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PubMed1993

Chagas' disease: control and surveillance through use of insecticides and community participation in Mambaí, Goiás, Brazil.

This article describes the nature and effectiveness of methods developed for longitudinal surveillance and control of Chagas' disease vectors in Mambaí, Brazil. The surveillance effort made use of an education program in the schools, community leader and resident participation, specific surveillance equipment (Gómez-Núñez boxes, instructive posters, and instructive calendars with special detection papers), periodic manual collection of triatomines, and a network of collection posts. Spraying of infested houses was accomplished partly by community leaders who received special training for this purpose. The methods used offer an affordable approach to triatomine surveillance and control well-suited to use in large-scale national programs.

Animals↗
PubMed1995

Community participation in health care decision making: is it feasible?

Health care reform strategies proposed by provincial governments include decentralized funding and increased public participation in decision making. These proposals do not give details as to the public participation process, and a number of questions have been raised by the experience of some communities. Which citizens should form the decision-making group? What information do they need? What kinds of decisions should they make? What level of participation should they have? The results of a survey by Abelson and associates (see pages 403 to 412 of this issue) challenge the assumption that "communities" are willing to participate in health-care and social-service decision making. Willingness varied according to the composition of the groups polled, and participants' support for traditional decision makers increased after the complexities of the decision-making process were discussed. However, whereas their study measured willingness to participate at one point in time only, experience gained from Ontario's Better Beginnings, Better Futures project indicates that, given sufficient time, "ordinary" citizens are willing and can acquire the skills needed to decide how resources should be allocated for social services.

Canada↗
PubMed1993

Community participation in vector-borne disease control.

Because vertical approaches, such as insecticidal house-spraying, to vector control problems have not been very successful in many instances in reducing the incidence of diseases such as malaria and Chagas, combined with the fact that there have been resurgences of some diseases, greater attention has been focused on 'bottom-up'-type control strategies. However, many attempts to actively involve the community in reducing its risks of becoming ill have met with failure. It has usually proved difficult to motivate communities into action, but there have been some successes, although it is generally too early to know whether such successes can be sustained. Apart from greater efforts to educate communities to disease risks and disease prevention methods, sociologists and anthropologists argue that we need to listen more to the people and pay greater attention to their beliefs and customs. The present paper discusses the problems of introducing self-help methods to minimize vector-borne disease transmission, and reviews the successes and failures of this approach.

Animals↗
PubMed1992

Adopting the primary health care approach in malaria control in Malaysia: lessons in community participation.

The Primary Health Care approach in Malaysia was first tried out in Sarawak, East Malaysia in 1982. In 1984, the Vector Borne Disease Control Program, Kelantan decided to adopt the Primary Health Care approach as an additional strategy in its effort to control malaria in the state, which then experienced an increase in malaria cases. Much effort was directed at creating the awareness and stimulating the interest of health staff and communities to adopt the strategy. Kelantan was made the model state. The paper gives an outline of the process involved and some characteristics of PHC workers. A study was carried out among health workers, community members and health staff on their knowledge and involvement in PHC in three states, including Kelantan. In view of the overall success of this approach, and the weaknesses which have been identified possible solutions have been suggested and should be acted upon.

Communicable Disease Control↗
PubMed1982

Women--the underused human resource: education and training of women for community participation.

This article goes beyond the rhetorical issue of women's participation as a key to implementing water supply and sanitation projects and suggests concrete ways in which training and education can make these plans a reality. With the improvements proposed for the International Drinking Water Supply and Sanitation Decade, women could be freed to do other tasks vital to the well being of the family and the community. Women, the "invisible resource" of society, play and essential part in encouraging family members to use technological advances and should be trained to effectively promote their acceptance. The author highlights the influence women have in the field of public health: with adequate training, for example, they can help control the spread of diarrheal disease with proper hygiene and an understanding of the fecal-oral route of infection. Moreover, she says that the central role women play in socializing the young and their permanence within the household make them suitable as trainees and trainers for water and sanitation projects at the community and household levels. Women should be recruited for these roles and should be consulted at every stage of development; while women's bureaus exist in many countries, the author states that planners often hesitate to call on them for assistance. The article describes several innovative training programs and, along with a bibliography, presents separate case studies for Mexico and Panama.

Africa↗
PubMed1988

The role of organizations in community participation--prevention of accidental injuries in a rural Swedish municipality.

Accidental injuries are a major public health problem in most of the industrialized world. It is no longer justifiable to accept accidents as unfortunate but unavoidable occurrences. Their prevention is important and appears increasingly possible. The health care sector is uniquely knowledgeable about health hazards and must be more involved in social planning. An intervention programme towards the prevention of accidental injuries based on local epidemiological data has since 1980 been conducted in a geographically defined population in Skaraborg County in western Sweden. This article describes a community intervention approach. The programme has been implemented in a local community with the application of a community oriented and organization oriented perspective. This has above all constituted a starting point for initiating the programme. The programme includes as well active as passive strategies and consists of information, education, supervision and changes in the physical environment. Intersectorial cooperation and community involvement are emphasized.

Accident Prevention↗
PubMed1995

[The paradox of community participation in primary health care in Zaire].

The classic approach fails from the very beginning when District Medical Officers and other health professionals are chosen to manage primary health care programmes. Their attempts to convince the communities of the necessity of following their advice are often far too overbearing, and thus reinforce the "expert to ignorant" situation to a point where maintaining a true partnership becomes difficult, even impossible. It often happens as well that the community representatives in PHC programmes adopt aspects of the overbearing, "expert-like" behaviour. When this happens, they alienate themselves from the community or, in the least, lose any influence toward initiating action. As for the health professionals, they most likely direct any influence they may have towards clinically-oriented health measures. The preceding tendencies result in programmes which are quite far from the community's true concerns for achieving well-being and development. The PHC's problems such as lack of medicine and care facilities are generally overtaken by the more pressing priorities such as lack of good roads, energy, safe water, diminishing crops, etc. Dr. Ngo Bebe's article describes an initiative wherein the traditional primary health care approach is replaced by an integrated, community-centered programme. The health center remains the physical point for coordination, and its personnel participates in a variety of activities already taking place in the community. A health aspect is included, but does not overpower the activity which was formerly underway. A community development worker is integrated into the health center team. This provides the opportunity for growth and exchange, thus rendering the various activities truly interdisciplinary. Although this community mobilisation process has been underway in certain villages in Zaire for the past two years, and seems to have a positive impact on community development and the health status of the villagers, it is still early to proclaim the initiative an entire success. Only an assessment of the long term benefits will indicate the strengths and weaknesses of the project.

Community Health Workers↗
PubMedDate not supplied

Institutionalizing women's oppression: the inherent risk in health policy that fosters community participation.

Current Canadian health policy is based on the implicit assumption that women are available to provide care in the home to the dependent, the ill, the elderly, and the physically and mentally disabled. Women are socialized from birth to accept caring roles within a traditional family structure, and current societal expectations and social policy reinforce this value system. Women's health can only be understood within the context of their lived experience of social inequity, medicalization, and family caregiving. Health care professionals are complicit in sustaining women's oppression by reinforcing these institutions of social control. For health policy to be responsive to women's needs, it must be based on research that considers the social complexity of ordinary women's lives.

Canada↗
PubMed1998

[Schistosomiasis and the challenge of community participation].

Using a semiotic and hermeneutical approach, the present paper discusses various theoretical elements in the analysis of popular views of schistosomiasis. Based on field work conducted in the State of Bahia, the authors identify two main processes in the construction of meaning related to schistosomiasis and show that depending on the social context of experience the disease may have a primary or secondary meaning for the populations affected by it. The first level of meaning refers to bodily experiences and is shared intersubjectively, whereas the second type is built on the discourse of health professionals. In the latter case, the popular view of the illness is directly linked to discourses and actions previously established by health programs designed for the control of the disease.

Adolescent↗
PubMed1992

Community participation and involvement: theoretical and empirical issues.

In 1978, the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF), in their Alma Ata Declaration, declared a war against ill health and lack of access to and use of health services by advocating a joint effort among countries to bring health for all for the year 2000. Although such wars have been waged many times before, this time the declaration had a slightly different message, one paying respect to the people who are the target of that declaration. The message was to help people achieve their health potential within their abilities, values, and technologies by helping them help themselves. Other significant parts to this message included dealing with the use of local technology, the involvement of intersectorial cooperation, and the view of health as integral to development (WHO, 1978).

Community Participation↗