Evidence map›Paper›PMID 31297243›Full record

ReviewBMJ global health2018

Beyond the building blocks: integrating community roles into health systems frameworks to achieve health for all.

Emma Sacks, Melanie Morrow, William T Story, Katharine D Shelley, D Shanklin, Minal Rahimtoola, Alfonso Rosales, Ochiawunma Ibe, Eric Sarriot

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Emma SacksDepartment of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0003-0743-7208
Melanie MorrowCommunity Health Team, USAID Maternal and Child Survival Program/ICF, Washington, District of Columbia, USA.
William T StoryDepartment of Community and Behavioral Health, University of Iowa, Iowa City, Iowa, USA.
Katharine D ShelleyHealth Systems Innovation and Delivery, PATH, Seattle, Washington, USA.
D ShanklinCORE Inc, Washington, District of Columbia, USA.
Minal RahimtoolaIndependent Health Systems Consultant, Boston, Massachusetts, USA.
Alfonso RosalesHealth Unit, World Vision, Federal Way, Washington, USA.
Ochiawunma IbeCommunity Health Team, USAID Maternal and Child Survival Program/ICF, Washington, District of Columbia, USA.
Eric SarriotGlobal Health, Save the Children Federation Inc, Washington, District of Columbia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Achieving ambitious health goals-from the Every Woman Every Child strategy to the health targets of the sustainable development goals to the renewed promise of Alma-Ata of 'health for all'-necessitates strong, functional and inclusive health systems. Improving and sustaining community health is integral to overall health systems strengthening efforts. However, while health systems and community health are conceptually and operationally related, the guidance informing health systems policymakers and financiers-particularly the well-known WHO 'building blocks' framework-only indirectly addresses the foundational elements necessary for effective community health. Although community-inclusive and community-led strategies may be more difficult, complex, and require more widespread resources than facility-based strategies, their exclusion from health systems frameworks leads to insufficient attention to elements that need ex-ante efforts and investments to set community health effectively within systems. This paper suggests an expansion of the WHO building blocks, starting with the recognition of the essential determinants of the production of health. It presents an expanded framework that articulates the need for dedicated human resources and quality services at the community level; it places strategies for organising and mobilising social resources in communities in the context of systems for health; it situates health information as one ingredient of a larger block dedicated to information, learning and accountability; and it recognises societal partnerships as critical links to the public health sector. This framework makes explicit the oft-neglected investment needs for community health and aims to inform efforts to situate community health within national health systems and global guidance to achieve health for all.

Indexed as

community healthframeworkshealth for all, Alma-Atahealth systemshealth system strengtheningmaternal, newborn and child healthprimary careSDGs

Identifiers

PMID31297243
PMCPMC6591791

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.