complete Summary on community participation 4 health student

 

complete Summary on community participation

     It is the process by which individuals and families assume responsibilities for their own health and welfare and for those of the community and develop the capacity to contribute to their and the community’s development-------WHO.

·          In conclusion,--It is the process in which the people of the community actively participate in the making of plans and policy, decision making, implementation, evaluation, and other various aspects for the betterment of their health and development.

Objectives of community participation

·     *To make people aware of community participation’s importance with respect to health facilities so that they are energetic for change.

·     *To participate in the community people to identify and understand the nature of health-related problems.

·     *To enable the community people to become self-dependent.

·     *To develop the capacity to identify and implement the new development activities with great enthusiasm.

·     *To enable the people of the community to utilize the locally available resources.

·     *To create interest within the people of the community to solve or decreased health-related problems.

·     *To enable the community people to overcome obstacles against community participation in health matters and others.

·     *To make people aware of the potential hidden inside them.

Advantages of community participation

1.       * It is a cost-effective method for providing health services to people.

2.       *Greater commitments of people to the success of health programs.

3.       *Health awareness becomes an integral part of the community.

4.       *Community makes extra resources available.

5.       *Less dependence on the government.

6.       *Results of health measures are more durable.

7.       *Health workers get greater support from the people for their activities.

8.       *People become more self-reliant in their ability to prevent diseases and promote positive health.

9.       *Health planning is done at most peripheral and grass-roots levels.

Levels of community participation

·         First level of community participation  

1.    1. Compliance or force:-It is an unwilling or unwanted change brought by force. Enforcement of the law, creating a situation of fear, and providing incentives and a punishment system is the example.

2. 2. Collaboration—It means working with the community together by a good relationship with community members. There will be good coordination and co-operation among the community people. Collaboration is one of the important parts to promote community participation.

3.    3. Local control(community empowerment)-This process challenges the existing power structure as well as demands to re-distribute power in order to build the minimal, if not equal, economic base for previously excluded groups. All the development activities are seen by local people. This level of participation remains long-lasting to occur sustainable and positive results in the public health field.

------  Empowerment refers to enabling people to understand the reality of their environment, reflect on the factors sharing that environment, and take steps to effect changes to improve the situation. It is a process that surrounds people deciding where they are now, where they want to go, and developing and implementing plans to reach their goals, based on self-reliance and sharing of power.

------  Hence, community empowerment is able to: a. define their needs, problems, and issues.b.develop plans and strategies to meet these needs, and implement such plans to recap the benefits and accept the outcomes rationally including hiring-firing  and supervision of health post

·         Second level of community participation

1.     1. The lowest level

2.   2. The mid-level

3.   3. The highest level

·         Third level of community participation

1.      1.  Marginal

2.      2. Substantial

3.      3. Structural          

M   Methods  of improving community participation

1.       1. By helping them to solve their health problems by themselves

2.     2. By assessing their health needs

3.     3. By taking responsibility for mobilizing local resources

4.     4. By suggesting new approaches and solutions to solve their problems

5.     5. By creating and maintaining the local organization

6.     6. By administrating and financing health services

7.     7. By supporting other health-related activities

·         Marginal participation:-In this, the participation of community people has a small direct effect on the result of the development activity. In this, the health post staff take the trouble to explain what services are available at what times .so, people are informed and can come to take the facilities. Since it costs a great deal to provide health services, it is a big waste of money if people do not come to the health facility. In more community development programs where plans and objectives are set beforehand, the people of the community gain only a marginal effect on performance.

·         Substantive participation:-In this, the people of the community are busily involved in recognizing their needs, and deciding priorities in carrying out health-related activities although the mechanism for these activities is extrinsically controlled. This is the higher level of community participation in which the community members take part actively in assessing local needs, planning, implementing, and evaluating the result of health activities.

--This type of participation also helps in the mobilization of the locally available internal resources. It is the means by which many community development programs obtain their objectives, but there is proof that the substance of the participation is fixed to the advantage of the project activities.

·         Structural participation:---It is community participation which means that the local people completely own and manage their health post and its activities including hiring, supervising, and firing staff. In this case, participation is an essential element of the project and the idealistic basis for all project activities.

--In this participation, people of the community play a dynamic and direct part in the development process and have the power to make sure that their views are noted. The community understands its real needs for health and development and hence participates more actively

--This type of participation is community-oriented in which a partnership is established between the government and non-government agencies for better planning and utilization of health services.

--This provides social control to the people over the health infrastructures and technologies used for PHC.

SOME OTHER METHODS OF PARTICIPATION

a. Spontaneous participation—It is based on local –initiatives that have small or no extrinsic support and which from the very beginning have the ability to be self–dependent.

b. Induced participation—It is the common form of participation that results from extrinsic initiatives searching for support or endorsement for extrinsic plans or projects.

c. Compulsory participation—It is referred to people who are mobilized or organized willy-nilly (willing or unwillingly) to undertake activities in which they have had no say and over which they have no control.

CLASSIFIED ON THE BASIS OF OBJECTIVES

a. Co-operative seeking participation—

b. Power–sharing participation—It is an intrinsically higher form of participation where the people of the community are allowed a share informal power, varying from the right to impose temporary or permanent bans to the right to participate directly in decision–making.

Both forms involve interaction between the decision-makers and those affected by the decisions.

Health services Delivery &Utilization Phases

a. Participation in the resources identification phase.

b. Participation in health needs identification phase.

c. Participation in the health planning program phase.

d. Participation in the program implementation phase.

e. Participation in program monitoring and assessment phase.

Health needs in the community

1. Felt needs—Felt needs are those health needs that are realized or felt by community people. These types of needs are felt only by community people. Felt needs are those health or developmental needs that the community people think are needed in their community for the development of their health,socio-economy, or any other sector.

--Felt needs are those needs that people think and feel the need, with respect to solving health or health-related problems. If community people do not understand their health problems then health workers should suggest and motivate them to feel their actual health need. Felt needs are not always the real needs. It may be different from the real needs. Felt need is changed into real need after approval by the health specialist.

--For example, Community people thought that pure drinking water is needed for them to be prevented water-borne diseases by which they are suffering, then it is a felt need.

2. Observed  Health Needs—It is the second step of health needs. Those health needs are observed scientifically by experts and prescribed for the improvement in health or health-related events. In a felt need community, people understand and feel themselves and demand their needs. If that need is observed scientifically and approved by health experts then that need will be changed into an observed health need.

--For example, if community people are suffering from problems with safe drinking water felt by they is felt needed. If  this need is observed  and approved by  a health worker then that need is observed the need

--Observed health needs are those health or developmental  needs that are scientifically  seen to be needed in order to solve community health  or health-related problems and hence to improve the health status  of community people

--All felt needs can’t be observed needs and also observed health needs can not be the solution to health problems.

3. Real  Health Needs---Those health needs which are felt by everybody i.e. community people, health personnel, and government service sectors. If a need felt by our study is also approved by the community and by a joint effort, it is identified to be a health problem to be prioritized with the involvement of the community then it is known to be a real health need.

--For example, if a need for a health post in a rural area is felt by a health specialist, community, and the government due to the unavailability of health services in that area, then that is a real health need.

PRINCIPLE OF HEALTH NEED ASSESSMENT

1.      * Community people feel and demand health-related needs to solve health problems or health events.

2.      * The demand of community people is/are re-analyzed and observed scientifically and proved by health experts or government sector service providers.

3.     * Coordination is established between community people or leaders and government service providers about their demands and is tried to fulfill.

4.     *  Government service providers fulfill that need if they feel the demand to be a real need

  tag-

definition of community participation*objective, advantage, and level of community participation* type of health needs in the community* principle of health need assessment* Marginal, Substantial, Structural type of community participation*felt needs, observed needs, real needs*

CONCLUSION: I hope that the above information will be beneficial for all health students.If any queries then comment to me at sarojnepal2059@gmail.com