Social participation in health – case studies from primary health care in Kosovo
Abstract Background Participation and inclusion of service users in health governance impact the quality of care and citizen well-being. In developing countries, such as Kosovo, disadvantaged groups are particularly important due to deep exclusionary structures and multiple systemic barriers to part...
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BMC
2024-12-01
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| Online Access: | https://doi.org/10.1186/s12889-024-21053-z |
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| author | Ilir Hoxha Vlora Basha-Berisha Erza Selmani Shege Bahtiri Ariana Bytyci-Katanolli Ardian Imeti Paula Valentine Jana Gerold |
| author_facet | Ilir Hoxha Vlora Basha-Berisha Erza Selmani Shege Bahtiri Ariana Bytyci-Katanolli Ardian Imeti Paula Valentine Jana Gerold |
| author_sort | Ilir Hoxha |
| collection | DOAJ |
| description | Abstract Background Participation and inclusion of service users in health governance impact the quality of care and citizen well-being. In developing countries, such as Kosovo, disadvantaged groups are particularly important due to deep exclusionary structures and multiple systemic barriers to participation and care provision. Purpose To investigate the effects of three interventions on social participation in decision-making in several primary healthcare sites among the population and particularly vulnerable groups, i.e. ethnic minorities of Roma, Ashkali, and Egyptian backgrounds, elderly citizens, and people with disabilities. Methods This study uses the consolidated framework of social participation and adapts it to Kosovo’s primary healthcare context. We analysed the degrees of inclusiveness, intensity, and influence across three interventions, i.e., social participation mechanisms implemented in four municipalities and related primary care networks in Kosovo. We applied an embedded multiple-case study design relying on qualitative data collection. Results Degrees of social participation within each case study ranged from low to moderate. Patient councils serve as representative mechanisms to consider patient complaints with an informative and liaising role. The community scorecard mechanism involves community representatives in decision-making processes, with varying levels of inclusiveness and participation intensity, effectively voicing their preferences and demands. The municipal health action plans process exhibits varying inclusiveness levels where community representatives wield decision-making influence. Conclusion The participation mechanisms examined in this study could sustain moderate social participation across inclusiveness, intensity, influence and impact domains. These shared platforms between service users and providers produce the most meaningful influence. The use of these mechanisms has a promise of increasing social participation in primary care settings in Kosovo. |
| format | Article |
| id | doaj-art-8066d978cbc947c296a8c9ac9c923492 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-8066d978cbc947c296a8c9ac9c9234922024-12-22T12:53:07ZengBMCBMC Public Health1471-24582024-12-0124111710.1186/s12889-024-21053-zSocial participation in health – case studies from primary health care in KosovoIlir Hoxha0Vlora Basha-Berisha1Erza Selmani2Shege Bahtiri3Ariana Bytyci-Katanolli4Ardian Imeti5Paula Valentine6Jana Gerold7The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthKantar (Index Kosova)Evidence Synthesis GroupAccessible Quality Healthcare (AQH)Accessible Quality Healthcare (AQH)Accessible Quality Healthcare (AQH)Save the ChildrenSwiss Centre for International Health, Swiss Tropical and Public Health InstituteAbstract Background Participation and inclusion of service users in health governance impact the quality of care and citizen well-being. In developing countries, such as Kosovo, disadvantaged groups are particularly important due to deep exclusionary structures and multiple systemic barriers to participation and care provision. Purpose To investigate the effects of three interventions on social participation in decision-making in several primary healthcare sites among the population and particularly vulnerable groups, i.e. ethnic minorities of Roma, Ashkali, and Egyptian backgrounds, elderly citizens, and people with disabilities. Methods This study uses the consolidated framework of social participation and adapts it to Kosovo’s primary healthcare context. We analysed the degrees of inclusiveness, intensity, and influence across three interventions, i.e., social participation mechanisms implemented in four municipalities and related primary care networks in Kosovo. We applied an embedded multiple-case study design relying on qualitative data collection. Results Degrees of social participation within each case study ranged from low to moderate. Patient councils serve as representative mechanisms to consider patient complaints with an informative and liaising role. The community scorecard mechanism involves community representatives in decision-making processes, with varying levels of inclusiveness and participation intensity, effectively voicing their preferences and demands. The municipal health action plans process exhibits varying inclusiveness levels where community representatives wield decision-making influence. Conclusion The participation mechanisms examined in this study could sustain moderate social participation across inclusiveness, intensity, influence and impact domains. These shared platforms between service users and providers produce the most meaningful influence. The use of these mechanisms has a promise of increasing social participation in primary care settings in Kosovo.https://doi.org/10.1186/s12889-024-21053-zSocial participationSocial inclusionDisadvantaged groupsDecision-makingPrimary health careKosovo |
| spellingShingle | Ilir Hoxha Vlora Basha-Berisha Erza Selmani Shege Bahtiri Ariana Bytyci-Katanolli Ardian Imeti Paula Valentine Jana Gerold Social participation in health – case studies from primary health care in Kosovo BMC Public Health Social participation Social inclusion Disadvantaged groups Decision-making Primary health care Kosovo |
| title | Social participation in health – case studies from primary health care in Kosovo |
| title_full | Social participation in health – case studies from primary health care in Kosovo |
| title_fullStr | Social participation in health – case studies from primary health care in Kosovo |
| title_full_unstemmed | Social participation in health – case studies from primary health care in Kosovo |
| title_short | Social participation in health – case studies from primary health care in Kosovo |
| title_sort | social participation in health case studies from primary health care in kosovo |
| topic | Social participation Social inclusion Disadvantaged groups Decision-making Primary health care Kosovo |
| url | https://doi.org/10.1186/s12889-024-21053-z |
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