Social participation in health – case studies from primary health care in Kosovo

作者：Ilir Hoxha, Vlora Basha-Berisha, Erza Selmani, Shegë Bahtiri, Ariana Bytyçi-Katanolli, Ardian Imeti, Paula Valentine, Jana Gerold · 发表于：BMC Public Health · 年份：2024 · DOI：10.1186/s12889-024-21053-z · 被引用次数：9 · 研究领域：Global Maternal and Child Health、Healthcare Systems and Reforms、Mental Health and Patient Involvement

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 ...