For almost 30 years, since the 1978 Declaration of Alma-Ata, people’s participation in and contribution to health systems has been recognized as central for primary health care and accepted as an essential element of many public health interventions. The health reforms of the 1990s have given less attention to community participation and social values, focusing more on technical, economic and management factors in health systems. Initiatives taken up by civil society to address the HIV epidemic have been a remarkable exception to this situation.
The challenges posed by major epidemics, such as HIV, tuberculosis and malaria, and the role civil society has played in helping individuals and families to cope with them, have certainly contributed to making people, including health policy-makers, more aware of some limitations of the health services (public and private), particularly in terms of inequality in coverage and access for people with the lowest income or living in remote areas.
You are viewing: Which Action Is Part Of Becoming Involved In Community Health
The mere existence of services in a certain administrative area does not prove that they are used or used correctly. Services have to be accessible to be used. This implies organizing a supply of care that is geographically, financially and culturally accessible.
The literature provides abundant evidence about the benefits and possible limitations of greater involvement of communities and civil society organizations in various functions traditionally held by health systems.
More active promotion of the participation of people with TB and the community in aspects of TB control, recommended by WHO and now included in the new Stop TB Strategy, has highlighted opportunities for links to other community-based initiatives, including those promoted by patients’ groups and TB activists. But it has also confirmed an urgent need for greater clarity about the terms and definitions used to describe people’s contributions to the health system.
For three decades, “community-based health care programmes” have used concepts and terms drawn from the literature on primary health care and health for all, from the United Nations Universal Declaration of Human Rights and from the domain of social justice. Concomitantly, similar civil society organizations that have played a paramount role in supporting people living with HIV and in advocating for their rights have used similar terms, sometimes with different meanings.
A common understanding of terms and issues is, therefore, essential not only to express the richness of experience that immediately becomes apparent in studying the good practices described in this publication but also to encourage collaborative actions with existing initiatives.
WHO defines health as a fundamental human right and a social goal the attainment of which requires a concerted action by the health sector and all the other sectors of society. Health is also a social achievement or goal. Social goals, such as improving the quality of life and health status, are achieved through social means, including communities and individual people accepting greater responsibility for health and actively participating in attaining them.
At the core of the right to health is the dignity of each and every person. The recognition of the dignity of every man and woman provides the most important reason for planning and implementing patient-centred services. Social services (of which health services are an important component) can contribute to safeguarding and promoting human dignity, addressing persistent situations of serious disparity and inequality.
The commitment to ensuring universal access to essential health care is, therefore, not only central to the social and economic development of a community but also an important aspect of social justice; the fundamental principles of social justice (see section 2) should inform how health care is planned and delivered.
Read more : Which Ivy League Is Best For Me
The first and fundamental community to which most people naturally belong is the family. Family members, and women in particular, are often the main providers of health care and have a fundamental role in health promotion.
The review of community participation in TB control highlighted that a sphere of close friends and neighbours plays an important role in every person’s daily life and acts as an immediate point of reference for help and advice.
A community consists of people living together in some form of social organization and cohesion. Although it may vary significantly in size and socioeconomic profile, its members usually share social, cultural, economic characteristics as well as common interests, including health.
Health can also therefore be defined as part of the common good (see the principles of social justice in Section 2), and all people therefore have the right and duty to participate individually and as a community in the process for improving and maintaining their health. Further, achieving improved health status is linked with and helps the promotion of development in general.
The term “community involvement” is generally preferred to “participation” and points to the idea of partnership and shared responsibility with health services rather than to the notion of using the community to reduce the burden on the health services. For example, involving people with TB and their communities in providing care and then failing to provide high-quality services in terms of diagnosis, drugs and follow-up would damage rather than improve any health initiative. If health services commit to delivering high-quality support but face constraints and if people and families then assume greater responsibility for the community’s health, the strain on the health services will be mitigated. Promoting involvement is much more than simply proposing participation in services planned and designed from the outside. People with TB and their communities should be an active part of the entire process from the very start of the intervention design, contributing to defining health problems and needs, to developing solutions and to implementing and evaluating health interventions.
Building an operational partnership with the community, with the goal of improving the health status of the population, is a step beyond participation and involvement. In a partnership, the institution that has the mandate to provide health and social services to address the essential needs of the population intervenes through its normative role and professional expertise to support the community in its own endeavour to achieve better health status. Essential to the creation of a formal or informal partnership is clearly defining the roles and responsibilities of all partners: what each partner can contribute, because of its specificity, to the common goal. Each partner, alone, may not be able to achieve the goal without the synergistic contribution of the other. The establishment of partnerships between the institution and the society requires that people empower themselves to be able to assume such responsibility.
The word “empowerment” has been increasingly used, over the last decade, in international development policy and in strategies for alleviating poverty, but its meaning often lacks clarity. Many different definitions have in common the notion of people who share the opportunities and responsibilities for action in the interest of their own health or of other issues important for their life; supporting such an active role of the society often requires education, adequate information, technical support and ensuring decision-making possibilities. Taking empowerment seriously requires a clear vision, in terms of a social justice approach, and practical strategies. Measuring empowerment in practice is challenging, but local stakeholders can agree on some key indicators, such as the actual involvement in the process of planning and evaluation.
People can undertake health promotion, preventive measures and action to support care in their own homes and communities. Communities, by sharing responsibilities with the health system, may often suggest an approach to these interventions that is more adequate for the local context.
A fundamental principle of primary health care states that everyone in the community should have access to it and everyone should be involved in it. Having access indicates the potential to use a service if it is needed. The proof of access is the use of the service rather than a simple existence of a facility. There may be personal, organizational and/or financial barriers to using the service; such barriers reflect actual or perceived obstacles to access. Adequate communication, social mobilization, access to information and education help communities and civil society organizations to assume responsibility for their health and enhance their ability to address their own health problems.
A society is made up of individual people, families and communities. Families and local communities that are given information about health and have reliable health services will usually act in their best interests. Health initiatives will be most effective and efficient when they connect directly with community structures and consider people’s interest and commitment in dealing with problems.
Read more : Which Of The Following Is An Advantage Of E-commerce
Civil society is usually defined as the social environment that exists between the state or institutional level and the individual person or family. It does not have the coercive and regulatory power of the state but provides the social power or influence of the general population.
All institutions and organizations outside of government can be defined as civil society. In the context of welfare, this includes: consumer organizations, nongovernmental organizations and community-based organizations, faith-based organizations delivering welfare services, patients’ and activists’ groups, etc.
Individuals and communities may organize themselves to pursue their collective interest and engage in activities of public utility. Civil society organizations may originate from the community, neighbourhood, working environment or any other social context beyond the immediate family, to collectively relate to the state, or lower institution. The role of civil society organizations is increasingly becoming more prominent thanks to a renewed public awareness and concern for the right to participate in policies and processes that affect people’s lives. The organization of national and global networks is providing valuable support to local civil society organizations that, nevertheless, remain important collaborators and counterparts of political leaders and administrators since they are rooted in and responsive to the local population they serve rather than to the agencies that may fund them.
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence the determinants of health as well as direct health-improving activities. A health system is therefore more than a pyramid of publicly owned facilities that deliver personal health services. It includes parents caring for a sick child at home; private providers; behaviour change programmes; public health campaigns; and health insurance organizations.
The health system is responsible for ensuring high-quality accessible health services, for providing clear information and advice on the benefits of health to the community and for facilitating its early involvement in assessing the situation, defining the problem and managing the action.
A partnership for health between the government or an institution and the community is based on the commitment of both actors to actively collaborate to support the quality of health services or to make public health programmes more effective. This formal or informal collaboration can only be established if political leaders and administrators take on a specific commitment to social development and if the society is ready to assume its responsibility. Political commitment is confirmed by a decision to provide human and financial resources and by the determination to start a dialogue with the society at the level where problems occur. This allows communities to contribute and shape a practical response to their problems and needs. When a partnership is successful, the health services maintain all their technical and professional responsibilities, but they also effectively support what the community, which is directly affected by a health problem, can do through its own efforts. It is a basic shift from a hierarchical relationship to recognizing and respecting the role of communities in health and development.
Health personnel are people who have undergone a formal health or public health training, such as doctors, nurses and public health workers; they are part of and in a continuous dialogue with the community. Their training as health service providers should be complemented with education in essential communication and social mobilization skills to prepare them for dialogue and collaboration with their communities.
The private health sector plays an important role, complementary to public institutions, through the services of private practitioners, pharmacists, traditional healers, etc. Public-private partnerships provide an opportunity to establish and recognize the collaboration of the private health sector with services of public utility and can foster respecting basic standards of service delivery.
Community health workers are generally people with a basic education who are given elementary training to contribute to some specific health activities (short practical training on a specific task). Their profile, role and responsibilities vary greatly between countries and often between communities. Their work, which may take several of their working hours every day, is often supported through incentives in kind or in cash provided by the community they serve or by the health services.
Community volunteers are community members who have been sensitized about a specific and often time-bound service required to benefit their family or wider community and provide their time and energies to render such service without any monetary compensation. Voluntary work is not just a matter of personal generosity but, often, of clearly understanding the benefits that come to one’s family or community. Volunteers are usually motivated for being useful to their communities: they recognize the need to do something and are proud of helping others.
The work and services rendered by community health workers and community volunteers actualize their full potential in the presence of effective support from the health system and of the possibility of a two-way referral between health facilities or public health services and the community. Such referral systems require a regular link – often provided by public health workers with community leaders – between the health system and the community, which must be simple, effective and easily accessible to both actors.
Source: https://t-tees.com
Category: WHICH
