COMMUNITY PARTICIPATION

OBJECTIVES
• At the end of this lesson, the leaner’s shall be
able to:-
• Define a community
• Define community participation
• Discuss the aims of community participation
• Discuss the differences between community
participation and involvement
• Determine the community participation process
• Identify factors that influence community
participation
 WHAT’S A COMMUNITY?
• It is a social entity made of people or families
who have the following characteristics:
• Live in the same geographical area
• Share common goals or problems
• Share similar development aspirations
• Have similar interests or social network or
relationship at local level
• Have a common leadership and tradition
• Have common system of communication
• Share some resources-water, school, etc
• Are sociologically and psychologically linked.
 COMMUNITY PARTICIPATION
• DEFINE
• A process by which a community mobilizes its
resources, initiates and takes responsibility for its
own development activities and share in decision
making for and implementation of all other
development programmes for the overall
improvement of its health status.
• The key to the successful organization of PHC is
community participation, through the process,
the people gain greater control over the social,
political, and economic and environmental
factors determining their health.
AIMS OF COMMUNITY PARTICIPATION

• The community develops self-reliance

• The community develops critical awareness
• The community develops problem solving
skills
• TYPES OF PARTICIPATION
• Passive – (Manipulation)
• Active – (consultation)
• Involvement – (Community control)
• PASSIVE PARTICIPATION
• In this type of participation, individuals or
families are mere spectators
 ACTIVE PARTICIPATION

• In this type of participation, they may be

carrying out some tasks in a programme but
are not involved with the final decision
making in what is to be done. The final
decision in such cases are made by people
who are not members of the community in
such situations, the community does not
develop a sense of self-reliance.
 COMMUNITY PARTICIPATION AND
INVOLVEMENT
• In this type of participation, the community is
involved in all aspect of a programme. This type
of approach enables the community to
participate willingly to improve its own health
status.It is important for a community to
participate in every stage of the health
programme for it to have long lasting results i.e.,
thinking, planning, acting and evaluating.
• Community participation and involvement
empowers or enables the community to make
informed decisions in matters affecting their
health or development
 INVOLVEMENT
• This entails involving the community in planning,
implemention,management and evaluation of
programmes.
• This is important because, it contributes towards a
feeling of responsibility and involvement in such a
programme. In other wards we could refer to the
process as that by which active partnership is
established between a developmental programme
within the community and the community itself. Thus
community participation and involvement contributes
to the attainment of community responsibility and
accountability over all development programmes.
Therefore preventing a community from alienating
itself from such a programme. The community
develops self-reliance and social control over its own
infrastructure.
• DIMENSIONS OF COMMUNITY
PARTICIPATION
• Community participations has three
dimensions;
• Involvement of all those affected in decision
making about what should be done and how
• Mass contribution to the development efforts
i.e to the implementation of decision
• Sharing in the benefits of the programme
(World Bank, 1978).
• COMMUNITY PARTICIPATION IN DIFFERENT
SITUATIONS
• Top-down – approach
• Bottom-up – approach
• TOP-DOWN – APPROACH
• IN traditional approach health care planning ,
the decisions are made by senior persons in
health services, the so called “experts”.
Research may be carried out through surveys
to what the community thinks or believes to
be the problem, but in the end it’s usually the
health workers who makes the decisions on
what goes into the programme based on
medically-defined needs.
• Traditional education is often indoctrinating
.We make decisions and expect them to
follow. This is always the case and you will
need to look carefully to findout what is really
going on. All the decision-making and
priorities are set by the external agency.
• BOTTOM-UP – APPROACH
• In this approach members of the community
make decisions.
• FACTORS WHICH INFLUENCE THE DEGREE OF
COMMUNITY PARTICIPATION POSITIVELY
• Relevance and accountability
• Education status of the community
• Community infrastructure (including
communication network)
• Economic factors
• Social and cultural factors
• The level of intersectoral collaboration
• Suppression of involvement and initiative by
projects which create dependency
• Political stability
• Good leadership
• Motivated community
• A sense of ownership
• Locally available resources
• THE PARTICIPATORY METHODS USED IN
RAPID ASSESSMENT OF SITUATIONS
• Daily routine schedule
• Seasonal calendar
• Time trends
• Direct observation
• Transect walk
• Venn diagram
• Key informants interviews of individuals from
the community
• Focus group discussion (FGD)
BENEFITS FROM COMMUNITY PARTICIPATION

• Justification for community participation come

from a variety of sources, including lessons
learned from the failures of conventional top-
down planning as well as the achievement of
community based programmes.
THE NEED FOR A COMMUNITY APPROACH
• The need to shift the emphasis from the
individual to the community. This is because
many influences on a behavior are at the
community level and not under the control of
individuals, these include;

• Social pressure from other people through

norms,
• Shared culture and the local social economic
situation.
• Even when the influences are at the national
level, it is often through pressure from
communities that governments will change.
Furthermore government budgetary resources
can be complemented by the efforts which
can be made within local communities, but
they go well beyond this.
DRAWING ON LOCAL KNOWLEDGE

• Communities often have detailed

knowledge about their surroundings. It
makes sense to involve communities in
making plans because they know local
conditions and the possibilities for
change
MAKING PROGRAMMES LOCALLY RELEVANT
AND ACCEPTABLE
• If the community is involved in choosing
priorities and deciding on plans, it is much
more likely to become involved in the
programme and take up the services.
DEVELOPING SELF-RELIANCE, SELF
CONFIDENCE, EMPOWERMENT AND
PROBLEM – SOLVING SKILLS.
• The enthusiasm that comes from community
participation can lead to a greater sense of
self-reliance for the future e.g. communities
are usually willing to participate in water a
programme because they see that benefits
will come. The feeling of community solidarity
and self-reliance from participating in
decisions over, their own future through a
water project can lead to future activities.
• BETTER RELATIONSHIP BETWEEN HEALTH
WORKERS AND COMMUNITY
• Community participation leads to a better
relationship between the community and the
health workers instead of a servant master
relationship, there is trust and partnership.
PRIMARY HEALTH CARE
• The Alma-Ata declaration on PHC in
1978extended the notion of appropriate
health care beyond that of simply providing
decentralized services, it also considered the
need to tackle economic and social causes of
ill-health.
• Health education and community
participation are essential ingredients of PHC
(WHO).
• TYPES OF COMMUNITY GROUPS
• SELF-HELP GROUPS
• Run by people for their own benefits e.g. co-
operatives, church saccos etc
PRESSURE GROUPS
• A group of self-appointed citizens taking
action on what they see to be the interests of
the whole community putting on pressure to
improve the school, get garbage collected, do
something about a dangerous road etc.
TRADITIONAL ORGANIZATIONS

• E.g Njuri Njeke in (Meru), these are well

established groups, usually meeting the needs
of a particular section of the community,
others rotary, club, mothers union parent-
teacher associations, and church groups.
WELFARE GROUPS

• Exist to improve the welfare of a group; merry

go round, feeding programmes etc.