Academic Journal
Community case study: overcoming barriers to social participation for improved local health governance in Madagascar.
| Τίτλος: | Community case study: overcoming barriers to social participation for improved local health governance in Madagascar. |
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| Συγγραφείς: | Petit D; WHO, Geneva, Switzerland., Rajan D; European Observatory on Health Systems and Policies/ WHO European Centre for Health Policy, Brussels, Belgium., Koch K; WHO, Geneva, Switzerland., Poulussen C; WHO, Geneva, Switzerland., Rakotomanga JDM; National Institute of Public and Community Health, Antananarivo, Madagascar., Rajaonarison M; Permanent Mission of the Republic of Madagascar, Geneva, Switzerland., Bajnóczki C; WHO, Geneva, Switzerland., Brousse S; Action Against Hunger, Paris, France., Kalambay H; WHO Regional Office for Africa, Brazzaville, Republic of Congo., Rambinintsoanomenjanahary SI; WHO Country Office, Antananarivo, Madagascar., Rohrer-Herold K; WHO, Geneva, Switzerland. |
| Πηγή: | Frontiers in public health [Front Public Health] 2026 Sep 08; Vol. 14, pp. 1778275. Date of Electronic Publication: 2026 Sep 08 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne : Frontiers Editorial Office |
| Ιατρικοί όροι (MeSH): | Community Participation* , Health Policy* , Social Participation*, Madagascar ; Humans ; Policy Making |
| Περίληψη: | Government engagement with communities are critical for achieving health equity goals. The available literature is plentiful on community and civil society's barriers to meaningful participation. However, considerably less documentation abounds on how to address barriers to equal interaction within the participatory process, with concrete interventions tested and assessed. This paper aims to bridge that research gap by studying community engagement for health policymaking in Madagascar, focusing on how policy makers can design interaction with communities in a way which decreases power imbalances within a participatory space, thereby enabling constructive dialogue to address health systems issues. We conducted 37 key informant interviews across all levels of the health system (community, district, regional, and national) in one urban and one rural district of Madagascar's Atsimo-Andrefana region. Purposive sampling techniques combined with emergent, opportunistic sampling, were used based on participants' experience with the country's national health planning processes. Multiple rapid literature reviews - before, during, and after the interview phase - helped to guide, steer, and underpin the main conclusions presented in this article. This paper points to three simple strategies which can contribute to providing counter-vailing power to those with less voice: using the same language as those whose views and input are solicited; creating smaller, homogenous dialogue groups with participants whose voices are less heard; and bringing consultations to people's own environment. While these strategies are neither novel nor complicated, they are rarely leveraged by those seeking people's views on health policies. It is hoped that by providing qualitative evidence suggesting the effectiveness of these strategies, when properly implemented, they will become more widely used to promote meaningful community participation for health policymaking. (Copyright © 2026 Petit, Rajan, Koch, Poulussen, Rakotomanga, Rajaonarison, Bajnóczki, Brousse, Kalambay, Rambinintsoanomenjanahary and Rohrer-Herold.) |
| Competing Interests: | The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Contributed Indexing: | Keywords: Africa; community engagement; health governance; policy making; social participation |
| Entry Date(s): | Date Created: 20260923 Date Completed: 20260923 Latest Revision: 20260924 |
| Update Code: | 20260924 |
| PubMed Central ID: | PMC13593836 |
| DOI: | 10.3389/fpubh.2026.1778275 |
| PMID: | 42774426 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2296-2565 |
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| DOI: | 10.3389/fpubh.2026.1778275 |