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This article examines the Qhapaq Ñan Project in Peru and its unprecedented mobilization of heritage policymaking to foster a participatory approach. The World Heritage listing of the Qhapaq Ñan, or Inca road system, catalyzed a new ethos in the Peruvian cultural heritage sector, reflected in a cohesive set of values and practices centered on community participation. This study analyzes the crafting of a participatory approach within Peruvian national heritage regulations despite legal, technical, and ideological constraints, following the rationales and processes that challenged traditional material-centered paradigms. It focuses on how heritage specialists reimagined their ethical commitments in conceptualizing and implementing this framework. It further demonstrates how participatory practices intersect with official regulations and informal practices within pre-existing technical and normative structures, integrating elements such as benefits, consultation, and collaboration. Therefore, the adoption of the Qhapaq Ñan’s participatory approach is argued not merely as a passive compliance with intergovernmental policy recommendations but as an active assertion of ethical perspectives and practices by heritage specialists.
Although wildlife management models across the world have since the early 1980s shifted from top-down fortress conservation to different labels of people-friendly community-based conservation, their outcomes remain contested. This paper explores how, and in whose interests, approaches to wildlife conservation in Malawi have been reconfigured from fortress conservation to market–community collaborative management. Based on qualitative field data, we demonstrate how varying levels of community participation in the processes of wildlife conservation transformed the identities and interests of powerful groups of people regarding wildlife conservation in the Majete Wildlife Reserve. We highlight how commodification and monetarization of wildlife conservation served the interests of the emergent powerful groups whilst marginalizing those of the weak. The work indicates how new community identities with regard to wildlife conservation mask the power hegemonies that dictate mechanisms of inclusion and exclusion regarding natural resource use.
Engaging patients, caregivers, and other stakeholders to help guide the research process is a cornerstone of patient-centered research. Lived expertise may help ensure the relevance of research questions, promote practices that are satisfactory to research participants, improve transparency, and assist with disseminating findings.
Methods:
Traditionally engagement has been conducted face-to-face in the local communities in which research operates. Decentralized platform trials pose new challenges for the practice of engagement. We used a remote model for stakeholder engagement, relying on Zoom meetings and blog communications.
Results:
Here we describe the approach used for research partnership with patients, caregivers, and clinicians in the planning and oversight of the ACTIV-6 trial and the impact of this work. We also present suggestions for future remote engagement.
Conclusions:
The ACTIV-6 experience may inform proposed strategies for future engagement in decentralized trials.
The Government of the Islamic Republic of Afghanistan (GIRoA), in power during 2002–2021, initiated the process of instituting community-based forest governance and building local capacity for natural resource management. These efforts coincided with the presence of international security forces and the mobilization of civil society organizations, and they were in response to community aspirations to protect and restore often degraded local forests. Legislation was passed to enable forest protection and management, including a provision to encourage participatory management by local community user groups organized as Forest Management Associations (FMAs). By the end of the GIRoA era, c. 20 registered FMAs were operating with c. 400 others in various stages of development across Afghanistan. Our analysis of relevant policy documents revealed that the policy framework developed during the GIRoA era scores favourably on the ideal criteria for community-based resource management. Despite the change in political administration with the inception of the current Islamic Emirate of Afghanistan regime, the influence of the GIRoA era serves as a starting point and may have enduring influences on rural communities in Afghanistan and the natural resources that support them. Anecdotal evidence suggests that community-based forest management may persist under the current national leadership despite international isolation and funding constraints. The model developed in Afghanistan may be relevant to other fragile states, especially in contexts where rural forest-dependent communities have strong local institutions, such as shuras, and where forests are not prone to heavy extraction pressure.
Les aînés qui vivent avec des problèmes de santé mentale ou des difficultés psychosociales sont souvent isolés et marginalisés. Le programme Participe-présent a été développé dans le but de promouvoir leur participation communautaire. Les objectifs de cette étude étaient de 1) décrire la pertinence, l’acceptabilité, et la faisabilité du programme lors de sa mise à l’essai et 2) d’explorer les bienfaits et les effets à court-terme du programme pour les participants. Vingt-trois aînés, quatre animateurs et trois responsables provenant de quatre organismes ont participé à l’étude. Les aînés ont été satisfaits de leur expérience de participation au programme et ont rapporté une meilleure connaissance des ressources et une plus grande satisfaction à l’égard de leur vie sociale. Les animateurs et les responsables d’organismes ont souligné l’adaptabilité de Participe-présent aux besoins de leur clientèle et à leur contexte de pratique, et ont identifié les facilitateurs et les obstacles à sa mise en œuvre. D’autres études mèneront à des recommandations favorisant le succès de la mise en œuvre de Participe-présent dans différents contextes.
Children need to be repeatedly and consistently exposed to a variety of vegetables from an early age to achieve an increase in vegetable intake. A focus on enjoyment and learning to like eating vegetables at an early age is critical to forming favourable lifelong eating habits. Coordinated work is needed to ensure vegetables are available and promoted in a range of settings, using evidence-based initiatives, to create an environment that will support children’s acceptance of vegetables. This will help to facilitate increased intake and ultimately realise the associated health benefits. The challenges and evidence base for a new approach are described.
Community health committees (CHCs) are a mechanism for communities to voluntarily participate in making decisions and providing oversight of the delivery of community health services. For CHCs to succeed, governments need to implement policies that promote community participation. Our research aimed to analyze factors influencing the implementation of CHC-related policies in Kenya.
Methods:
Using a qualitative study design, we extracted data from policy documents and conducted 12 key informant interviews with health workers and health managers in two counties (rural and urban) and the national Ministry of Health. We applied content analysis for both the policy documents and interview transcripts and summarized the factors that influenced the implementation of CHC-related policies.
Findings:
Since the inception of the community health strategy, the roles of CHCs in community participation have been consistently vague. Primary health workers found the policy content related to CHCs challenging to translate into practice. They also had an inadequate understanding of the roles of CHCs, partly because policy content was not adequately disseminated at the primary healthcare level. It emerged that actors involved in organizing and providing community health services did not perceive CHCs as valuable mechanisms for community participation. County governments did not allocate funds to support CHC activities, and policies focused more on incentivizing community health volunteers (CHVs) who, unlike CHCs, provide health services at the household level. CHVs are incorporated in CHCs.
Conclusion:
Kenya’s community health policy inadvertently created role conflict and competition for resources and recognition between community health workers involved in service delivery and those involved in overseeing community health services. Community health policies and related bills need to clearly define the roles of CHCs. County governments can promote the implementation of CHC policies by including CHCs in the agenda during the annual review of performance in the health sector.
In Europe, migrants and ethnic minority groups are at greater risk for mental disorders compared to the general population. However, little is known about which interventions improve their mental health and well-being and about their underlying mechanisms that reduce existing mental health inequities. To fill this gap, the aim of this scoping review was to synthesise the available evidence on health promotion, prevention, and non-medical treatment interventions targeting migrants and ethnic minority populations. By mapping and synthesising the findings, including facilitators and barriers for intervention uptake, this scoping review provides valuable insights for developing future interventions. We used the PICo strategy and PRISMA guidelines to select peer-reviewed articles assessing studies on interventions. In total, we included 27 studies and synthesised the results based on the type of intervention, intervention mechanisms and outcomes, and barriers and facilitators to intervention uptake. We found that the selected studies implemented tailored interventions to reach these specific populations who are at risk due to structural inequities such as discrimination and racism, stigma associated with mental health, language barriers, and problems in accessing health care. The majority of interventions showed a positive effect on participants’ mental health, indicating the importance of using a tailored approach. We identified three main successful mechanisms for intervention development and implementation: a sound theory-base, systematic adaption to make interventions culturally sensitive and participatory approaches. Moreover, this review indicates the need to holistically address social determinants of health through intersectoral programming to promote and improve mental health among migrants and ethnic minority populations. We identified current shortcomings and knowledge gaps within this field: rigorous intervention studies were scarce, there was a large diversity regarding migrant population groups and few studies evaluated the interventions’ (cost-)effectiveness.
Academic and community investigators conducting community-engaged research (CEnR) are often met with challenges when seeking Institutional Review Board (IRB) approval. This scoping review aims to identify challenges and recommendations for CEnR investigators and community partners working with IRBs. Peer-reviewed articles that reported on CEnR, specified study-related challenges, and lessons learned for working with IRBs and conducted in the United States were included for review. Fifteen studies met the criteria and were extracted for this review. Four challenges identified (1) Community partners not being recognized as research partners (2) Cultural competence, language of consent forms, and literacy level of partners; (3) IRBs apply formulaic approaches to CEnR; & (4) Extensive delays in IRB preparation and approval potentially stifle the relationships with community partners. Recommendations included (1) Training IRBs to understand CEnR principles to streamline and increase the flexibility of the IRB review process; (2) Identifying influential community stakeholders who can provide support for the study; and (3) Disseminating human subjects research training that is accessible to all community investigator to satisfy IRB concerns. Findings from our study suggest that IRBs can benefit from more training in CEnR requirements and methodologies
By the end of the 20th century, there was general agreement that most labour markets were in transition and that employment was becoming less secure. However, official labour market data have not shown a dramatic increase in temporary or casual employment. This article takes a new look at the changing characteristics of employment and offers a new method to measure employment security: the Employment Precarity Index. We use the Employment Precarity Index to assess how insecure employment associated with a ‘gig’ economy might affect well-being and social relations, including health outcomes, household well-being and community involvement.
This chapter focuses on how community engagement (CE) can be implemented at the national and sub-national levels. CE has been identified as an essential pillar of strong people-centred governance which is needed to underpin Universal Health Coverage (UHC) reforms. The “whole of society approach” acknowledges the importance of families and communities in support of the efforts for disease prevention and control. It provides an overview of the evidence and outlines processes that enable effective community engagement and highlights lessons drawn. In particular, Thailand’s Universal Coverage Scheme’s (UCS) participatory governance approach has been a practical example and one of the myriad ways in which the voice of Thailand’s people has been embedded in legislations and operations to ensure that the governance of UCS is responsive to their needs. Four lessons from this experience include leadership and commitment at all levels, transparency and accountability to enable sustained engagement, legal frameworks, and the need for strong capacities in both the government and among communities. Lastly, it proposes the lessons learned and key messages for a proactive approach to CE in health.
Chapter 7 uses three case studies to describe existing practice and processes for using and sharing data for linkage research in three jurisdictions: Western Australia, Scotland and Manitoba. Each case study looks at the decision makers; the relevant law, policy and guidelines regulating the decision-making process; and the ethical review process. The chapter assesses the practice and process in each case study against metrics of good decision making. These metrics are efficiency, transparency, accountability and community participation. The chapter concludes that there are significant similarities between the jurisdictions but that there are many areas in which decision making can be improved in all jurisdictions.
Chapter 8 concludes the book by proposing ways to improve decision-making in relation to sharing linked data for research. It considers improvements in a number of areas: the decision-making framework of interests, values, and rights; the decision-making criteria and conditions; the decision makers who are best placed to make each decision; and the decision-making process. The chapter sets out the interests, values and rights that should frame decisions in this sphere, not all of which are currently represented in decision-making frameworks. It provides a list of decision-making criteria and considerations that should be taken into consideration by the relevant decision makers. The chapter distinguishes between ethical decisions, which should be made by ethics committees and governance decisions, which should be made data custodians. Finally, the chapter makes recommendations for a decision-making process that will be efficient, transparent, accountable and collaborative. This process is designed to lead to better decisions and to ensure that both the decision-making process and the decisions themselves develop and sustain the social licence needed to support the important enterprise of research using linked data.
Chapter 7 uses three case studies to describe existing practice and processes for using and sharing data for linkage research in three jurisdictions: Western Australia, Scotland and Manitoba. Each case study looks at the decision makers; the relevant law, policy and guidelines regulating the decision-making process; and the ethical review process. The chapter assesses the practice and process in each case study against metrics of good decision making. These metrics are efficiency, transparency, accountability and community participation. The chapter concludes that there are significant similarities between the jurisdictions but that there are many areas in which decision making can be improved in all jurisdictions.
Chapter 8 concludes the book by proposing ways to improve decision-making in relation to sharing linked data for research. It considers improvements in a number of areas: the decision-making framework of interests, values, and rights; the decision-making criteria and conditions; the decision makers who are best placed to make each decision; and the decision-making process. The chapter sets out the interests, values and rights that should frame decisions in this sphere, not all of which are currently represented in decision-making frameworks. It provides a list of decision-making criteria and considerations that should be taken into consideration by the relevant decision makers. The chapter distinguishes between ethical decisions, which should be made by ethics committees and governance decisions, which should be made data custodians. Finally, the chapter makes recommendations for a decision-making process that will be efficient, transparent, accountable and collaborative. This process is designed to lead to better decisions and to ensure that both the decision-making process and the decisions themselves develop and sustain the social licence needed to support the important enterprise of research using linked data.
This chapter begins with an overview of the rural and regional clinical context, and explores the connections that rural mental health practitioners have within rural communities. Models of mental health promotion and service delivery are discussed. The nature of life in rural settings and the ways in which climate and geographical location affect the mental health of people are also considered in the context of mental health resilience and vulnerability. Attention is given to the effects of natural disasters, agribusiness, mining, the itinerant rural workforce and under-employment, and the associated mental health consequences. This chapter discusses some rural community benefits in regard to mental health promotion, such as a deeply felt sense of close social proximity despite significant geographical distances between rural people. After reading this chapter, students will be able to reflect on, and critically think about, the ways in which mental health promotion, well-being and recovery can be enhanced among rural populations.
This chapter begins with an overview of the rural and regional clinical context, and explores the connections that rural mental health practitioners have within rural communities. Models of mental health promotion and service delivery are discussed. The nature of life in rural settings and the ways in which climate and geographical location affect the mental health of people are also considered in the context of mental health resilience and vulnerability. Attention is given to the effects of natural disasters, agribusiness, mining, the itinerant rural workforce and under-employment, and the associated mental health consequences. This chapter discusses some rural community benefits in regard to mental health promotion, such as a deeply felt sense of close social proximity despite significant geographical distances between rural people. After reading this chapter, students will be able to reflect on, and critically think about, the ways in which mental health promotion, well-being and recovery can be enhanced among rural populations.
Multinational oil companies adopted corporate social responsibility as a means of addressing the challenges of their relationship with the Niger Delta communities, which had been turbulent for several decades as a result of the ecological devastation of the Niger Delta region. This article analyses the challenges of implementing corporate social responsibility in the Niger Delta, from the inception of the Nigerian oil industry to the present day. Using the experiences of multinational oil companies in the Niger Delta as a case study, the article explores the extent to which multinational oil companies operating in developing countries are increasingly assuming roles that are not traditional corporate roles, to compensate for the bad governance and poor regulatory standards in these countries. The article also provides recommendations for what the Nigerian government can do to develop corporate social responsibility and make it more effective.
Using historical, ethnographic, and archival research, this chapter examines the intersection of environmental policies and community well-being through the lens of community psychology, particularly its attention to the entwinement of socioeconomic and environmental conditions. Focusing on the Gowanus community in Brooklyn, New York, which is midway through a federally mandated environmental cleanup as a Superfund site, we describe how advancing the collective well-being at the scale of the neighborhood can also entail challenging entrenched power structures that have supported systemic inequalities and working within a diverse group. The collective efforts of the Gowanus Canal Community Advisory Group illustrate how chronic toxic environmental degradation can be addressed within an extended collaborative process. We conclude that while endeavoring to improve the surrounding physical environment, the Group’s efforts have also strengthened collaborative engagement across groups to foster community well-being and social justice.
Community participation is an essential component in a primary health care (PHC) and a human rights approach to health. In South Africa, community participation in PHC is organised through health committees linked to all clinics.
Aims:
This paper analyses health committees’ roles, their degree of influence in decision-making and factors impacting their participation.
Methods:
Data were collected through a mixed-methods study consisting of a cross-sectional survey, focus groups, interviews and observations. The findings from the survey were analysed using simple descriptive statistics. The qualitative data were analysed using thematic content analysis. Data on health committees’ roles were analysed according to a conceptual framework adapted from the Arnstein ladder of participation to measure the degree of participation.
Findings:
The study found that 55 per cent of clinics in Cape Town were linked to a health committee. The existing health committees faced sustainability and functionality challenges and primarily practised a form of limited participation. Their decision-making influence was curtailed, and they mainly functioned as a voluntary workforce assisting clinics with health promotion talks and day-to-day operational tasks. Several factors impacted health committee participation, including lack of clarity on health committees’ roles, health committee members’ skills, attitudes of facility managers and ward councillors, limited resources and support and lack of recognition.
Conclusions:
To create meaningful participation, health committee roles should be defined in accordance with a PHC and human rights framework. Their primary role should be to function as health governance structures at facility level, but they should also have access to influence policy development. Consideration should be given to their potential involvement in addressing social determinants of health. Effective participation requires an enabling environment, including support, financial resources and training.