Community Participation and Health Care
Community Participation and Health Care
Introduction
Community participation in healthcare is a concept that entails involving the local community members in the process of making decisions that concern local health services. In this concept, other stakeholders within the healthcare system work closely with community members to address healthcare problems. Community participation seeks to address the collective needs of a homogenous group of people. Community participation redistributes decision making power to the community.Community participation is related to consumerism model. Consumerism is whereby consumers a particular service come together in order to increase their bargaining power over the provider (Nicholls, 2000). Consumerism model of participation emphasizes on the uniqueness of individuals. Consumerism model seek to ensure that unique needs of individuals are met through collective power. Community participation is also closely related to the democratic model. Democratic model emphasize on granting individual greater control over their lives (Nicholls, 2000). The democratic model suggests that patients are autonomous and rational beings and, therefore, should be given an opportunity to make their own choices. This model focuses on ensuring that the rights of individuals are respected during the delivery of care. The democratic model focuses on creating a bottom up approach to healthcare.This paper has explored how the concept of community participation was developed. Specifically, the paper has examined the role of the UN and WHO in the development of this concept.
Role of the UN and WHO in Development of Community Participation in Health Care
The UN has made a significant contribution towards the development of the concept of community participation in primary health. The United Nation considers democracy as one of its basic principle and value (United Nations, 2011). The UN believes links democracy with the freedom to express one self and to direct matters that have a direct impact on one’s life. The UN considers self-control as the foundation of a legitimate government. The UN has been proactive in promoting the establishment of democratic principles around the world. Some of the essential principle of democracy include; respect for human rights, freedom of expression, equity, transparency and accountability and many others. Encouraging community participation in governance and administration activities has been identified as one of the ways in which democratic principles can be reinforced within a particular society (United Nations. 2011). Taking power to the grass root people promotes human rights, freedom of expression, equality and accountability. It ensures that the majority of persons are able to sway resolutions that affect their lives.
The agenda of promoting the concept of community participation in primary health care, by the UN and WHO, become clear in 1978 (World Health Organization, 1978). The UN and WHO held an international conference in Alma-Ata in which the two organizations expresses the need to promote the health of the people. The conference led to several declarations. One of the declarations affirms that health is not merely absence of an illness but a state of social, physical and mental wellbeing (World Health Organization, 1978). This means that social and economic goals are essential to the realization of health.
The concept of primary healthcare identifies the relationship between health socioeconomic developments in society. It also recognizes that wellbeing does not only focus on the elimination of a disease but should focus on promoting habits that result in healthier lives. This concept recognizes the role of other elements such as the environmental, living condition, poverty and sanitation in shaping the state of health of a given population. The conference also declared the existence of health care inequality within the global society as unacceptable (World Health Organization, 1978). The fourth declaration indentifies the people rights, and duty to partake both collectively and individually in the setting up and implementation of healthcare (World Health Organization, 1978). According to this declaration, governments should support individual and community participation in the organization, control and operation of primary health care executive.
Ama-Ata declaration marked the conception of the principle of community participation in primary health care. After the declaration in 1978, various approaches for enhancing community participation in health care emerged (Vos, 2009). First was the medical approach. The medical approach is whereby medical professional worked with communities in order to reduced individual morbidity. It focused on efforts such as improving sanitation. Second was the health service approach. This approach entailed mobilization of local populations in order to encourage them to take part in the process of delivery of health services (Vos, 2009). Third was the community development approach. This approach sought to engage community in planning and implementation of activities that are directed towards enhancing the political, social and economic conditions of the community.
In the 21st century, the concept of community participation was reinforced by the growing prominence of the human rights perspective in health (Vos, 2009). Human perspective seeks to promote greater individual autonomy in matters concerning health. This principle suggests that humans are rational beings and are capable of acting in the best interest when they are given this opportunity. This argument reinforced the concept of community participation. Human right perspective also suggests that health is a basic right of individuals (Vos, 2009). This perspective emphasize on creation of setting where healthcare is accessible, transparent and fair. The human right framework also focuses on reinforcing the capacities of people and communities.The UN and WHO has played a significant role in the emergence and development of community participation in primary healthcare. Though the concept of community participation has been enhanced in the past decades, a few obstacles still remain, which are hindering the full realization of this principle (Vos, 2009). This barriers include; political tension, inadequate resources, huge social inequality within the society and many others.
Benefits of Community Participation
Equity
One of the benefits of promoting community participation in healthcare is that it promotes equity in terms of sharing of health care resources (Nicholls, 2000). Community generally refers to a group of individuals, who are joined together by common features or interests. Often, communities are tied together by geographical setting. However, there are numerous other elements that can be used to classify members of the society into communities. These elements include; ethnic group, gender, race, social and economic status among others. Gender can divide the society into the male and the female community.
Members of different communities have different needs and priorities when it comes to healthcare (Nicholls, 2000). Thus, taking a uniform approach to addressing healthcare problems might result in inequalities. Community involvement ensures that the interests of all communities within the society are represented when it comes to delivery of healthcare. Community participation ensures that communities engage in health care policy formulation as well as, in the planning process. Thus, local community members are able to point out areas that are of greatest interest to them.
Efficient Utilization of Resources
Community participation also brings about efficient utilization of resources. Efficient utilization of resources is realized by ensuring that health care resources are directed to priority areas (Nicholls, 2000). As already stated, different communities have different needs. While addressing life style disease may be a priority in one community other community may view the provision of amenities such as housing and water as the most urgent priority when it comes to promotion of wellbeing. Community participation also promotes efficient utilization of resources by fostering accountability. Community participation seeks to remove concentration power from a few individuals and redirect this power to members of the community. This introduces a system of “check and balance” when it comes to the utilization of healthcare resources.
Better Quality Services
Community participation also enhances the quality of health care services within the community by enabling provision of community sensitive care (Nicholls, 2000). Involving members of the community in healthcare delivery promotes the incorporation of community’s values and expectations into the care delivery process. This makes healthcare services highly appealing to members of the community. Community participation also improves quality of care by emphasizing on health promotion rather than curative care (Nicholls, 2000). Community participation recognizes that promotion of health is dependent on other sources besides delivery of care. It appreciates that there are wider determinants of health such as poverty, transport policy and the environment
Conclusion
Community participation in primary health care is a concept that promotes the involvement of members of the community in the planning and implementation of health care program. This concept emphasizes on a bottom up approach to the delivery of care and seeks to enhance individual freedom, equality and right to health. The UN and the WHO have played a significant role in the development of this concept. The two organizations were behind the declaration in Ama-Ata in 1978 that made community participation a basic principle in primary health care.
References
Nicholls V. (2000). The Role of community Involvement in Health Needs Assessment. November 3, 2012. http://www.nice.org.uk/nicemedia/documents/welcominglocal.pdf
United Nations (2012). Democracy and the United Nations. November 3, 2012. http://www.un.org/en/events/democracyday/pdf/presskit.pdf
Vos P. et al (2009). Health through People’s Empowerment, A Right Based Approach to Participation. November 3, 2012. http://www.hhrjournal.org/index.php/hhr/article/viewArticle/126/201
World Health Organization (1978). Primary Health Care. November 3, 2012. http://whqlibdoc.who.int/publications/9241800011.pdf
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