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What is Participation?
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Susan B Rifkin
London School of Hygiene and Tropical Medicine
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CHAPTER 3
What is
Participation?
Susan B. Rifkin, Maria Kangere.
SUMMARY
This chapter presents arguments as to why participation is important
for improving life situations, particularly for the poor and disadvantaged,
including people with disabilities and their families. It begins by noting
that the contribution of participation to health development is not easily
agreed upon. It then, outlines the reasons for participation in health
development and how this has affected the development of community
based rehabilitation programmes. Ways of defining and assessing
community participation are discussed. The penultimate section
identifies critical issues that must be addressed in considering
participation as a basis for CBR programme planning, giving examples
from the Ugandan context. The conclusion points to the complexity and
challenges that participation presents, for planners and managers of
community based health and disability programmes.
INTRODUCTION
There is no agreement among planners and professionals about the
contribution of community participation to improving the lives of people,
particularly the poor and disadvantaged. Some completely dismiss its
value altogether, while others believe that it is the ‘magic bullet’, that
will ensure improvements especially in the context of poverty alleviation.
Despite this lack of agreement, community participation has continued
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WHAT IS PARTICIPATION?
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CBR A PARTICIPATORY STRATEGY IN AFRICA
Information sharing—consultation—collaboration—empowerment
ASSESSING PARTICIPATION
If there is no agreement about how to define participation, there is a
growing understanding among professionals and planners at least, that
participation is best seen as a process, rather than an outcome of an
intervention. This does, however, pose questions about how to assess
the process in order to assess programme achievements.
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WHAT IS PARTICIPATION?
Needs Assessment
Leadership
Management
5 4 3 2 1
Organisation
Resource
Mobilisation
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WHAT IS PARTICIPATION?
CONCLUSION
In conclusion, to answer the question—what is participation? We
can say it is a complex and challenging approach to improving the
lives of all people, but particularly the poor and disadvantaged.
We can also say that viewing participation as an intervention to
achieve this goal, has produced disappointing results and suggests
that viewing participation as a product, raises expectations that
experience shows cannot be met. For those addressing issues of
disability and community-based rehabilitation, there are lessons
to be learnt from the health experience, which can influence the
development of service strategies for people with disabilities. It
is important to critically examine these experiences and distil the
important points. But it is more important to keep an open mind
and be flexible. This includes examining our own assumptions
about what works, and developing attitudes and behaviours that
support intended beneficiaries, in their search to gain control over
their own lives.
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HELANDER, E., MENDIS, P., NELSON, G. & GOERDT, A. (1989).
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LANG, R. (1999). Empowerment and CBR?: Issues raised by the South
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from action in the majority world. The Disability Press.
LANG, R. (2000). The role of NGO’S in the process of empowerment
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MITCHELL, R. (1999). The research base of community based
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NUNZI, E. (ed) (1996). Health Cooperation Papers. Proceedings of a
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OAKLEY, P. (1989), Community Involvement in Health Development.
Geneva: WHO.
O’TOOLE, B. (1996). Evaluation Report of CBR services in Uganda.
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RIFKIN, S.B. (1985). Health Planning and Community Participation:
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RIFKIN, S.B., MULLER, F. & BICHMANN, W. (1988). Primary health
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RIFKIN, S.B. (1990). Community participation in MCH/FP
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