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At least 487 records · Page 27Linked to original sources
PubMed1977

Neighborhood health centers: a decade of experience.

The first neighborhood health center was funded in 1965 by the Office of Economic Opportunity. Now, 12 years later, 127 federally funded centers are serving over a million people. The centers have offered a high quality of service, delivered comprehensive care that includes preventive services and health supervision, developed a workable team approach in such care, and shown that this can be done at reasonable cost. Evaluative studies made on center effectiveness in disease prevention, in reduction of hospitalization and emergency room usage, and in improving the quality of care show that the centers compare favorably with other methods of providing similar care. Problems of financing are discussed, as well as possible directions for the future.

Community Health Centers↗
PubMed1996

Community-based approach to schistosomiasis control.

With few exceptions, efforts to control schistosomiasis have relied upon ongoing community cooperation with "outsiders' rather than creating within the community the capacity and means for carrying out ongoing disease control measures with minimal external support. Offered as a useful model is a program in Kaele subdivision, Extreme North Province, Cameroon designed to establish and integrate within the primary health care (PHC) system the control of urinary schistosomiasis, hyperendemic in the region. At the community level, and with minimal dependence upon external resources, culturally appropriate and effective health education was instituted, the capacity to diagnose and treat schistosomiasis was created, diagnosis and drug therapy (praziquantel) was made available conveniently and at low cost, and, on a very limited basis, snails were controlled. Efforts were made to build upon and strengthen existing community structures and institutions rather than create new ones. The impact of the interventions was measured in terms of changes in knowledge and behavior, prevalence and intensity of infection, utilization of health services, and the ability to finance the control activities within the context of a generalized cost recovery system. Program successes and failures are discussed, as well as lessons learned and their implications.

Animals↗
PubMed1983

The community health volunteer scheme in India: an evaluation.

In this paper, we have placed the discussion of community health volunteer (CHV) scheme within the larger context of the evolution of primary health care organization in India. Drawing on a national evaluation study and a micro village level study, we have outlined the key issues in the design and implementation of the CHV scheme. These issues relate to the range and quality of services, the characteristics of clients served, nature of health problems attended, community participation, extent of help rendered by CHV to PHC staff, and problems of logistics and supply of manuals, kits and medicines. Our analysis shows that the CHV scheme has succeeded in bringing primary curative care to the doorsteps of the people. To a smaller extent, it has also helped in improving related services such as family planning, immunization and detection and treatment of malaria. Both the village community and the field staff of the regular health care organization find the CHV as a useful link between the community and the primary health center. Also CHVs are not confining to only a privileged few but they are catering to a cross-section of different caste and class groups in the village community.

Allied Health Personnel↗
PubMed1986

Primary health care for whom? Village perspectives from Nepal.

Over the last decade, many developing nations have embraced Primary Health Care (PHC) within their national health plans. PHC, in contrast to earlier approaches to national health development, emphasizes community participation and basic health care for the poorer segments of society. The research reported here finds that in the enthusiasm for the PHC concept in Nepal, important sociocultural processes have been overlooked. This paper describes the relationship between certain sociocultural factors and PHC activities in rural Central Nepal. It reveals a contradiction between the stated PHC intentions to address local interests and promote community participation on the one hand, and the actual approach taken on the other hand. Specifically it argues that PHC is encountering problems in Nepal for three reasons: (1) PHC fails to appreciate villagers' values and their own perceived needs. In particular, PHC is organized primarily to provide health education, whereas villagers value modern curative services and feel little need for new health knowledge. (2) PHC views rural Nepali culture only pejoratively as a barrier to health education. Alternatively, local cultural beliefs and practices should be viewed as resources to facilitate dissemination and acceptance of modern health knowledge. (3) In attempting to incorporate Nepal's traditional medical practitioners into the program, PHC has mistakenly assumed that rural clients passively believe in and obey traditional practitioners. In fact, clients play active roles and are themselves in control of the therapeutic process. Thus, instead of attempting to recruit traditional practitioners to do its work, PHC should recognize the precedent for community participation in Nepal's traditional medical system and develop the respect for villagers' own ideas and values that traditional practitioners already possess.

Attitude to Health↗
PubMed1992

Cultural and structural influences in the creation of and participation in community health programmes.

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.

Community Health Services↗
PubMed1996

Integrated local health systems in Central America.

This paper describes a few Central American experiences related to the development of integrated, participatory health care systems. Theory and analytic method center on the tensions inherent in the dichotomies of professional/popular, center/periphery and biomedical/traditional. Using a framework rooted in the World Health Organization's 1978 call for 'health for all' based on community-oriented primary care, this paper concludes that the underlying conditions necessary for truly integrated local health systems have not yet developed. Except for the cases of Costa Rica during 1978-1982 and Nicaragua during 1979-1990, the political will to create and support such systems has not existed. Perhaps more importantly, the cultural milieu in which Central Americans interact with their society fosters an individualistic, commercial, and paternalistic citizen/society relationship rather than the cooperative, community-oriented and democratic spirit needed for successful development of integrated local health systems. Nevertheless, there are a number of positive examples from which we can learn, and a growing tradition of citizen participation which may lead toward appropriate, sustainable, and truly integrated local health systems.

Central America↗
PubMed1996

Community participation in health care: the Turkish case.

World Health Organization's global goal of Health for All by the Year 2000 (HFA) and achievement of this laudable goal through the Primary Health Care (PHC) approach has been accepted unanimously by participant countries of the Alma-Ata Conference in 1978. Turkey is also among the countries that showed their approval to the concept. However, that approval of the policy did not generate particular attention among the policy-makers until the 1990s. The year 1990 can be regarded as a watershed in the Turkish health policy-making environment as attempts at producing a National Health Policy document that centred around the global goal of HFA and PHC commenced. This paper aims at discussing the commitment of Turkey to one of the prerequisites of the approach, or heart of the PHC as regarded by some: community participation. After a brief presentation of community participation the Turkish commitment to the concept is analyzed based on a research carried out among Turkish health policy-makers. It is concluded that the prospect for community participation in Turkey does not look good mainly because of the medical approach adopted by the policy-makers. The need for more discussion of the topic among the academic circles has been emphasized.

Community Health Planning↗
PubMed2001

Child sexual abuse and incest: community-based intervention.

OBJECTIVE: The primary aim of this article is to determine the effectiveness of community intervention in the case of child sexual abuse. The article describes and analyses an actual case in a small urban community in Israel. METHOD: After several incidents of child sexual abuse, much of it incestuous, were brought to light in the community, they were discussed openly, contained, and punished. A community campaign, in which community activists as well as all the service providers were involved, was organized by community social workers. Individual, group, and community interventions were used. RESULTS: The continuation of the abuse has been checked, and, so far, there is no evidence to suggest its resurgence. Community apathy to child sexual abuse seems to have been halted and reversed. The involvement of community residents, particularly the activists, has increased, and this appears to be the major factor in changed community norms toward child sexual abuse. CONCLUSION: Implications of the individual, group, and community interventions are discussed. An integrated program of intervention practices is advocated to contain and prevent the incidence of child sexual abuse and incest.

Attitude to Health↗