Document Type : Review Article
Authors
1
Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway
2
National University Health System, Singapore, Singapore
3
Imperial College London, London, UK
4
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
5
London School of Hygiene and Tropical Medicine, London, UK
6
Department for Global Public Health, Karolinska Institutet and Centre for Resilent Health, Stockholm School of Economics, Stockholm, Sweden
7
Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
8
London School of Economics and Political Science, London, UK
9
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
10
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
11
Centro de Investigação Em Saúde de Manhiça (CISM), Manhica, Mozambique
12
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
13
The Helen Clark Foundation, Auckland, New Zealand
14
George Institute for Global Health UK, London, UK
Abstract
Background
The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassrootsinclusive approaches to developing indicators. Our objective is to assess how and why grassroots-inclusive approaches complement top-down approaches to developing indicators, and to synthesise their theoretical and practical contributions to public health.
Methods
We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We systematically searched six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO), as well as Google Scholar, to identify relevant articles published from their inception to September 1, 2024. We included peer-reviewed articles, opinion pieces, and book chapters, narratively synthesising their findings.
Results
This review included 43 studies from various disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas such as environmental sustainability, disaster resilience, public health, well-being, and local development. The reported strengths included greater local relevance, community ownership, and accountability, alongside challenges in sustaining participation, integrating into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness.
Conclusion
Despite retrieving and analysing articles from various disciplines, no study has specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence clearly shows that it is both feasible and practical to integrate expert and non-expert perspectives when developing indicators.
Keywords
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