Background
Methods
Study search
Eligible criteria
Data collection
Data synthesis
Assessment of the methodological quality
Identification of barriers and facilitators to community engagement in HSR
Thematic analysis
Results
Search outcome
Characteristics of the included studies
No | Study author & year [ref no.] | Country | Study objective | Design | Approach | Types of community |
---|---|---|---|---|---|---|
1 | Abeyewickreme 2013 [20] | Sri Lanka | to assess the validity of assumption that waste management through community mobilization can reduce breeding places at HH level | prospective interventional study | FGD & IDI | community volunteers, community & project staff. All senior students (Grade ≥ 10), teachers & school principals |
2 | Asri 2017 [21] | Indonesia | to describe the existing social capital in a community & how it was used to fight DHF. | qualitative descriptive | IDI | social groups, strong leaders, community volunteers |
3 | Echaubard, 2020 [22] | Cambodia | To describe the processes of community engagement & transdisciplinary collaboration underpinning community-based dengue management in rural primary schools & HHs. | case study based on a qualitative data collection. | community dialogues, participant observations, FGD, IDI | CHW, health centre chiefs, school directors, monks, priests, teachers, farmers & members of the local education office, school children & their parents |
4 | Espino 2012 [23] | Philippines | to examine responses to introducing water container management to control dengue vectors in two diverse communities in Masagana City. | community-based intervention study | FGD & IDI | HH members, local government & health officials, barangay captains & homeowners’ association presidents; city sanitation inspectors, CHWs or BHWs |
5 | Kay 2002 [24] | Vietnam | to determine whether the communities viewed dengue and DHF as a serious health threat; to determine their knowledge of the etiology, attitudes, and practices regarding control methods including mesocyclops; and to determine their receptivity to various information methods. | Community-based research | community-based methods on surveillance | CHV, trained health workers, residents, schoolchildren. teachers, of schoolchildren. |
6 | Kay 2010 [25] | Vietnam | to evaluate whether or not the programs were still being maintained 7 years and 4.5 years after formal project activities had ceased, respectively. | CS descriptive study | FGD & IDI | health collaborators, SC,& community members in the study communes. 26 key informants, project managers at the national level, community POs, POS from the provincial centers of preventive medicine, POs from DHC district health centers, representatives from two different communal people’s committees, health staff from different communal health centers, & heads of different primary/secondary schools. |
7 | Kittayapong 2012 [26] | Thailand | To report the successful application of an eco-bio-social or ecohealth approach to dengue prevention and control in urban and peri-urban settings in eastern Thailand. | CPAR | cluster RCT approach | community leaders, local administrative authorities, municipal mayors, local public health officers, & communities. |
8 | Lwin 2017 [27] | Sri Lanka | To combat the issues of an exhausted dengue management system and to make use of new technology, in 2015, a mobile participatory system for dengue surveillance called Mo-Buzz was developed and launched in Colombo, Sri Lanka. | CPAR | digitalized surveillance | PHIs, general public |
9 | Mathur 2020 [28] | India | to ascertain the existing KAP n dengue hotspot areas and empower them for vector borne disease control using a HE models and also to find different challenges and barriers faced by frontline health workers during vector borne disease surveillance. | CS followed by intervention | IDI | ASHAs, 4 ANMs, 1 LHV, 2 MOs in Pratapnagar, HH members |
10 | Murray 2014 [29] | Thailand | to test the effectiveness of permethrin-impregnated school uniforms for dengue prevention in Chachoengsao Province | community acceptability survey mixed-method approach including double-blind, cross-over RCT | FGD & IDI | investigators (health staff), teachers, parents, students |
11 | Nguyen-Tien 2019 [30] | Vietnam | to explore the barriers to the implementation of CE in a dengue VC program in an urban district of the Hanoi city. | qualitative study | FGD & IDI | community members, stakeholders, |
12 | Suwanbamrung 2021 [31] | Thailand | to develop risk dengue village prediction criteria, predict village dengue risk, and strengthen dengue prevention based on community participation | CPAR | 5 phases approach: (i) preparing the community, (ii) developing assessment criteria for assessing dengue risk village, (iii) application of a computer program (http://surat.denguelim.com), (iv) predicting dengue risk villages, (v) utilising the findings for village dengue prevention | stakeholders, who involved dengue prevention of village, LAO, PHP, community leaders in villages, VHV, heads of hospital, HHs & community |
13 | Wai 2012 [32] | Myanmar | To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders | community-based intervention study | FGD & IDI | Multi-stakeholder partner groups (Thingaha) & ward-based volunteers |
Types of participating communities
Methodological quality
Barriers and facilitators
Domains | Barriers | Facilitators |
---|---|---|
Intervention characteristics | ||
■ Evidence strength and quality | ||
■ Relative advantage | N/A | ■ Local manufacturers were explained to produce tightly fitted lid covers at low cost (p 463) [32]. |
■ Adaptability | ■ Vertical interventions in dengue vector control are not sustainable particularly if they are built upon ‘crisis management’ as in our case the response to the dengue threat after cyclone Nargis (p 467) [32]. ■ Most of the general public was unwilling to participate in the survey [27]. ■ The participants felt that it would be the government’s responsibility to ensure good dengue control [29]. | ■ The extent of interest of the community, acceptance, and their active participation including the development of a sense of the responsibility (p 467) [32]. ■ Factory-impregnation of the school uniforms could not be detected via smell or other changes in the textiles [29]. |
■ Complexity | ■ “This work belongs to health station. So, it’s very hard for us” (p 967) [30]. | |
■ Design quality and packaging | ■ Most were not mobile technology literate [27]. | “Co-design of dengue prevention communication material by students and community members” (p.8) [22] Specific groups of “ecohealth volunteers” were established in each community, who were then engaged in regular dialogue with local community leaders and coordinators [32]. |
■ Cost | ■ Budget is usually low and perceived as inadequate to undertake the duties required (p 969) [30]. ■ “The participants work hard but the allowance is too little, therefore, nobody certainly feels happy” (p 969) [30]. | ■ “If the budget increases, the interaction between WPC and the stakeholders will be better” (p 969) [30]. ■ Sustainability of the current intervention package depends upon………. additional programme costs (p 467) [32]. |
Inner setting | ||
■ Structural characteristics | ■ Dynamic disease mapping component (i.e., hotspot mapping), although useful for them, was not deemed necessary for the public. They were worried that it might trigger outbreaks of panic [27]. ■ Distribution of responsibility on disease control between two important sides of WPC and WHS was not balanced (p 966) [30]. | N/A |
■ Networks and communications | ■ Limited stakeholder participation [31]. ■ Poor attendance at the project inception negatively affected engagement in the project [23]. ■ Communication with stakeholders was problematic, as the Mo-Buzz research team was based in Singapore (i.e., language problem) [27]. ■ Knowledge gaps between the provider and communities: “Even there are many participants in PEM but only a few people expressed their idea in the meeting” (p.9) [22] ■ “….because some children can learn but they cannot explain to their parents….” (p.8) [22]. | ■ Multi-partnership approach: the EFG acted as the liaison between the community and the THD. They established close relationships among different partners and helped to build and maintain the sense of ownership [27]. ■ Careful choice of local coordinating committee members and of the health volunteers [24]. ■ trained ecohealth volunteers informed householders of general knowledge regarding dengue prevention measures, the public health services and local administration in collaboration with the university research teams provided materials and resources [26]. ■ Bench conferences in village setting [23]. ■ High level stakeholder meetings with official representatives of government bodies & community leaders to prepare the planning/ monitoring/evaluation of intervention activities, & to help to mobilize local resources and give logistical support (p.9) [22]. ■ The students communicated their material to an audience of 20–45 villagers in each session with the support of CHW for the design of specific messages (p.9) [22]. |
■ Culture | ■ Cultural barriers persisted in the management of spiritual bowls; the use of dragon fly nymphs for cement tanks still needs promotion (p 466) [32]. ■ Using serial blood samples from an apparently healthy population was the culturally based resistance to the collection of blood (p 47) [24]. | N/A |
■ Learning climate | N/A | ■ Each group comprised one leader and four core members. They were trained for information dissemination and how to manage vector control tools (p 463) [32]. ■ Communication problem was overcome by learning about Sri Lankan customs and culture from Sri Lankans living in Singapore and by undertaking field trips and interviews [27]. |
■ Leadership engagement | ■ “Mass organizations and community leaders are lacking in enthusiasm”, “Frankly speaking, the role of mass organizations, for example women’s union, youth union in some wards is still only doing for show as a movement” (p 967) [30]. | ■ Distributing pamphlets and booklets and assisting people in the application of targeted container interventions strengthened the leadership of EFG and the development of sense of ownership by community members (p 464) [32]. ■ Head of CHC, vice head of central project commune, and head of school provided leadership for dengue control [25]. ■. Since Risma became mayor, village leaders were asked to focus on dengue fever, because it was a health concern not only for the Department of Health. Risma said this was your region; if people are sick, you have to help mobilize society (p 376) [21]. ■ Monks, who received HE on dengue control, have proposed ceremonial occasions at the pagoda as acceptable moments to communicate dengue related control knowledge or procedure [22]. |
■ Available resources/Staff/ | ■ There was fewer staff to service large catchment areas [28]: “We need more staff for surveillance as area is big and we have 10 ANM’s. We have been allotted 5 wards and population is 1 lakh. To cater such a big population, ANM’s should be double in number” (p 1759). ■ Inadequate manpower and vehicles for ward-based waste collections [32]. ■ Overburdened workloads [30]. | A BHW said that household member in a village in Philippine told her, ‘It is good that we are being visited by you and that there is a project like this’ [23]. |
■ Readiness | ■ Lack of readiness and activeness (p 968) [32]. | N/A |
■ Access to knowledge and information | ■ Lack of knowledge and preparedness also has been the result of ineffective community engagement (p 967) [30]. ■ Communities (Haiphong residents) treated information from local officers with greater skepticism [24]. | ■ information from the trained health workers in the team was respected because rural commune residents develop a closer relationship with their elected representatives than with city dwellers [24]. |
■ Organizational incentives and rewards | ■ “I think the caring with community leaders on allowance and spiritual issues is lacking, so they were unenthusiastic” (p 967) [30]. | ■ A compactor was financed through a small grant scheme to improve efficiency, and a percentage of the profits was returned to the commune to facilitate the payment of health volunteers after the project ceased [24]. ■ incentives as a facilitating factor for success in reducing of dengue incidence. “Because they received it (pocket money), changes occurred. …. ” [21]. ■ “This monthly allowance was sufficient to encourage collaborators to continue implementing their tasks” (p 829) [25]. |
Outer setting | ||
■ Cosmopolitanisms | ■ WPC should take the lead and organize the dengue vector control activities under the consultation of WHS. However, the WPC handed over almost all work related to health protection to the WHS (p 966) [30]. | N/A |
■ External policy and incentives | ■ Launching of the system was delayed as a political election was underway and had implications for government approvals [27]. ■ Lacking local government leadership (p 459) [23]. ■ Attrition of EFG members and volunteers required the need of the development of a system for volunteer replacement [32]. ■ When a new chairman of WPC takes up the duty, everything has changed. He said that there is no need to do this work (p 967) [30]. | ■ Sustainability of the current intervention package depends upon political commitment and continuing support by the local governance [32]. ■ Leadership of EFGs was successful as the ward authorities developed a strong commitment in problem identification (p 467) [32]. ■ Incentivize reports submitted by the PHIs [27]. |
Individual characteristics | ||
■ Knowledge and beliefs about the intervention | ■ Because dengue control was their (city health officers) responsibility, the honorarium task force members had stopped (p 459) [23]. | N/A |
■ Self-efficacy | ■ Language posed a barrier. The main mode of communication in Sri Lanka is Sinhalese or Tamil, but none of the researchers were proficient in either language [27]. ■ All physicians in the district hospital should be trained (for using the DPCG) (p 100,168) [31]. ■ Health workers need to have qualification and being trained to improve the persuading skills while working with community (p 967) [30]. | ■ An external translator who was fluent in Sinhalese, Tamil, and English was employed to overcome the language barrier [27]. |
■ Individual identification with organization | ■ Stakeholder communication was made more difficult by differences in opinions borne of views that were influenced by different specialties [27]. | ■ The leadership of EFGs was successful as they achieved that ward authorities developed a strong commitment in problem identification at baseline and in scheduling, motivating people, and distributing intervention materials and later on in monitoring the implementation and results (p 467) [32]. |
Individual stage of change | ■ They (communities) also have not cooperated and followed the health staff’s instructions for dengue vector control (p. 968) [30]. ■ A sense of fear of the ANWS and ASHAs in engaging communities [28]; “One incident occurred with me when I was alone during the survey and I visited one house. That man ran after me to hit me with his stick. So, there is always a sense of fear in mind” (p. 1757). | N/A |
Process Implementation | ||
■ Planning | ■ Implementing rules and/or regulations were absent (p 459) [23]. | ■ Six multi-stakeholder groups involved, and in the first phase, each stakeholder group were thoroughly discussed about power, legitimacy, interests, and interactions towards controlling dengue vectors [32]. |
■ Key stakeholders | ■ The DPCG needs all stakeholders to participate, integrate, and coordinate for continued monitoring and use (the guideline) (p 13) [31]. ■ Involving multiple stakeholders was a challenge to ensure the sustainability of the intervention [20]. | The cross-sectorial collaboration & transdisciplinary action that took place during the school-based sessions together with the strong engagement of students in activities of knowledge sharing in communities, led the department of school health of the MoE to incorporate the co-designed dengue curriculum into the national school program [22]. |
■ Reflecting and evaluating | ■ Lack of interest and an attitude of dependency on action from the health sector of local people’s committee [30]. ■ “The common problems that people complained were less loudspeakers and unclear sound… The communication by loudspeakers is bad” (p 969) [32]. ■ The participants felt that it would be the government’s responsibility to ensure good dengue control [23]. ■ “Encouraging the community itself to change is rather difficult.” (p 375) [21]. | ■ Favourable and unfavourable conditions related to the six strategic options to reduce dengue vector breeding was discussed (p 465) [32]. ■ Reflection of meeting discussion [31]. ■ community members indicated that guppies (i.e. vector control tools) were informally distributed outside interventions areas, suggesting knowledge transfer, cultural acceptability, strong feasibility of scaling up & project outcome sustainability [22]. |
■ Champions | ■ Because low attendance to the training session. The issue is who is a suitable champion for strategies in dengue control (p 459) [23]. ■ A form of social capital, which plays an important role in the efforts to eradicate dengue fever is Sanitarian. They were responsible for the entire DHF prevention and control program in the region and implemented it in their own PHCs. They have to cooperate with the village offices, the sub-district office, the regional DOH, volunteer larvae observers (Bumantik, Jumantik, Rumantik, and Wamantik) in each region [21]. | ■ Sending one of the more technically proficient PHIs to Singapore to learn the system well. The PHI then tasked with troubleshooting issues faced by other PHIs. The PHI returned to Colombo as an ambassador to train his fellow PHIs and help promote the usage and troubleshoot. Following this training, uptake of the app increased [27]. |