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Health Policy |
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Priorities in Health |
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Projects |
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Documents |
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Priority Countries |
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| Priorities in Health |
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Community based health services and initiatives
Participation of communities, of both organised and unorganised public groups, is widely argued to be an important factor in improving health outcomes and the performance of health systems. Despite this, and the common inclusion of ’participation’ as both means and ends in health policy, participation is poorly operationalised, both in governance and accountability in health and in technical health interventions, so that there is little systematic analysis of its specific contribution to health and health systems outcomes. The term ’participation’ has been loaded with many meanings and aspirations. To some it implies a mechanism for increasing the efficiency or reducing the costs of programme implementation, improving sustainability of programmes and building local skills and experience useful for future interventions. This form of participation is a means to other development ’ends’, a way in which goals and objectives may be better achieved. Participation is however also conceived of as an end in itself, building networks of solidarity and confidence in social groups, building institutional capacity, empowering people to understand and influence the decisions which affect their lives, legitimising policy and practice, ensuring that they relate more closely to perceived public need and strengthening the incorporation of local knowledge. The term ’community’, as a social grouping with common characteristics, interests or identity equally needs to be unbundled to identify the interests or features that create that collective identity, and to recognise the conflicts or divisions that exist within groups. The manner in which participation is expressed is an important dimension of how a society conceives and practises democracy. It reflects the extent to which democracy extends to and beyond representative democracy, or the delegation of power through the election of representatives, to the systems of ’participatory democracy’ that society uses to direct or control the exercise of power, establish accountability, communicate views and interests and contribute towards development between elections.
Rene Loewenson: Participation in Health: Making People Matter. IDS Working Paper 84 (2000) |
| Related SDC Projects |
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Community and Basic Health Project
(Related Country:
Tajikistan)
To provide coherence to its ongoing health programmes, and moreover to better integrate health care reform projects in Tajikistan, the SDC found it rational to co-fund the World Bank "Community and Basic Health Project" (CBHP) which is seen also as a ground work for a future Sector Wide Approach (SWAP) in health sector.
 Project Documentation
Community Health Care Project
(Related Country:
Tajikistan)
The goal of the project is to improve the health status of the community in general and the health of children under five years and women of reproductive age in particular.
Project Documentation
Tajik Swiss Health Reform and Family Medicine Project
(Related Country:
Tajikistan)
Project Sino is assisting the Ministry of Health and districts (=rayons) of the Republic of Tajikistan in carrying forward health reforms and strengthening of family medicine services. The population of four rayons (Varzob, Dangara, Turzunsade and Shakrinov) is the prime beneficiary of the project.
Project Documentation
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| SDC Documents |
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International Approaches to Community-Based Health
(12.2005)
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| Show archived Items (1) |
| Resources |
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Managing Community Health Services
Eldis Participation Resource Guide
World Bank Poverty Net: Empowerment
The community development dilemma
Community Action for Health
Management of community health services
Partnerships management: Community involvement |
| Organisations |
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International Development Research Centre IDRC |
| Basics |
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Self-help: What future role in health care for low and middle-income countries?
AKHS Kenya: Best Practices
Health promotion through self-care and community participation
AQUIRE: Community Mobilization
Oxfam Canada: Sharing Knowledge for Community Development and Transformation |