[How health education can promote health for everyone through community participation in the urban milieu].
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An operational field trial on community-based malaria control efforts in West Timor, one district in Indonesia, had been implemented since 1987. The trial investigated the utilization of Posyandu cadres in case finding and treatment of malaria. From this trial it appears feasible to utilize these cadres for malaria control. Efficacy of cadres in case finding and treatment of chills and fevers surpassed all expectations.
A community-based dengue vector control trial was conducted at transmission foci in Plaeng Yao District, Chachoengsao Province, eastern Thailand. Implementation was done by the local community in collaboration with local administration, public health, and school authorities. Our cost-effective approaches combined a source reduction campaign with appropriate vector control technologies applied within the foci (within 100 m around the foci) and also within schools attended by children from the treated areas. Vector management measures by local government included cleanup campaigns before the rainy season followed by a routine garbage pickup during the rainy season. Locally made screen covers for water jars, a combination of local Bacillus thuringiensis subsp. israelensis and Mesocyclops thermocyclopoides (copepod), and locally made lethal ovitraps were appropriate technologies used by the community in this campaign. The success of our intervention was evidenced by the significant reduction of dengue vectors and dengue hemorrhagic fever cases in treated areas compared with untreated areas.
Community participation in health care programmes is considered axiomatic in health development. Cultural and structural influences are discussed in relation to community participation with the intention of highlighting some critical issues affecting its generation and sustainability. These influences include structurally defined perspectives and perceptions of community participation, limitations of the necessary supportive systems, the structural and cultural factors of marginalization, community stratification and organization, mobilization, and the political context. It is concluded that given these factors against a situation of a financial and economic crisis, of economic restructuring and the values of competition and individualization, community participation will be increasingly difficult to generate and sustain.
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Primary health care requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care, making fullest use of local, national and other available resources; and to this end develops through appropriate education the ability of communities to participate.
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