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Improving access and quality of primary healthcare through women and adolescents’ user committees: a mixed-methods case study in Kinshasa, DRC
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  • Marie-Douce Primeau,
  • Marie Jobin-Gelinas,
  • Cécile Maleko Mayabanza,
  • Maguy Mayaza,
  • Geneviève Blouin
Marie-Douce Primeau
Universite de Montreal Unite de Sante Internationale

Corresponding Author:marie-douce.primeau@umontreal.ca

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Marie Jobin-Gelinas
Universite de Montreal Unite de Sante Internationale
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Cécile Maleko Mayabanza
no affiliation
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Maguy Mayaza
no affiliation
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Geneviève Blouin
no affiliation
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Abstract

Background. Patient engagement is seen as a fundamental strategy for achieving quality patient-centred care, especially in community-based primary healthcare (OMS2023, Haesebaert et al. 2018). Despite growing interest in patient engagement in Sub-Saharan Africa, few patient engagement initiatives have been identified, and those often are limited to lower-levels of engagement, in participation in health research or in health system improvement (Gogovor et al. 2023). With the aim of giving a voice to under-represented community groups in healthcare governance, the ASSK project supported the implementation of primary health services user committees in the Democratic Republic of the Congo (DRC), designed to enable the representation of two user groups with specific unmet sexual and reproductive health (SRH) needs: women and adolescents. Aims and Methods. Using a mixed-method case study design combining quantitative secondary data (DHIS2) and qualitative data from two research World Cafés (WC1:Women user committees (WUC) n=55; WC2: Adolescents user committee (AUC) n=63)(Schield et al. 2022), this paper looks at the implementation facilitators and barriers, and at the results of this initiative. Results. Women and adolescent members of the user committees highlighted that their participation resulted in increased knowledge of SRH and their related rights, as well as in their “soft skills” such as communication and leadership. In addition, participants reported greater transparency and accountability on the part of the community primary health centers (e.g. by displaying fees for procedures to counter over-billing). Ultimately, WUC and AUC were associated with improved health practices in the community such as increased use of sexual and reproductive health services, including adolescent family planning and assisted childbirth (15-49 years old). Conclusions. Patient user committees for specific marginalized or under-represented groups appear to be an effective way of improving the quality of primary health care services. Further research is needed to better understand how to maximize its potential.
09 May 2024Submitted to International Journal of Health Planning and Management
11 May 2024Submission Checks Completed
11 May 2024Assigned to Editor
11 May 2024Review(s) Completed, Editorial Evaluation Pending
04 Aug 20241st Revision Received
24 Aug 2024Review(s) Completed, Editorial Evaluation Pending
24 Aug 2024Submission Checks Completed
24 Aug 2024Assigned to Editor
26 Aug 2024Reviewer(s) Assigned
13 Sep 2024Editorial Decision: Accept