Journal of community systems for health最新文献

{"title":"Forest neighbourhoods and healthcare access for Adivasi communities in India: A critical interpretive synthesis.","authors":"Anika Juneja, N S Prashanth, Surekha Garimella, Anna-Karin Hurtig","doi":"10.36368/jcsh.v2i2.1187","DOIUrl":"10.36368/jcsh.v2i2.1187","url":null,"abstract":"<p><strong>Introduction: </strong>Environments where people live and work shape resources and opportunities available to them and studying healthcare access in relation to people's living environments helps in understanding structural factors beyond individual factors. This is especially relevant for many Adivasi communities whose lives are closely connected with forests.</p><p><strong>Methods: </strong>We used the critical interpretive synthesis method, a flexible, critical and iterative approach to literature synthesis. We conceptualised health and healthcare access in relation to neighbourhood environment and used this lens to examine healthcare access in Adivasi communities living in forest neighbourhoods in India.</p><p><strong>Results: </strong>We developed a lens of neighbourhood as a physical and social environment and used it to build a conceptual framework describing forest neighbourhoods in India. We describe forest neighbourhoods in terms of their built and social environment. The availability of mobile networks, condition of roads, flooding of streams during rains and the forms of transport available constitute the built environment. There are two important components of the social environment, first is the connection of the Adivasi people with the forest and second is the institutional environment comprising of different actors working in the forest neighbourhood. The life of Adivasi people is connected with the forest through their livelihood, nutrition, physical and mental well-being and their ecological knowledge about the forest from their lived experience. The institutional environment consists of different actors that shape the built and social environment that comprise the government institutions, private for-profit providers, civil society organisations, traditional healers and the forest department.</p><p><strong>Conclusion: </strong>While working on Adivasi health, it is critical to consider their connection with the forest. Exploring forest neighbourhoods as physical and social environments can help examine distribution of public services and how they are shaped by external policies and actors working in the neighbourhood. This could shift the focus of Adivasi health and healthcare interventions away from the current emphasis on individual-level health interventions.</p>","PeriodicalId":523897,"journal":{"name":"Journal of community systems for health","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring self-reliance in primary healthcare from peoples' perspectives among families using traditional medicine: A case study from southern India.","authors":"Shivanand Savatagi, N S Prashanth, Unnikrishnan Payyappallimana, John Dh Porter, Upendra Bhojani, Harini Nagendra","doi":"10.36368/jcsh.v2i1.1207","DOIUrl":"10.36368/jcsh.v2i1.1207","url":null,"abstract":"<p><strong>Introduction: </strong>Self-reliance consists of using available resources, making informed decisions, and responsible health and lifestyle practices. The complex nature of healthcare practices by the people necessitates the quest for understanding self-reliance in primary healthcare. In LMICs, around 70% in India and approximately 80% in sub-Saharan African countries use traditional medicine for primary healthcare. Because of its emphasis on local resources, context, culture, and other determinants, traditional medicine potentially enables self-reliance in primary healthcare. The study explored the meaning of self-reliance in primary healthcare from peoples' perspective among families using traditional medicine in a Southern Indian site.</p><p><strong>Methodology: </strong>We conducted case study research in HD Kote, a taluka in Mysore district of Karnataka in Southern India, from September 2021 to April 2022. We selected 30 study participants using purposive sampling and the data was collected through in-depth interviews. Data was subjected to thematic analysis using QDA Miner lite 2.01 version software.</p><p><strong>Results: </strong>The study identified following themes: 1) perception of health and illness, 2) healthcare pathways, 3) negotiation between the environment and self in the emergence of self-reliance, and 4) efficiency and authenticity as a means to choose healthcare approach. Pathways to healthcare decisions were influenced by various cultural, social, religious, health system, and individual level factors. Self-reliance emerges from an individual through negotiation between the self, the environment, and the social context in which they live.</p><p><strong>Conclusion: </strong>The meaning of self-reliance was navigated within healthcare practices, choices, and the context in which an individual lived. Capturing people's perspectives and local views addresses the gap in scientific understanding by situating these perspectives within the broader context of the health system, particularly in relation to self-reliance and the role of individuals. Understanding self-reliance through studies of this kind is critical to contributing to a people-centered health system for India to achieve the goal of universal health coverage.</p>","PeriodicalId":523897,"journal":{"name":"Journal of community systems for health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining Innovation in Health Equity: Making a Case for a Community embedded Participatory Learning Site for Adivasi Health Research.","authors":"N S Prashanth, Sabu Kochupurackal Ulahannan, Anika Juneja, Tanya Seshadri, C Mahadeva, Muthaiah Venkategowda, C Made Gowda, Mathew Sunil George, Sumit Kane, Joris Michielsen, Sara Van Belle","doi":"10.36368/jcsh.v2i1.1102","DOIUrl":"10.36368/jcsh.v2i1.1102","url":null,"abstract":"<p><strong>Introduction: </strong>This paper explores the development of the Realist Implementation Action Research Lab (RIAL), a participatory learning site aimed at addressing health disparities among Adivasi communities in India. Despite national health improvements, Adivasis face significant health inequities. RIAL employs a realist-inspired, theory-driven design to co-create solutions with communities, fostering collaboration among diverse stakeholders. The paper discusses insights from the establishment of RIAL, focusing on strategies implemented, opportunities identified, challenges encountered, and lessons learned to inform public health research and practice for Adivasi populations.</p><p><strong>Methods: </strong>We utilized processual analysis to examine the evolving dynamics of RIAL, combining historical and current documentation with collaborative team reflections. Context-Mechanism-Outcome (CMO) configurations were developed to tailor interventions to community needs and foster stakeholder engagement. These methods emphasized the contextual nature of health interventions, aligning with a systems-oriented, participatory approach. The establishment of RIAL involved consultations with community-based organizations, capacity-building workshops, and collaborative platforms to engage community leaders, healthcare providers, and policymakers, ensuring a participatory and contextually relevant foundation.</p><p><strong>Results: </strong>RIAL's implementation highlighted the importance of reconfiguring power dynamics and fostering participatory processes. Strategies included co-design workshops, town hall assemblies, and capacity-building sessions, which enhanced community ownership and engagement. Challenges such as gender norms, logistical barriers, and resistance from non-Adivasi stakeholders were encountered, but iterative adaptation allowed for overcoming these barriers. Key findings included improved intervention receptivity, such as the successful relocation of a deaddiction clinic to a community-trusted NGO hospital and the implementation of sports-based psychosocial interventions for Adivasi youth, which demonstrated increased mental health awareness and reduced stigma.</p><p><strong>Conclusion: </strong>RIAL exemplifies the potential of participatory and context-aware methodologies in addressing health inequities among marginalized populations. Although scalability and resource availability pose limitations, this paper advocates for a shift from techno-centric solutions to those that are participatory, emphasizing sustained community engagement and co-creation of health interventions. The insights from RIAL's implementation offer potential implications for adapting similar models in other contexts, aiming to reduce health disparities through inclusive research practices.</p>","PeriodicalId":523897,"journal":{"name":"Journal of community systems for health","volume":"2 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148869723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}