;Karin Diaconu ,&nbsp;Ayesha Idriss ,&nbsp;Sophie Witter","doi":"10.1016/j.ssmhs.2025.100139","DOIUrl":"10.1016/j.ssmhs.2025.100139","url":null,"abstract":"<div><div>Non-communicable diseases (NCDs) represent a rising health burden globally, yet low- and middle-income countries (LMICs), particularly fragile states, face persistent barriers to NCD prevention and control policy adoption and implementation. This qualitative case study examines the factors influencing NCD policy adoption in Sierra Leone, a country that, in recent years, has focused on tackling these conditions. Drawing on 20 key informant interviews and 39 policy documents and media analysis, the study highlights the interplay of global health norms, commercial determinants, and local capacities. Findings reveal how international frameworks like WHO’s ‘best buys’ provide essential guidance but often fail to accommodate local socio-political realities. The analysis underscores how multisectoral coalitions, power dynamics, and commercial interests shape outcomes of policy adoption, while chronic underfunding and donor-driven priorities further complicate governance. Recommendations emphasize the importance of context-sensitive strategies that integrate local knowledge systems, strengthen leadership, and embed implementation research. Ultimately, fostering adaptive, accountable, and well-resourced health systems, supported by global solidarity and coordinated governance reforms, is essential to achieving sustainable NCD responses, particularly in an era marked by fractured multilateralism and weakened collective action, where strengthening local capacities and political commitment becomes even more critical.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an indicator to measure emergency interfacility referral readiness for maternal and newborn care at national and sub-national levels","authors":"Megan M. Lydon ,&nbsp;Prateek Gupta ,&nbsp;Peter Acker ,&nbsp;Loveday Penn-Kekana ,&nbsp;Emily B. Keyes","doi":"10.1016/j.ssmhs.2025.100137","DOIUrl":"10.1016/j.ssmhs.2025.100137","url":null,"abstract":"<div><h3>Purpose</h3><div>Emergency referral systems are vital to robust and resilient health systems, however, referral system strengthening efforts have been fragmented, often narrowly focused and lacking a clear measurement approach. We aimed to design a comprehensive standardized indicator to assess health facility readiness to refer emergency obstetric and newborn cases to a receiving health facility to improve the quality of referrals.</div></div><div><h3>Methods</h3><div>We first developed an overarching emergency referral system monitoring framework. Through literature review and content analysis, we defined key dimensions for measurement. We mapped existing indicators to the monitoring framework’s dimensions and developed a tool to collect inputs for the emergency referral readiness indicator. We repeatedly sought consultation and feedback from stakeholders throughout the 2.5-year process and piloted the tool in Senegal and Mozambique. We consolidated feedback, adjusted and finalized the indicator.</div></div><div><h3>Results</h3><div>The final health facility assessment tool includes 123 questions across six dimensions. The dimensions include (1) Transportation readiness, (2) Referral efficiency and coordination of care, (3) Care during transport, (4) Financial accessibility of referral, (5) Family-centered referral, and (6) Inter-facility relational dynamics. Health facility responses can be scored by level of readiness (essential, improved or advanced) or by dimension. The pilot study showed that the tool was practical and effective.</div></div><div><h3>Conclusion</h3><div>Referral system strengthening efforts can benefit from the emergency interfacility referral readiness indicator put forward in this work. It considers the complexity of the referral system, yet offers a standardized approach to identify gaps in referral systems, focus efforts, and track progress over time.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health information sharing between the public and private sectors during Covid in Zambia","authors":"Dell D. Saulnier ,&nbsp;Felix Masiye","doi":"10.1016/j.ssmhs.2025.100136","DOIUrl":"10.1016/j.ssmhs.2025.100136","url":null,"abstract":"<div><div>Information sharing between the public and private sectors of the health system is essential to decision-making during shocks, and understanding the process between sectors can provide information on the health system’s ability to utilize knowledge. The aim of this study was to analyze the process of capturing and registering Covid-19 test information from public and private facilities in Zambia for use in disease surveillance and monitoring. Process mapping was done through document review, key informant interviews, and a workshop to generate information on the process and its challenges. Three pathways for data capture and registration with seven stakeholder groups were identified: tests conducted, test results, and the DHIS2 tracker. The process for sharing information between the public and private sectors was active and functioning, but challenged by fragmentation, limited resources and ownership, and difficulty governing multiple pathways and uses. Unique public-private challenges included an underdefined role for the private sector in public health emergencies and a lack of integration and governance of the private sector in extraordinary circumstances. The findings suggest that implementing a new reporting process for the private sector during a public health crisis was an internal shock itself, which implies that information sharing for decision-making during crises could be improved by engaging and integrating the private sector into emergency preparedness prior to the moment of crisis.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of work culture delineated by workplace sense of belonging: A comparative qualitative study of clinical support staff","authors":"Petra J. Sprik ,&nbsp;Katherine A. Meese ,&nbsp;Shanequa Roscoe-Nelson ,&nbsp;Leila Sadri ,&nbsp;Samuel O. Boadu ,&nbsp;Feras Olyan ,&nbsp;Laurence M. Boitet","doi":"10.1016/j.ssmhs.2025.100135","DOIUrl":"10.1016/j.ssmhs.2025.100135","url":null,"abstract":"<div><h3>Background</h3><div>Promoting workplace sense of belonging (WSB) is suggested to improve the wellbeing and retention of clinical support staff (CSS), a critical group in healthcare systems. This comparative thematic analysis explored how CSS with and without WSB described their work culture, using the multi-level Job Demands-Resources (JD-R) model. Using an exploratory approach, we aimed to capture the breadth of cultural elements potentially related to WSB among CSS.</div></div><div><h3>Methods</h3><div>An anonymous employee engagement survey from a large academic medical center in the Southeastern United States was analyzed using hybrid thematic analysis. Responses to an open-ended question about work culture were inductively coded, then codes were deductively sorted into multi-level JD-R categories. Matrix coding explored differences in code frequency and content between those who agreed/strongly agreed with a WSB and those who disagreed/strongly disagreed.</div></div><div><h3>Results</h3><div>Among 385 analyzed respondents, 77 % indicated WSB. Respondents described positive and negative elements of work culture; those with WSB highlighted positive aspects more frequently (64 %) and negative aspects less frequently (56 %), whereas the opposite pattern was more pronounced for those without WSB (22 % positive, 89 % negative). Code and content differences emerged across organizational, team, and individual level themes. Those without WSB uniquely described being treated as inferior based on their profession, directly experiencing discrimination, and more intensely experiencing team conflict, among others. Those with WSB more saliently describe workplace diversity, inclusion, and collegial relationships, among others.</div></div><div><h3>Conclusion</h3><div>Findings suggest that work culture experiences differ by WSB, warranting further research to better understand and support this understudied population.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and usability of community and facility-based health sector client feedback mechanism in Tanzania public health system. A mixed methods study","authors":"James T. Kengia ,&nbsp;Pius Kagoma ,&nbsp;Ally Kinyaga ,&nbsp;Helga Mutasingwa ,&nbsp;Simon Debere ,&nbsp;Robert Smith ,&nbsp;Marcos Robert Mzeru ,&nbsp;Rashid Mbunda ,&nbsp;Claud Kumalija ,&nbsp;Paul Chaote ,&nbsp;Felix Sukums ,&nbsp;Msafiri Kabulwa ,&nbsp;Eliud Eliakimu ,&nbsp;Rashid S. Mfaume ,&nbsp;Ntuli A. Kapologwe ,&nbsp;Paschal Ruggajo ,&nbsp;Wilson C. Mahera ,&nbsp;Albino Kalolo","doi":"10.1016/j.ssmhs.2025.100133","DOIUrl":"10.1016/j.ssmhs.2025.100133","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Client feedback systems are increasingly becoming important in person-centered health care. The systems provide opportunities to the public to interact with the health care providers and policymakers, present their concerns related to the performance of the health care system in order to improve the quality, equity, and responsiveness in the provision of services, hence increase social accountability. This study aimed to assess the situation of client feedback systems in Tanzania, focusing on the awareness and usability of existing facility- and community-based feedback platforms from the client’s perspective.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The study employed a concurrent mixed-method design using both quantitative and qualitative methods. Quantitatively, surveys were administered in July 2023 to 1009 clients who received either inpatient or outpatient services from 109 health care facilities in 20 councils across 10 regions of Tanzania mainland to gather structured data on satisfaction levels, perceptions of feedback mechanisms, and suggestions for improvement. Qualitative data were collected through Focus group Discussion (FGD) to get in-depth healthcare workers and or clients’ perspectives and experiences. These methods provided nuanced information, contextual insights, and a deeper understanding of the client feedback process. Combining these approaches yielded a comprehensive, multi-dimensional view of the client feedback mechanism landscape. We used Generalized Linear Mixed Model and thematic analysis for quantitative and qualitative data respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Our findings revealed that, the majority of the clients were aware of their right to provide feedback (79.78 %), and in particular familiar with the suggestion box (82.95 %) followed by phone calls (34.49), nevertheless most of them never provided feedback (67.3 %). Phone calls (83.75) and SMS (44.10 %) were the most preferred platforms to provide feedback. Comparatively, clients attending higher level health facilities, clients who visited facilities 4–5 times or more, those who received services for 45–60 min or more and those who were aware of existence of client feedback system than their counterparts were significantly more likely to provide feedback. Moreover, in qualitative findings availability of real time feedback, authenticity, user-friendliness of the system, digitalization, clarity in referral pathway and information use to support decisions and quality improvement was important factors to enhance usability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Improving the usability of client feedback system is essential to attain person-centered health care and advance universal health coverage. The majority of the clients attending heath care facilities are aware of their right to provide feedback, nevertheless, most of them never provide feedback. Our study, have shed light on the need to invest on user friendly syst","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financing and purchasing mechanisms of primary health care in Southeast Asia region: Findings from a scoping review","authors":"Hsu Myat Mon ,&nbsp;Aungsumalee Pholpark ,&nbsp;Leonard Thomas Sy Lim ,&nbsp;Tsolmongerel Tsilaajav ,&nbsp;Valeria de Oliveira Cruz ,&nbsp;Piya Hanvoravongchai","doi":"10.1016/j.ssmhs.2025.100132","DOIUrl":"10.1016/j.ssmhs.2025.100132","url":null,"abstract":"<div><h3>Background</h3><div>Despite commitment to Primary Health Care (PHC), financing has been a persistent challenge in Southeast Asia, with limited discussions. To address this knowledge gap, this study explores three key financing mechanisms: revenue mobilization, pooling, and purchasing across the region.</div></div><div><h3>Methods</h3><div>A scoping review, with searches in PubMed, Scopus, Embase, and Google Scholar, was conducted. Screening was done via Covidence, with data extracted and analyzed in Excel using a framework analysis.</div></div><div><h3>Results</h3><div>Of 2521 sources, 171 were included. Limited information specific to PHC was found. Revenue mobilization mainly includes out-of-pocket payment, government funding, social insurance contributions, and a mix of government and external funding. Pooling for PHC financing was seen in Thailand, while other countries showed multiple levels of pooling under general health financing. The prevalent purchasing method for public facilities is line-item budgeting, with salaries as the primary payment method for healthcare providers. Some countries employ performance-linked methods and capitation for provider payments. Significant challenges include inadequate budget allocations, financial flow fragmentation, and poor coordination and low capacity for financial management.</div></div><div><h3>Conclusion</h3><div>Financing for PHC is found to be insufficient and inefficient, mainly using traditional mechanisms. Cross-country learning and collaboration can support the development of strategic PHC financing mechanisms.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and challenges of Accredited Social Health Activists (ASHAs) in delivering key Maternal and Newborn Health (MNH) services in India: A systematic review and meta-analyses","authors":"Sukriti Chawla ,&nbsp;Chandan Kumar ,&nbsp;Montu Bose ,&nbsp;Shikha M. Shrivastav","doi":"10.1016/j.ssmhs.2025.100134","DOIUrl":"10.1016/j.ssmhs.2025.100134","url":null,"abstract":"<div><h3>Background</h3><div>Accredited Social Health Activists (ASHAs), a cadre of community health workers in India, have played a significant role in improving key maternal and newborn health (MNH) services since their inception in 2005 under the National Rural Health Mission (NRHM). However, persistent inequalities in the coverage of these health services and the expanding engagement of ASHAs within the health system necessitate a revisit to their performance and the challenges they face. This study synthesizes existing evidence on ASHAs' performance in MNH services.</div></div><div><h3>Methods</h3><div>A comprehensive search of bibliographic databases, including PubMed, Scopus, Embase, and Web of Science, yielded a total of 9140 studies. Of these, 38 studies were included in the systematic review, and 31 in the meta-analyses. Random-effects models were used to estimate the pooled effect size (Relative Risk) of ASHAs in delivering three key MNH services: antenatal care visits, institutional deliveries, and postnatal care.</div></div><div><h3>Findings</h3><div>The meta-analyses suggest that ASHAs have a positive, albeit marginal, impact on improving key MNH services. Qualitative studies revealed both enablers and barriers to ASHA’s performance, which were classified into individual, cultural, and health system-related factors.</div></div><div><h3>Interpretation</h3><div>The study highlights that fostering a supportive environment is crucial for enhancing ASHAs’ impact on MNH service coverage. Given significant interstate disparities, regionally adaptive strategies are required. Additionally, the scope of ASHAs' responsibilities should be periodically reviewed to ensure the provision of holistic and culturally sensitive maternal care.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of informal health providers in the management of neglected tropical diseases in Liberia: A participatory investigation","authors":"Hannah Berrian ,&nbsp;Laura Dean ,&nbsp;Shahreen Chowdhury ,&nbsp;Zeela Zaizay ,&nbsp;Sally Theobald ,&nbsp;Wede Seekey ,&nbsp;Jerry Kollie ,&nbsp;John Solunta Smith Jr ,&nbsp;Colleen Parker ,&nbsp;Emerson Rogers ,&nbsp;Rosalind McCollum","doi":"10.1016/j.ssmhs.2025.100131","DOIUrl":"10.1016/j.ssmhs.2025.100131","url":null,"abstract":"<div><h3>Background</h3><div>Informal health providers (e.g. traditional and faith healers) are the first point of contact for many persons affected by skin Neglected Tropical Diseases (NTDs) due to varying beliefs and perceptions, yet, they are typically not considered within interventions designed to support persons affected. Despite this neglect, most informal providers are already using their existing roles within communities to support persons affected with care. We sought to investigate the role of informal providers in the management of NTDs in Liberia using participatory approaches to understand and identify ways to improve equitable and effective care for people affected by skin NTDs.</div></div><div><h3>Methods</h3><div>Qualitative and participatory data were collected from two purposively selected counties in Liberia: Grand Gedeh and Lofa. Key informant interviews (6), photovoice (16), and vignettes (32) with traditional and faith healers and informal drug sellers sought to understand their roles in providing care for people affected by skin NTDs. Analysis was conducted using a thematic framework approach.</div></div><div><h3>Findings</h3><div>Health beliefs influenced care seeking from informal providers and/or biomedical care. Informal providers provide persons affected with holistic support, including physical, psychosocial, spiritual, social and financial. This care, based on their respective underlying health beliefs and cultural norms, is driven by perceptions of poor quality of the formal or biomedical health system. During care provision, traditional and faith healers emphasised referring persons affected to the health facility as part of their roles.</div></div><div><h3>Conclusion</h3><div>Understanding the roles of informal providers in the management of skin NTDs is important in reducing the burden of NTDs. Informal providers are trusted by their communities and seen as a primary contact to provide care. They expressed willingness to collaborate with the formal health system. Training them on identification and referral, and basic psychosocial support would enhance early referral and collaboration between formal and informal health systems.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community health worker contributions to climate resilient health systems: A qualitative study of how community health workers navigate extreme weather events in the Philippines","authors":"Bridget Beggs ,&nbsp;Laura Jane Brubacher ,&nbsp;Monica Bustos ,&nbsp;Lincoln Lau ,&nbsp;Jennifer Liu ,&nbsp;Warren Dodd","doi":"10.1016/j.ssmhs.2025.100130","DOIUrl":"10.1016/j.ssmhs.2025.100130","url":null,"abstract":"<div><div>Community health workers (CHWs) are an important source of health-related support and care across many resource-constrained settings. However, amid the increasing frequency and intensity of extreme weather events globally, there is a need to understand how CHWs may experience and navigate these events, and consider potential opportunities to strengthen their contributions to climate resilient health systems. This study explored the experiences of CHWs before, during, and after extreme weather events to examine how their identities, existing responsibilities, and perceived capacity shaped their ability to contribute towards preparedness, response, and recovery efforts in their communities. In collaboration with a Philippines-based non-governmental organization (NGO), we conducted 51 semi-structured interviews with CHWs affiliated with an NGO-led CHW program across four municipalities in Negros Oriental, Philippines. All interviews were audio-recorded, transcribed, and thematically analyzed using a hybrid deductive-inductive approach. Participants described how the various roles and responsibilities they held within and outside of their household shaped their engagement with preparedness, response, and recovery to extreme weather events. Importantly, participants highlighted opportunities to enhance their contributions to preparedness, response, and recovery efforts in their communities. Further, participants discussed how additional training and material resources could be leveraged to enhance preparedness to and recovery from extreme weather events in their communities. Overall, this study provides insight into how CHWs may contribute to climate resilient health systems amid extreme weather events, and underscores the complexities of recognizing CHWs as both health leaders and community members in disaster risk management practices.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"5 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}