Challenging logics of complex intervention trials: community perspectives of a health care improvement intervention in rural Uganda

Social Science & Medicine
Ferdinand M OkwaroSarah G Staedke

Abstract

Health systems in many African countries are failing to provide populations with access to good quality health care. Morbidity and mortality from curable diseases such as malaria remain high. The PRIME trial in Tororo, rural Uganda, designed and tested an intervention to improve care at health centres, with the aim of reducing ill-health due to malaria in surrounding communities. This paper presents the impact and context of this trial from the perspective of community members in the study area. Fieldwork was carried out for a year from the start of the intervention in June 2011, and involved informal observation and discussions as well as 13 focus group discussions with community members, 10 in-depth interviews with local stakeholders, and 162 context descriptions recorded through quarterly interviews with community members, health workers and district officials. Community members observed a small improvement in quality of care at most, but not all, intervention health centres. However, this was diluted by other shortfalls in health services beyond the scope of the intervention. Patients continued to seek care at health centres they considered inadequate as well as positioning themselves and their children to access care throu...Continue Reading

References

Sep 15, 2000·BMJ : British Medical Journal·M CampbellP Tyrer
Jul 10, 2003·Health Policy·Jessica JittaNathan Nshakira
Jun 26, 2004·BMJ : British Medical Journal·Penelope HaweTherese Riley
Feb 18, 2006·BMJ : British Medical Journal·Ann OakleyUNKNOWN RIPPLE Study Team
Jun 7, 2008·BMJ : British Medical Journal·Alan ShiellLisa Gold
Jan 5, 2010·Malaria Journal·Rachel L PullanSimon Brooker
May 5, 2010·Lancet·Arthur Kleinman
Jul 21, 2010·Australian and New Zealand Journal of Public Health·Elizabeth CominoJenny Knight
Oct 26, 2010·Evaluation and Program Planning·Sanjeev Sridharan, April Nakaima
Jan 25, 2012·Bulletin of the World Health Organization·Mike EnglishJim Todd
Jan 22, 2013·Annual Review of Public Health·Sara J Singer, Timothy J Vogus
Feb 9, 2013·Journal of Health Services Research & Policy·Simon CohnPaul Stronge
Mar 26, 2013·Human Resources for Health·Clare I R ChandlerSarah G Staedke
Apr 26, 2014·Medical Anthropology·Ian Harper, Melissa Parker
Apr 1, 2004·Anthropology & Medicine·Helle Samuelsen

❮ Previous
Next ❯

Citations

Jun 3, 2015·Social Science & Medicine·Penelope Hawe
Jan 13, 2018·Annual Review of Public Health·Emily E Tanner-Smith, Sean Grant
Jun 8, 2017·BMJ Global Health·Eleanor HutchinsonClare I R Chandler
Oct 1, 2016·Health Systems and Reform·Clare I R ChandlerChristopher J M Whitty
Jun 23, 2020·Journal of Global Health·Hani SalimUNKNOWN NIHR Global Health Research Unit on Respiratory Health (RESPIRE) collaborations
Jun 10, 2021·Medical Anthropology·Isabelle L LangeLoveday Penn-Kekana

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antimalarial Agents (ASM)

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.

Antimalarial Agents

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.