The Institute for Global Health and Development
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Item A comparison of health-related quality of life using the World Health Organization Quality of Life-BREF and 5-Level EuroQol-5 Dimensions in the Malaysian population.(2025-03-31) Liem, Andrian; Chih, Hui Jun; Velaithan, Vithya; Norman, Richard; Reidpath, Daniel; Su, Tin TinThis study aimed to describe and compare health-related quality of life (QoL) as measured by the World Health Organization Quality of Life-BREF (WHOQoL-BREF) and the EuroQol-5 Dimensions (EQ-5D) among the Malaysian population, examining differences by sociodemographic characteristics including age, income, sex, ethnicity, educational level, and occupation. This cross-sectional study used data from 19,402 individuals collected as part of a health and demographic surveillance system survey conducted in the Segamat district of Malaysia in 2018-2019. Descriptive statistics and measures of central tendency were produced. Differences in QoL among demographic sub-groups were examined using the t-test and analysis of variance, while the correlations between the WHOQoL-BREF and EQ-5D were evaluated using Pearson correlation coefficients. Based on complete case analysis (n=19,129), the average scores for the 4 WHOQoL-BREF domains were 28.2 (physical), 24.1 (psychological), 12.0 (social relationships), and 30.4 (environment). The percentages of participants not in full health for each EQ-5D dimension were 12.8% (mobility), 3.1% (self-care), 6.9% (usual activities), 20.9% (pain/discomfort), and 6.8% (anxiety/depression). Correlations between the 4 WHOQoL-BREF domains and the 5 EQ-5D dimensions were relatively weak, ranging from -0.06 (social relationships with self-care and pain/discomfort; p<0.001) to -0.42 (physical with mobility; p<0.001). Although health-related QoL as measured by the WHOQoL-BREF and the EQ-5D are correlated, these 2 measures should not be considered interchangeable. The choice between them should be guided by the specific research questions and the intended use of the data.Item Lessons from community participation in primary health care and water resource governance in South Africa: A narrative review(Taylor & Francis, 2022-01-07) Hove, Jennifer; D’Ambruoso, Lucia; Kahn, Kathleen; Witter, Sophie; van der Merwe, Maria; Mabetha, Denny; Tembo, Kingsley; Twine, RhianBackground In South Africa, community participation has been embraced through the development of progressive policies to address past inequities. However, limited information is available to understand community involvement in priority setting, planning and decision-making in the development and implementation of public services.Item Comprehensive primary health care and non-communicable diseases management: A case study of El Salvador(BMC, 2020-04-06) Jimenez Carrillo, Marta; León García, Montserrat; Vidal, Nicole L.; Bermúdez, Keven; De Vos, PolOne of today's greatest challenges in public health worldwide - and especially its key management from Primary Health Care (PHC) - is the growing burden of non-communicable diseases (NCDs). In El Salvador, since 2009 the Minister of Health (MoH) has scaled up a national public health system based on a comprehensive PHC approach. A national multi-sectorial strategic plan for a comprehensive approach to NCDs has also been developed. This analysis explores stakeholders' perceptions related to the management of NCDs in PHC and, in particular, the role of social participation. A case-study was developed consisting of semi structured interviews and official document reviews. Semi-structured interviews were developed with chronic patients (14) and PHC professionals working in different levels within PHC (12). Purposive sampling was used to recruit participants. A non-pure, deductive approach was implemented for coding. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and the triangulation of the data. The research was conducted between March and August of 2018 in three different departments of El Salvador. The structure and the functioning of the Salvadoran PHC system and its intersectoral approach is firstly described. The interdisciplinary PHC-team brings holistic health care closer to the communities in which health promoters play a key role. The findings reflect the generally positive perception of the PHC system in terms of accessibility, quality and continuity of care by chronic patients. Community engagement and the National Health Forum are ensuring accountability through social controllership mechanisms. However, certain challenges were also noted during the interviews related to the shortage of medication and workforce; coordination between the levels of care and the importance of prevention and health promotion programmes for NCDs. The Salvadoran PHC and its comprehensive approach to NCDs with an emphasis on intersectoral participation has been positively perceived by the range of stakeholders interviewed. Social engagement and the NHF works as a driving force to ensure accountability as well as in the promotion of a preventive culture. The challenges identified provide keys to amplify knowledge for addressing inequalities in health by strengthening PHC and its NCDs management.Item The role of social movements in strengthening health systems: The experience of the National Health Forum in El Salvador (2009–2018)(SAGE Publications, 2020-02-19) León, Montserrat; Jiménez, Marta; Vidal, Nicole L.; Bermúdez, Keven; De Vos, PolIn 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009–2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.Item Building cooperative learning to address alcohol and other drug abuse in Mpumalanga, South Africa: A participatory action research process(Taylor & Francis, 2020-03-02) Oladeinde, Oladapo; Mabetha, Denny; Twine, Rhian; Hove, Jennifer; van der Merwe, Maria; Byass, Peter; Witter, Sophie; Kahn, Kathleen; D'Ambruoso, Lucia; Wall, StigBackground: Alcohol and other drug (AOD) abuse is a major public health challenge disproportionately affecting marginalised communities. Involving communities in the development of responses can contribute to acceptable solutions.Item Augmenting frameworks for appraising the practices of community-based health interventions(Oxford University Press, 2009-04-20) Pérez, Dennis; Lefèvre, Pierre; Romero, Maria Isabel; Sánchez, Lizet; De Vos, Pol; Van der Stuyft, PatrickThis paper aims at augmenting the frameworks proposed by Rifkin in 1996 to distinguish between target-oriented and empowerment approaches to participation in community-based health interventions. In her paper, Rifkin defined three criteria: who makes decisions on resource allocation, expected outcome and outcome assessment. We propose five additional criteria: the definition of community, the characteristics of the capacity-building process, the leadership characteristics, the documentation process, and ethical issues regarding participation. Derived from our analysis of a community-based project, the proposed criteria are discussed in the light of the principles of Popular Education and other literature on community participation. The augmented frameworks are intended to assist health professionals and planners interested in the empowerment approach of community participation to consciously sharpen their practice.Item Rights-based training enhancing engagement of health providers with communities, Cape Metropole, South Africa(Frontiers Media S.A., 2019-04-30) Zwama, Gimenne; Stuttaford, Maria Clasina; Haricharan, Hanne Jensen; London, LeslieCommunity participation, the central principle of the primary health care approach, is widely accepted in the governance of health systems. Health Committees (HCs) are community-based structures that can enable communities to participate in the governance of primary health care. Previous research done in the Cape Town Metropole, South Africa, reports that HCs' potential can, however, be limited by a lack of local health providers' (HPs) understanding of HC roles and functions as well as lack of engagement with HCs. This study was the first to evaluate HPs' responsiveness towards HCs following participation in an interactive rights-based training. Thirty-four HPs, from all Cape Metropole health sub-districts, participated in this qualitative training evaluation. Two training groups were observed and participants completed pre- and post-training questionnaires. Semi-structured interviews were held with 10 participants 3–4 months after training. Following training, HPs understood HCs to play an important role in the communication between the local community and HPs. HPs also perceived HCs as able to assist with and improve the quality and accessibility of PHC, as well as the answerability of services to local community needs. HPs expressed intentions to actively engage with the facility's HC and stressed the importance of setting clear roles and responsibilities for all HC members. This training evaluation reveals HPs' willingness to engage with HCs and their desire for skills to achieve this. Moreover, it confirms that HPs are crucial players for the effective functioning of HCs. This evaluation indicates that HPs' increased responsiveness to HCs following training can contribute to tackling the disconnect between service delivery and community needs. Therefore, the training of HPs on HCs potentially promotes the development of needs-responsive PHC and a people-centred health system. The training requires ongoing evaluation as it is extended to other contexts.