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Biomedical subjects

S B Rifkin

Publications and source records attributed to S B Rifkin.

At least 19 recordsLinked to original sources
PubMed2001

Learning by doing: teaching qualitative methods to health care personnel.

PURPOSE: We describe and assess the teaching of qualitative methods to postgraduate students using a case study from the Centre of International Child Health, Institute of Child Health, London, which trains mainly health personnel with developing country experience. As the majority of these students are practitioners rather than academics, the teaching focuses on combining theory with practice. We then analyse the results of the assessment of students about this approach and examine lessons learned from this experience. APPROACH: We present the format of a two-week course and the evaluation of this course by the students of the past four years. We describe the process of conducting a learning-by-doing course, giving the day-to-day details of how the course is conducted. We also give examples of how this teaching is done. RESULTS: One indicator of the value of this course is its increasing popularity over the past three years. In 1997-1998, 11 students out of 20 took the course. In 1998-1999, 16 students out of 21 opted for this qualitative module. In 1999-2000, 12 students out of 17 chose this module. DISCUSSION: The lessons learned from this experience include challenges in how to present the teaching within the available time and having realistic expectations concerning course outcomes. We argue that a learning-by-doing approach accomplishes the objectives of having students recognize the value of these methods for health systems research and giving them skills needed to use these methods.

Journal Article↗
PubMed2001

Ten best readings on community participation and health.

This article reviews, in the opinion of the author, the 10 most influential reading on community participation and health development. The introduction notes that some of the articles do not address health directly but still do bring crucial interpretations to the topic. All articles view community participation as an intervention by which the lives of people, particularly the poor and marginalised can be improved. In addition, they all address the issue of the value of participation to equity and sustainability. The article considers the readings under four heading: concepts and theory; advocacy; critiques and case studies. It highlights the important contributions each reading makes to the understanding of participation in the wider context of health and health development. In conclusion, the article argues that participation has not met the objectives of planners and professionals, in good part, because it is questionable as to whether viewing participation as an intervention enables them to make correct assessments of its contribution to development. The bottom line is that participation is always about power and control, an issue planners and professionals do not want explicitly to address.

Community Health Planning↗
PubMed1996

Paradigms lost: toward a new understanding of community participation in health programmes.

Community participation has been a critical part of health programmes, particularly since the acceptance of primary health care as the health policy of the member states of the World Health Organisation. However, it has rarely met the expectations of health planners/professionals. This paper argues that the reason for this failure is that community participation has been conceived in a paradigm which views community participation as a magic bullet to solve problems rooted both in health and political power. For this reason, it is necessary to use a different paradigm which views community participation as an iterative learning process allowing for a more eclectic approach to be taken. Viewing community participation in this way will enable more realistic expectations to be made. Community participation in disease control programmes focusing on community health workers is used as an example to show the limitations of the old paradigm. Participatory rapid appraisal is used to illustrate the new.

Community Health Planning↗
PubMed1995

The pursuit of equity: a health sector case study from Vietnam.

The health care system in Vietnam has long been cited as an example of primary health care that has worked well. The achievements of the system during the past decades have indeed been impressive, but the changing economic situation in Vietnam has consequences for all public sector activities, including health care. Liberalization of economic policies has encouraged private medical practice and free trade in medicines and drugs, while financial support for the state health system is decreasing. Equity has always been an important goal for the vietnamese health system, but it becomes harder and harder to realize under the new conditions of financing. The restrictions in centralized planning and funding brought about by recent changes also reveal weak points in the system, from planning to training to management at the different levels. This situation is discussed and issues concerning policy, legislation and human resources are highlighted in terms of their effect on equity.

Financing, Government↗
PubMed1989

Towards the measurement of community participation.

A description is given of the initial stages in the development of a methodology for assessing community participation in health schemes. A study in Nepal indicates that the approach adopted will be useful to planners who wish to evaluate involvement in primary care programmes.

Community Health Services↗
PubMed1988

Primary health care: on measuring participation.

This paper considers the problems of finding measurements for the two major principles of primary health care (PHC), equity and participation. Although both are of equal importance, the authors concentrate on the assessment of participation. A methodology is put forward to define indicators for participation in health care programmes as how wide participation is on a continuum developed for each of the five factors which influence community participation. These factors are: needs assessment leadership, organisation, resource mobilisation and management. By plotting a mark on a continuum which is defined as wide and narrow at the extremes and is connected with all other marks in a spoke arrangement, it is possible to describe a baseline for participation in any specific health programme. This baseline can be used to compare the same programme at a different point in time, to compare observations by different evaluators, and/or to compare perceptions of different participants in the same programmes. A case study provides an example of how the indicators might be used. These indicators focus on the breadth of participation and not its potential social impact, an area which is recognised to be critical for future research.

Community Participation↗
PubMed1986

Why health improves: defining the issues concerning 'comprehensive primary health care' and 'selective primary health care'.

What is the impact of technology on improving the life situations of people, especially the poor? How is this impact analyzed in terms of health improvements? These questions are paramount in the minds of health planners as they pursue national policies of primary health care, a policy popularized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and accepted by over 150 governments at Alma Ata in 1978. The purpose of this paper is to explore these questions in depth. It begins by giving the background to the debate, then examines the origins of two concepts which have dominated the field, those of 'primary health care' and 'selective primary health care.' On this basis it suggests areas of differences in the two concepts and discusses the policy and practical implications of confusing the two approaches. The paper suggests that the differences are firstly who controls the outcome of technological interventions and the perceived time frame in which plans can be carried out.

Health Policy↗
PubMed1983

Primary health care in Southeast Asia: attitudes about community participation in community health programmes.

Although community participation in health has become a major plank in WHO's Primary Health Care platform, comparatively little concrete programme data has been collected which helps to define its potentials and problems. In an effort to expand knowledge in this area, a study of three Church-related community health programmes in Southeast Asia was undertaken. All three programmes have the stated goal of 'having the community take responsibility for its own health care' and as a concrete step in this direction, have developed training programmes for community health workers (CHWs). Starting about the same time, 1973-1975, they provide data for comparative examination of the development of community participation. As part of the study, a questionnaire was designed to elicit information from three categories of programme participants (the medical professionals, the community development workers and the CHWs) in community health programmes. It sought to discover their attitudes about the objectives of community health programmes; impact and measurements of success of these programmes; the role of health services; the role of medical professionals and community development workers in community health programmes; the role and training of community health workers; and financing community health programmes. The hypothesis of the investigation was that all three categories of programme participants in one programme share attitudes distinct from participants in the other two programmes. Although, due to technical reasons, it was not possible to test this hypothesis, the survey produced other conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Asia, Southeastern↗