Exploring the unmet needs for creating an enabling environment for nurturing care to promote migrant child health in Bishkek, Kyrgyzstan: A theory-guided community-based participatory action research

摘要

Empirical evidence on community-driven child health promotion programs in disadvantaged migrant populations is limited despite various promotional strategies. Therefore, we implemented a developmental process to shape child health interventions using theory-guided community-based participatory action research (CBPAR) in a migrant community in Bishkek, Kyrgyzstan between 2015 and 2019.The collaborative and iterative CBPAR process was conducted through participatory workshops and focus group discussions with support from trusting and collegial partnerships between community members and the research team. The goal and scope of the intervention was guided by enabling environments for nurturing care, including the four domains of caregivers' capabilities, empowered communities, supportive services, and enabling policies. Diverse interests and needs identified by community members were aggregated in the theoretical model and reflected in the intervention.Community-driven intervention is perceived as a culturally acceptable, sustainable, sensitive and relevant approach to solve problems. There are several challenges in conducting the CBPAR, such as the effort and time spent on building partnerships, co-learning and mutual understanding, and the power equilibrium involved. Despite this, the success of the CBPAR process provided opportunities for community mobilization, empowerment and sustainability of the intervention. Evaluation of the process and outcomes of the intervention provided community health researchers and practitioners with evidence of the theory-guided community participatory approach.