Community Participation in Health Promotion: A Practical Approach
Community Participation in Health Promotion
The promotion of health, understood as a process that aims to empower individuals and communities to act on the determinants of health, requires the involvement of people and organizations that will be affected by policies, programs, or activities that may arise. Participation is thus one of the fundamental principles, while working method to promote health. The concept of community participation has become fashionable since it emerged in the health strategies of the WHO and various policy documents that have been developed in recent years in all countries, regions, and cities. However, when an idea is so attractive and it is spreading rapidly, there is a risk that the word, being so used, as a concept loses its value. One way to avoid this is to define it and use it properly.
Participate: Latin takes part, to take part. The dictionary of the RAE is defined as taking a part in something.
By community means that group of people who share the same geographical space and have certain interests and common bonds.
If we combine both concepts, community participation is configured as a social process in which specific groups, which have shared needs and living in a defined geographical area, actively identify their needs, make decisions and establish mechanisms to achieve satisfying.
When effective participation, we must know and consider the structural elements that make up the statement: the territory, the demand (the problems that the community expresses), resources, and population. Thus, while the community needs are the starting point for undertaking participatory action, the structural elements of this are set as the key intervention process, since they provide the image of the situation of the community which planned actions.
Players of Participation
People who work as professionals. They are suppliers of resources that will be offered to the community. Their involvement in community participation means that they will have to reorient their work in ways that facilitate the incorporation of individuals, groups, organizations, and social sectors related to the actions carried out.
Persons responsible for health policy and service planning and management. Would have to provide from its scope of participation through laws and regulations, and the redirection of services in terms of structures, functions, and working methods.
Citizens. Shall participate in any proceedings in which they are involved, either individually or through groups or associations.
At the time of its implementation, it is necessary to take a series of decisions about who participates and how to organize the process.
Benefits of Participation
The participation of people in proceedings that affect their health is a right in itself, and exercise is the first benefit. Community involvement also has positive effects on:
- Coverage: Participation provides greater support for health programs and services by the population, which increases the number of potential beneficiaries.
- Efficiency: Community participation in planning, monitoring, and evaluation of actions facilitates the coordination and better utilization of resources.
- Effectiveness: Agree jointly identify priorities and goals, objectives, and action strategies to strengthen the knowledge, skills, and resources.
- Equity: Participation in development projects can provide better access to services and health information of individuals or groups with specific problems or risks.
Styles of Participation
Response to two aspects of its implementation in practice: how and how much is involved.
According to how participation can specify the form of:
- Contribution: When is a contribution by the community of material resources or volunteer labor.
- Organization: When the effort is focused on creating structures to engage the community.
- Community empowerment: When the emphasis is on community development for it to be autonomous in the effective management of development and in solving their problems.
According to how much, you can set different levels:
- Total absence of participation.
- Full control over the process by the community.
- Intermediate situations: handling, consultation, delegation of power, information, and collaboration.
In the programs of health promotion, the protagonists of participatory action are usually the technicians and the population.
Levels of Community Participation
Table 7.1. Levels of community participation in terms of the roles of technicians and people in the direction and control of the process of program planning and health actions
| Degree | Role of Technicians | Role of the Population |
|---|---|---|
| 1 | Control and direct wholly | Passive / Not heard |
| 2 | Owned or managed jointly | Is heard / Answer questions / Choose between alternatives offered / Is involved in a timely manner |
| 3 | Controlled openly | Is heard / Answer questions / Decide together / Is involved in all |
| 4 | Target facilitate and negotiate openly | Controls and directs |