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...

Full description

Saved in:
Bibliographic Details
Main Authors: Ilir Hoxha, Vlora Basha-Berisha, Erza Selmani, Shege Bahtiri, Ariana Bytyci-Katanolli, Ardian Imeti, Paula Valentine, Jana Gerold
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-024-21053-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846112056623759360
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
work_keys_str_mv AT ilirhoxha socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT vlorabashaberisha socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT erzaselmani socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT shegebahtiri socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT arianabytycikatanolli socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT ardianimeti socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT paulavalentine socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo
AT janagerold socialparticipationinhealthcasestudiesfromprimaryhealthcareinkosovo