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Published in: International Journal for Equity in Health 1/2019

Open Access 01-12-2019 | Research

Gender and health social enterprises in Africa: a research agenda

Authors: Kevin McKague, Sarah Harrison

Published in: International Journal for Equity in Health | Issue 1/2019

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Abstract

Background

Health social enterprises in Africa working with community health workers (CHWs) are growing rapidly but understudied. In particular, gender equality issues related to their work has important public health and equity implications.

Methods

Particularly suited for generating timely findings from reviews at the intersection of overlapping disciplines, we utilized the rapid evidence assessment (REA) methodology to identify key unanswered research questions at the intersection of the fields of gender equality, social enterprises and community health workers. The REA used a series of structured Google Scholar searches, expert interviews and bibliography reviews to identify 57 articles in the academic and grey literatures that met the study inclusion criteria. Articles were thematically coded to identify answers to “What are the most important research questions about the influence of gender on CHWs working with health social enterprises in Africa?”

Results

The analysis identified six key unanswered research questions relating to 1) equitable systems and structures; 2) training; 3) leadership development and career enhancement; 4) payment and incentives; 5) partner, household and community support; and 6) performance.

Conclusion

This is the first study of its kind to identify the key unanswered research questions relevant to gender equality in health social enterprises in Africa using community health workers. As such, it sets out a research agenda for this newly emerging but rapidly developing area of research and practice with important public health implications.
Literature
2.
go back to reference Bhutta ZA, Black RE. Global maternal, newborn, and child health—so near and yet so far. N Engl J Med. 2013;369(23):2226–35.CrossRef Bhutta ZA, Black RE. Global maternal, newborn, and child health—so near and yet so far. N Engl J Med. 2013;369(23):2226–35.CrossRef
3.
go back to reference Boeker M, Vach W, Motschall E. Google scholar as replacement for systematic literature searches: good relative recall and precision are not enough. BMC Med Res Methodol. 2013;13(1):131.CrossRef Boeker M, Vach W, Motschall E. Google scholar as replacement for systematic literature searches: good relative recall and precision are not enough. BMC Med Res Methodol. 2013;13(1):131.CrossRef
4.
go back to reference Condo J, Mugeni C, Naughton B, Hall K, Tuazon MA, Omwega A, et al. Rwanda’s evolving community health worker system: a qualitative assessment of client and provider perspectives. Hum Resour Health. 2014;12(1):71.CrossRef Condo J, Mugeni C, Naughton B, Hall K, Tuazon MA, Omwega A, et al. Rwanda’s evolving community health worker system: a qualitative assessment of client and provider perspectives. Hum Resour Health. 2014;12(1):71.CrossRef
5.
go back to reference Crispin N, Wamae A, Ndirangu M, Wamalwa D, Wangalwa G, Watako P, Mbiti E. Effects of selected socio-demographic characteristics of community health workers on performance of home visits during pregnancy: a cross-sectional study in Busia District, Kenya. Glob J Health Sci. 2012;4(5):78.CrossRef Crispin N, Wamae A, Ndirangu M, Wamalwa D, Wangalwa G, Watako P, Mbiti E. Effects of selected socio-demographic characteristics of community health workers on performance of home visits during pregnancy: a cross-sectional study in Busia District, Kenya. Glob J Health Sci. 2012;4(5):78.CrossRef
6.
go back to reference Feldhaus I, Silverman M, LeFevre AE, Mpembeni R, Mosha I, Chitama D, et al. Equally able, but unequally accepted: gender differentials and experiences of community health volunteers promoting maternal, newborn and child health in Morogoro region, Tanzania. Int. J Equity Health. 2015;(70):14. https://doi.org/10.1186/s12939-015-0201-z. Feldhaus I, Silverman M, LeFevre AE, Mpembeni R, Mosha I, Chitama D, et al. Equally able, but unequally accepted: gender differentials and experiences of community health volunteers promoting maternal, newborn and child health in Morogoro region, Tanzania. Int. J Equity Health. 2015;(70):14. https://​doi.​org/​10.​1186/​s12939-015-0201-z.
9.
go back to reference George A. Nurses, community health workers, and home carers: gendered human resources compensating for skewed health systems. Glob Public Health. 2008;3(1 Suppl):75–89.CrossRef George A. Nurses, community health workers, and home carers: gendered human resources compensating for skewed health systems. Glob Public Health. 2008;3(1 Suppl):75–89.CrossRef
11.
go back to reference Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, Rashidian A. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database Syst Rev. 2013;(10, 10). Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, Rashidian A. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database Syst Rev. 2013;(10, 10).
12.
go back to reference Glenton C, Scheel IB, Pradhan S, Lewin S, Hodgins S, Shrestha V. The female community health volunteer programme in Nepal: decision makers’ perceptions of volunteerism, payment and other incentives. Soc Sci Med. 2010;70(12):1920–7.CrossRef Glenton C, Scheel IB, Pradhan S, Lewin S, Hodgins S, Shrestha V. The female community health volunteer programme in Nepal: decision makers’ perceptions of volunteerism, payment and other incentives. Soc Sci Med. 2010;70(12):1920–7.CrossRef
13.
go back to reference Greenspan JA, McMahon SA, Chebet JJ, Mpunga M, Urassa DP, Winch PJ. Sources of community health worker motivation: a qualitative study in Morogoro region, Tanzania. Hum Resour Health. 2013;11(1):52.CrossRef Greenspan JA, McMahon SA, Chebet JJ, Mpunga M, Urassa DP, Winch PJ. Sources of community health worker motivation: a qualitative study in Morogoro region, Tanzania. Hum Resour Health. 2013;11(1):52.CrossRef
14.
go back to reference Haddaway NR, Collins AM, Coughlin D, Kirk S. The role of Google scholar in evidence reviews and its applicability to Grey literature searching. PLoS One. 2015;10(9):e0138237.CrossRef Haddaway NR, Collins AM, Coughlin D, Kirk S. The role of Google scholar in evidence reviews and its applicability to Grey literature searching. PLoS One. 2015;10(9):e0138237.CrossRef
15.
go back to reference Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, Jan S, et al. Achieving child survival goals: potential contribution of community health workers. Lancet. 2007;369(9579):2121–31.CrossRef Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, Jan S, et al. Achieving child survival goals: potential contribution of community health workers. Lancet. 2007;369(9579):2121–31.CrossRef
17.
go back to reference Global Affairs Canada. Canada’s feminist international assistance policy. #HerVoiceHerChoice. (report). Ottawa: Global Affairs Canada. 2017. Global Affairs Canada. Canada’s feminist international assistance policy. #HerVoiceHerChoice. (report). Ottawa: Global Affairs Canada. 2017.
18.
go back to reference Horton, R., Araujo, E. C., Bhorat, H., Bruysten, S., Jacinto, C. G., McPake, B., … Yamin, A. E. (2016). Final report of the expert group to the High-Level Commission on Health Employment and Economic Growth. Geneva, CH: WHO. Horton, R., Araujo, E. C., Bhorat, H., Bruysten, S., Jacinto, C. G., McPake, B., … Yamin, A. E. (2016). Final report of the expert group to the High-Level Commission on Health Employment and Economic Growth. Geneva, CH: WHO.
21.
go back to reference Kabir N. Women’s economic empowerment and inclusive growth: labour markets and enterprise development. UK: School of Oriental and African Studies; 2016. Kabir N. Women’s economic empowerment and inclusive growth: labour markets and enterprise development. UK: School of Oriental and African Studies; 2016.
22.
go back to reference Kayser O, Budinich V. Scaling up business solutions to social problems: a practical guide for social and corporate entrepreneurs. New York, NY: Springer; 2015.CrossRef Kayser O, Budinich V. Scaling up business solutions to social problems: a practical guide for social and corporate entrepreneurs. New York, NY: Springer; 2015.CrossRef
23.
go back to reference Kraft JM, Wilkins KG, Morales GJ, Widyono M, Middlestadt SE. An evidence review of gender-integrated interventions in reproductive and maternal child health. J Health Commun. 2014;19:122–41.CrossRef Kraft JM, Wilkins KG, Morales GJ, Widyono M, Middlestadt SE. An evidence review of gender-integrated interventions in reproductive and maternal child health. J Health Commun. 2014;19:122–41.CrossRef
24.
go back to reference Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? The state of evidence on programmes, activities, costs and health outcomes of using community health workers. Geneva, CH: WHO. Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? The state of evidence on programmes, activities, costs and health outcomes of using community health workers. Geneva, CH: WHO.
25.
go back to reference Lewin SA, Dick J, Pond P, Zwarenstein M, Aja G, van Wyk B, et al. Lay health workers in primary and community health care: Cochrane systematic review. Int J Epidemiol. 2005;34(6):1250–1.CrossRef Lewin SA, Dick J, Pond P, Zwarenstein M, Aja G, van Wyk B, et al. Lay health workers in primary and community health care: Cochrane systematic review. Int J Epidemiol. 2005;34(6):1250–1.CrossRef
26.
go back to reference Mason C, Barraket J, Friel S, O'Rourke K, Stenta C-P. Social innovation for the promotion of health equity. Health Promot Int. 2015;30(2 Suppl):116–25.CrossRef Mason C, Barraket J, Friel S, O'Rourke K, Stenta C-P. Social innovation for the promotion of health equity. Health Promot Int. 2015;30(2 Suppl):116–25.CrossRef
27.
go back to reference McKague K, Menke M, Arasaratnam A. Access Afya: micro-clinic health franchise designed for scale. In: Alon I, editor. Social franchising. London: Palgrave Pivot; 2014. p. 61–79. McKague K, Menke M, Arasaratnam A. Access Afya: micro-clinic health franchise designed for scale. In: Alon I, editor. Social franchising. London: Palgrave Pivot; 2014. p. 61–79.
28.
go back to reference Miles MB, Huberman AM, Saldana J. Qualitative data analysis: a methods sourcebook. California: Sage Publications Ltd; 2014. Miles MB, Huberman AM, Saldana J. Qualitative data analysis: a methods sourcebook. California: Sage Publications Ltd; 2014.
29.
go back to reference Mumtaz Z, Salway S, Waseem M, Umer N. Gender-based barriers to primary health care provision in Pakistan: the experience of female providers. Health Policy Plan. 2003;18(3):261–9.CrossRef Mumtaz Z, Salway S, Waseem M, Umer N. Gender-based barriers to primary health care provision in Pakistan: the experience of female providers. Health Policy Plan. 2003;18(3):261–9.CrossRef
30.
go back to reference Nyqvist, M., Guariso, A., Svensson, J., & Yanagizawa-Drott, D. (2018). Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda. American Economic Journal: Applied Economics. Nyqvist, M., Guariso, A., Svensson, J., & Yanagizawa-Drott, D. (2018). Reducing Child Mortality in the Last Mile: Experimental Evidence on Community Health Promoters in Uganda. American Economic Journal: Applied Economics.
31.
go back to reference Perry H. A brief history of community health worker programs. In: Kirch W, editor. Encyclopedia of public health. Berlin: Springer; 2013. p. 1–12. Perry H. A brief history of community health worker programs. In: Kirch W, editor. Encyclopedia of public health. Berlin: Springer; 2013. p. 1–12.
32.
go back to reference Rosato M, Laverack G, Grabman LH, Tripathy P, Nair N, Mwansambo C, et al. Community participation: lessons for maternal, newborn, and child health. Lancet. 2008;372(9642):962–71.CrossRef Rosato M, Laverack G, Grabman LH, Tripathy P, Nair N, Mwansambo C, et al. Community participation: lessons for maternal, newborn, and child health. Lancet. 2008;372(9642):962–71.CrossRef
33.
go back to reference Roy MJ, Donaldson C, Baker R, Kerr S. The potential of social enterprise to enhance health and well-being: a model and systematic review. Soc Sci Med. 2014;123:182–93.CrossRef Roy MJ, Donaldson C, Baker R, Kerr S. The potential of social enterprise to enhance health and well-being: a model and systematic review. Soc Sci Med. 2014;123:182–93.CrossRef
34.
go back to reference Schneider H, Okello D, Lehmann U. The global pendulum swing towards community health workers in low-and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014. Hum Resour Health. 2016;14(1):65.CrossRef Schneider H, Okello D, Lehmann U. The global pendulum swing towards community health workers in low-and middle-income countries: a scoping review of trends, geographical distribution and programmatic orientations, 2005 to 2014. Hum Resour Health. 2016;14(1):65.CrossRef
35.
go back to reference Seelos C, Mair J. Social entrepreneurship: creating new business models to serve the poor. Bus Horiz. 2005;48(3):241–6.CrossRef Seelos C, Mair J. Social entrepreneurship: creating new business models to serve the poor. Bus Horiz. 2005;48(3):241–6.CrossRef
36.
go back to reference Seelos, C., & Mair, J. (2017). Innovation and scaling for impact: how effective social enterprises do it. Stanford, CA: Stanford University Press. Seelos, C., & Mair, J. (2017). Innovation and scaling for impact: how effective social enterprises do it. Stanford, CA: Stanford University Press.
37.
go back to reference Schaaf M, Fox J, Topp SM, Warthin C, Freedman LP, Robinson RS, et al. Community health workers and accountability: reflections from an international “think-in”. Int J Equity Health. 2018;17(1):66.CrossRef Schaaf M, Fox J, Topp SM, Warthin C, Freedman LP, Robinson RS, et al. Community health workers and accountability: reflections from an international “think-in”. Int J Equity Health. 2018;17(1):66.CrossRef
38.
go back to reference Shariff SZ, Bejaimal SA, Sontrop JM, Iansavichus AV, Haynes RB, Weir MA, Garg AX. Retrieving clinical evidence: a comparison of PubMed and Google scholar for quick clinical searches. J Med Internet Res. 2013;15(8).CrossRef Shariff SZ, Bejaimal SA, Sontrop JM, Iansavichus AV, Haynes RB, Weir MA, Garg AX. Retrieving clinical evidence: a comparison of PubMed and Google scholar for quick clinical searches. J Med Internet Res. 2013;15(8).CrossRef
40.
go back to reference Thomas J, Newman M, Oliver S. Rapid evidence assessments of research to inform social policy: taking stock and moving forward. Evidence Policy. 2013;9(1):5–27.CrossRef Thomas J, Newman M, Oliver S. Rapid evidence assessments of research to inform social policy: taking stock and moving forward. Evidence Policy. 2013;9(1):5–27.CrossRef
43.
go back to reference Walley J, Lawn JE, Tinker A, De Francisco A, Chopra M, Rudan I. & Lancet Alma-Ata Working GroupPrimary health care: making Alma-Ata a reality. Lancet. 2008;372(9642):1001–7.CrossRef Walley J, Lawn JE, Tinker A, De Francisco A, Chopra M, Rudan I. & Lancet Alma-Ata Working GroupPrimary health care: making Alma-Ata a reality. Lancet. 2008;372(9642):1001–7.CrossRef
Metadata
Title
Gender and health social enterprises in Africa: a research agenda
Authors
Kevin McKague
Sarah Harrison
Publication date
01-12-2019
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2019
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-019-0994-2

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