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首页> 外文期刊>International Journal of Environmental Research and Public Health >Framework for Participatory Quantitative Health Impact Assessment in Low- and Middle-Income Countries
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Framework for Participatory Quantitative Health Impact Assessment in Low- and Middle-Income Countries

机译：低收入和中等收入国家的参与式定量健康影响评估框架

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Background: Conducting health impact assessments (HIAs) is a growing practice in various organizations and countries, yet scholarly interest in HIAs has primarily focused on the synergies between exposure and health outcomes. This limits our understanding of what factors influence HIAs and the uptake of their outcomes. This paper presents a framework for conducting participatory quantitative HIA (PQHIA) in low- and middle-income countries (LMICs), including integrating the outcomes back into society after an HIA is conducted. The study responds to the question: what are the different components of a participatory quantitative model that can influence HIA implementation in LMICs? Methods: To build the framework, we used a case study from a PQHIA fieldwork model developed in Port Louis (Mauritius). To explore thinking on the participatory components of the framework, we extract and analyze data from ethnographic material including fieldnotes, interviews, focus group discussions and feedback exercises with 14 stakeholders from the same case study. We confirm the validity of the ethnographic data using five quality criteria: credibility, transferability, dependability, confirmability, and authenticity. We build the PQHIA framework connecting the main HIA steps with factors influencing HIAs. Results: The final framework depicts the five standard HIA stages and summarizes participatory activities and outcomes. It also reflects key factors influencing PQHIA practice and uptake of HIA outcomes: costs for participation, HIA knowledge and interest of stakeholders, social responsibility of policymakers, existing policies, data availability, citizen participation, multi-level stakeholder engagement and multisectoral coordination. The framework suggests that factors necessary to complete a participatory HIA are the same needed to re-integrate HIA results back into the society. There are three different areas that can act as facilitators to PQHIAs: good governance, evidence-based policy making, and access to resources. Conclusions: The framework has several implications for research and practice. It underlines the importance of applying participatory approaches critically while providing a blueprint for methods to engage local stakeholders. Participatory approaches in quantitative HIAs are complex and demand a nuanced understanding of the context. Therefore, the political and cultural contexts in which HIA is conducted will define how the framework is applied. Finally, the framework underlines that participation in HIA does not need to be expensive or time consuming for the assessor or the participant. Yet, participatory quantitative models need to be contextually developed and integrated if they are to provide health benefits and be beneficial for the participants. This integration can be facilitated by investing in opportunities that fuel good governance and evidence-based policy making.
机译：背景：进行健康影响评估（HIAS）是各种组织和国家的日益增长的做法，但HIA的学术兴趣主要集中在暴露和卫生成果之间的协同作用。这限制了我们对影响HIAS的因素和对其结果的吸收的理解。本文介绍了在低收入和中等收入国家（LMIC）中进行参与式定量HIA（PQIIA）的框架，包括在进行HIA后将结果整合回社会。该研究响应了这个问题：可以影响LMIC中的HIA实施的参与式定量模型的不同组成部分是什么？方法：建立框架，我们使用了在口岸（毛里求斯）开发的PQHIA实地工作模型的案例研究。为了探索框架的参与性组成部分的思考，我们从相同案例研究中提取和分析包括野外发票，访谈，焦点小组讨论和反馈练习的民族造影材料的数据。我们使用五个质量标准确认民族志中的有效性：可信度，可转移性，可靠性，确认性和真实性。我们构建连接主HIA的PQIA框架与影响HIAS的因素。结果：最终框架描绘了五个标准的HIA阶段，总结了参与性活动和结果。它还反映了影响PQHIA实践和HIA结果的关键因素：参与的成本，利益攸关方的知识和利益，政策制定者的社会责任，现有政策，数据可用性，公民参与，多层利益相关者参与和多部门协调。该框架表明，完成参与式HIA所需的因素是重新将HIA结果重新整合回社会所需的同意。有三个不同的领域可以作为PQHIAS的促进者：良好的治理，基于证据的政策制定，以及获得资源。结论：该框架对研究和实践有几种影响。它强调了批判性地应用参与式方法的重要性，同时为参与当地利益相关者的方法提供蓝图。定量HIA的参与性方法是复杂的，并要求对环境的详细了解。因此，对HIA进行的政治和文化背景将定义框架的应用方式。最后，该框架强调，参与HIA不需要对评估员或参与者昂贵或耗时。然而，如果要为参与者提供健康福利，则需要进行广泛的定量模型，并集成，并为参与者有益。通过投资促进良好治理和基于证据的政策制定的机会，可以促进这种融合。

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