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Editors Choice: Community accountability at peripheral health facilities: a review of the empirical literature and development of a conceptual framework

机译：编辑选择：外围医疗机构的社区责任制：对经验文献的回顾和概念框架的发展

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Public accountability has re-emerged as a top priority for health systems all over the world, and particularly in developing countries where governments have often failed to provide adequate public sector services for their citizens. One approach to strengthening public accountability is through direct involvement of clients, users or the general public in health delivery, here termed ‘community accountability’. The potential benefits of community accountability, both as an end in itself and as a means of improving health services, have led to significant resources being invested by governments and non-governmental organizations. Data are now needed on the implementation and impact of these initiatives on the ground. A search of PubMed using a systematic approach, supplemented by a hand search of key websites, identified 21 papers from low- or middle-income countries describing at least one measure to enhance community accountability that was linked with peripheral facilities. Mechanisms covered included committees and groups (n = 19), public report cards (n = 1) and patients’ rights charters (n = 1). In this paper we summarize the data presented in these papers, including impact, and factors influencing impact, and conclude by commenting on the methods used, and the issues they raise. We highlight that the international interest in community accountability mechanisms linked to peripheral facilities has not been matched by empirical data, and present a conceptual framework and a set of ideas that might contribute to future studies.
机译：公共问责制已重新成为全世界卫生系统的头等大事，尤其是在发展中国家，在这些国家，政府常常未能为其公民提供适当的公共部门服务。加强公共问责制的一种方法是通过让客户，用户或公众直接参与卫生保健，这里称为“社区问责制”。社区问责制本身的目的和改善卫生服务的潜在好处，已导致政府和非政府组织投入了大量资源。现在需要有关这些举措在实地的实施和影响的数据。使用系统的方法对PubMed进行搜索，并手动搜索关键网站，从低收入或中等收入国家中识别出21篇论文，其中描述了至少一项与周边设施相关的增强社区责任感的措施。涉及的机制包括委员会和小组（n = 19），公共报告卡（n = 1）和患者权利宪章（n = 1）。在本文中，我们总结了这些论文中提供的数据，包括影响和影响影响的因素，并通过对所使用的方法及其提出的问题进行评论来得出结论。我们强调指出，国际经验对与外围设施相关的社区问责机制的兴趣并未与经验数据相提并论，并提出了可能有助于未来研究的概念框架和一系列想法。

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