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      Community-based organizations in the health sector: A scoping review

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      1 , 2 , 3 , 4 , , 1 , 2 , 3 , 5 , 6
      Health Research Policy and Systems
      BioMed Central

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          Abstract

          Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.

          We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed.

          We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).

          Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement.

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          Most cited references22

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          HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action.

          Internationally, there has been a recent resurgence of interest in HIV and AIDS-related stigma and discrimination, triggered at least in part by growing recognition that negative social responses to the epidemic remain pervasive even in seriously affected communities. Yet, rarely are existing notions of stigma and discrimination interrogated for their conceptual adequacy and their usefulness in leading to the design of effective programmes and interventions. Taking as its starting point, the classic formulation of stigma as a 'significantly discrediting' attribute, but moving beyond this to conceptualize stigma and stigmatization as intimately linked to the reproduction of social difference, this paper offers a new framework by which to understand HIV and AIDS-related stigma and its effects. It so doing, it highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. It highlights the limitations of individualistic modes of stigma alleviation and calls instead for new programmatic approaches in which the resistance of stigmatized individuals and communities is utilized as a resource for social change.
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            A review of literature about involving people affected by cancer in research, policy and planning and practice.

            To systematically review the literature on involving people affected by cancer in healthcare research, policy and planning and practice. Database searches, cited author, and grey literature searches were conducted. 131 documents were included. Rationales for the agenda of involvement represent two polar characteristics of modernity: individualism and collectivism. In research, people acted as advocates, strategists, advisors, reviewers and as participatory researchers. In policy and planning, people were involved in one-off involvement exercises and in longer-term partnerships. Men, those with rare cancers, children, and people who are socially deprived have been rarely involved. There is little research evidence about the impact of involvement. Training and information, resources and a change in attitudes and roles are required to implement an agenda of involvement. The USA, the UK, followed by Canada and Australia have promoted an agenda of involvement. A dissemination strategy to share good practice; involvement of all types of people; an individualised and flexible approach; training, resources and a shift in thinking from paternalism towards partnership working are required. More research is needed about the impact of involvement and relationships between rationales for involvement and implementation.
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              Addressing social determinants of health inequities: what can the state and civil society do?

              In this Health Policy article, we selected and reviewed evidence synthesised by nine knowledge networks established by WHO to support the Commission on the Social Determinants of Health. We have indicated the part that national governments and civil society can play in reducing health inequity. Government action can take three forms: (1) as provider or guarantor of human rights and essential services; (2) as facilitator of policy frameworks that provide the basis for equitable health improvement; and (3) as gatherer and monitor of data about their populations in ways that generate health information about mortality and morbidity and data about health equity. We use examples from the knowledge networks to illustrate some of the options governments have in fulfilling this role. Civil society takes many forms: here, we have used examples of community groups and social movements. Governments and civil society can have important positive roles in addressing health inequity if political will exists.
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                Author and article information

                Journal
                Health Res Policy Syst
                Health Res Policy Syst
                Health Research Policy and Systems
                BioMed Central
                1478-4505
                2012
                21 November 2012
                : 10
                : 36
                Affiliations
                [1 ]McMaster Health Forum, McMaster University, 1280 Main St. West, MML 417, Hamilton, ON, L8S 4L6, Canada
                [2 ]Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main St. West, CRL 209, Hamilton, ON, L8S 4K1, Canada
                [3 ]Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
                [4 ]Ontario HIV Treatment Network, 1300 Yonge St, Suite 600, Toronto, ON, M4T 1X3, Canada
                [5 ]Department of Political Science, McMaster University, 1280 Main St. West, Hamilton, ON, Canada
                [6 ]Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
                Article
                1478-4505-10-36
                10.1186/1478-4505-10-36
                3511187
                23171160
                37982f7c-78ec-4e5b-aaaa-4130a73901b7
                Copyright ©2012 Wilson et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 February 2012
                : 25 September 2012
                Categories
                Review

                Health & Social care
                Health & Social care

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