ArticlePloS one2019
"It's like these CHCs don't exist, are they featured anywhere?": Social network analysis of community health committees in a rural and urban setting in Kenya.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Effects of decentralization on the functionality of health facility governing committees in lower and middle-income countries: a systematic literature review.Global health action · 2022Pooled it
- Health system responsiveness: a systematic evidence mapping review of the global literature.International journal for equity in health · 2021Pooled it
- Multi-actor collaborations in primary health care implementation: a Social Network Analysis of the primary health care strategy in Ghana.Health policy and planning · 2026Article
- Health managers' perspectives of community health committees' participation in the annual health sector planning and budgeting process in a devolved unit in Kenya: a cross-sectional study.The Pan African medical journal · 2024Article
- Role of actor networks in primary health care implementation in low- and middle-income countries: a scoping review.Global health action · 2023Article
- Teamwork in community health committees: a case study in two urban informal settlements.BMC health services research · 2023Article
- Who makes health governance decisions at the local level? A cross sectional study from primary health facilities in Tanzania.Health science reports · 2023Article
- Health facility delivery and early initiation of breastfeeding: Cross-sectional survey of 11 sub-Saharan African countries.Health science reports · 2023Article
- Community participation in the health system: analyzing the implementation of community health committee policies in Kenya.Primary health care research & development · 2023Article
- The functionality of health facility governing committees and their associated factors in selected primary health facilities implementing direct health facility financing in Tanzania: A mixed-method study.Health science reports · 2022Article
- Participation in primary health care through community-level health committees in Sub-Saharan Africa: a qualitative synthesis.BMC public health · 2022Review
- Community health workers at the dawn of a new era: 9. CHWs' relationships with the health system and communities.Health research policy and systems · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Kenya, Community Health Committees (CHC) were established to enhance community participation in health services. Their role is to provide leadership, oversight in delivery of community health services, promote social accountability and mobilize resources for community health. CHCs form social networks with other actors, with whom they exchange health information for decision-making and accountability. This case study aimed to explore the structure of a rural and an urban CHC network and to analyze how health-related information flowed in these networks. Understanding the pathways of information in community settings may provide recommendations for strategies to improve the role and functioning of CHCs.
methodsIn 2017, we conducted 4 focus group discussions with 27 community discussants and 10 semi-structured interviews with health professionals in a rural area and an urban slum. Using social network analysis, we determined the structure of their social networks and how health related information flowed in these networks.
resultsBoth CHCs were composed of respected persons nominated by their communities. Each social network had 12 actors that represented both community and government institutions. CHCs were not central actors in the exchange of health-related information. Health workers, community health volunteers and local Chiefs in the urban slum often passed information between the different groups of actors, while CHCs hardly did this. Therefore, CHCs had little control over the flow of health-related information. Although CHC members were respected persons who served in multiple roles within their communities, this did not enhance their centrality. It emerged that CHCs were often left out in the flow of health-related information and decision-making, which led to demotivation. Community health volunteers were more involved by other actors such as health managers and non-governmental organizations as a conduit for health-related information.
conclusionSocial network analysis demonstrated how CHCs played a peripheral role in the flow of health-related information. Their perception of being left out of the information flow led to demotivation, which hampered their ability to facilitate community participation in community health services; hence challenging effective participation through CHCs.
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