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Abstract
Background During the COVID-19 pandemic, governments and health authorities faced tough decisions about infection prevention and control measures such as social distancing, face masks and travel. Judgements underlying those decisions require democratic input, as well as expert input. The aim of this review is to inform decisions about how best to achieve public participation in decisions about public health and social interventions in the context of a pandemic or other public health emergencies.
Objectives To systematically review examples of public participation in decisions by governments and health authorities about how to control the COVID-19 pandemic.
Design We searched Participedia and relevant databases in August 2022. Two authors reviewed titles and abstracts and one author screened publications promoted to full text. One author extracted data from included reports using a standard data-extraction form. A second author checked 10% of the extraction forms. We conducted a structured synthesis using framework analysis.
Results We included 24 reports (18 from Participedia). Most took place in high-income countries (n=23), involved ‘consulting’ the public (n=17) and involved public meetings (usually online). Two initiatives reported explicit support for critical thinking. 11 initiatives were formally evaluated (only three reported impacts). Many initiatives did not contribute to a decision, and 17 initiatives did not include any explicit decision-making criteria.
Conclusions Decisions about how to manage the COVID-19 pandemic affected nearly everyone. While public participation in those decisions had the potential to improve the quality of the judgements and decisions that were made, build trust, improve adherence and help ensure transparency and accountability, few examples of such initiatives have been reported and most of those have not been formally evaluated. Identified initiatives did point out potential good practices related to online engagement, crowdsourcing and addressing potential power imbalance. Future research should address improved reporting of initiatives, explicit decision-making criteria, support for critical thinking, engagement of marginalised groups and decision-makers and communication with the public.
PROSPERO registration number 358991.
- COVID-19
- public health
- health policy
- systematic review
Data availability statement
Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Handling editor Valery Ridde
Contributors ADO prepared the first draft of the protocol. All the authors contributed to revisions of the protocol and approved the final version. ADO conducted the Participedia search. Marit Johanssen developed and carried out searches of bibliographic databases. HMM-K checked screening and data extraction of the Participedia results, screened abstracts and full-text and extracted data from the articles found by searching bibliographic databases. BvL screened abstracts and checked data extraction. BvL, SG and AO provided feedback throughout the review process. HMM-K and ADO prepared the first draft of the manuscript. All the authors read, provided feedback and approved the final manuscript. HMK is responsible for the overall content as the guarantor of this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests HMM-K, ADO, BvL and AO have no competing interests. SG is Pro-Dean for Research, Social Sciences Faculty, University of Bergen, Co-Director Chr.Michelsen, Institute at the University of Bergen Centre on Law & Social Transformation and Advisory Board member Norwegian Human Rights Institution.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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