While the Consortium on ’Community Health Promotion’ is suggesting a definition of this new concept to qualify health practices, this article questions the relevance of introducing such a concept since no one has yet succeeded in really differentiating the three existing processes: public health, community health, and health promotion. Based on a literature review and an analysis of the range of practices, these three concepts can be distinguished in terms of their processes and their goals. Public health and community health share a common objective, to improve the health of the population. In order to achieve this objective, public health uses a technocratic process whereas community health uses a participatory one. Health promotion, on the other hand, aims to reduce social inequalities in health through an empowerment process, which is argued to be more effective.
Governance and participation in health
During a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza, northern Tanzania the researchers used participatory research tools to facilitate open dialogue and partnership between researchers and study participants. Participatory techniques were instrumental in promoting meaningful dialogue between the research team, study participants and community representatives in Mwanza, allowing researchers and community representatives to gain a shared understanding of project-related priority areas for intervention.
The provision of appropriate reproductive health care remains one of the main health care challenges in developing countries. The delivery of reproductive health services is continually confronted by challenges from the changing environment, as health sector reforms are implemented, and particularly by decentralisation.
Are reproductive health and HIV prevention outcomes for young people better when a project makes an explicit effort to involve community members? This briefing paper summarises the findings of a range of studies that have sought to investigate this question. Most evaluations reviewed identify positive effects including empowerment of participants, increased sustainability, greater acceptance of the initiative, and improved knowledge and attitudes. However, while studies that compared programmes that involved communities with standard programmes found these positive effects, some noted little or no differences in young people’s behaviour. The paper also provides references and links to resources on community involvement and youth reproductive health and HIV prevention.
Care of the mentally ill in Botswana is provided at different levels of coverage and sophistication. There is a single mental hospital in the country. Attached to the district hospitals are psychiatric outpatient clinics run by psychiatric nurses and a psychiatrist who visits them on monthly basis. Mental health care in Botswana has gone through a paradigm shift, from the prepenal years, penal years and institutional to community based care, which reflects a philosophy of citizen involvement and collaboration. The purpose of this article is to provide an insight into the developmental trends in community mental health care in Botswana. Different approaches are discussed and the opportunities that have emanated from them.
Severe acute malnutrition remains a major killer of children under five years of age. Until recently, treatment has been restricted to facility based approaches, greatly limiting its coverage and impact. New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.
This paper in Globalisation and Health assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN. Responding to the global burden of chronic disease requires an assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level. The paper assesses the merits of the Millennium Development Goals and the WHO framework Convention on Tobacco Control (FCTC), and considers that lessons might be learned for enhancing the implementation of the Global Strategy on Diet.
Capacity strengthening of rural communities, and the actors that support them, is needed to enable them to lead their own malaria control programmes. The existing capacity of a rural community in western Kenya was evaluated in preparation for a larger intervention. The study shows that culturally sensitive but evidence-based education interventions, utilising participatory tools, are urgently required which consider traditional beliefs and enable understanding of causal connections between mosquito ecology, parasite transmission and the diagnosis, treatment and prevention of disease.
This paper presents findings from a survey of a section of Tanzanian NGOs on their perceptions of their relationships with the government and donors, and their views on their roles and impacts on poverty reduction and development. Key findings of the study indicate that the relationship between NGOs and the government of Tanzania is expanding and improving, characterised by increased communication, interaction and trust. NGOs' relations with donors are seen by respondents as cordial and smooth, but with further probing, numerous frustrations were evident. NGOs view donors as more powerful than the government and the government often sees civil society as a competitor for resources. Despite many barriers, most NGOs felt their organisations have a largely positive impact on policy.
President of the Conference of NGOs in Consultative Relationship with the United Nations (CONGO) Renate Bloem said that without the active engagement of civil society organizations (CSOs) the chances of African countries to meet the Millennium Development Goals (MDGs) is minimal. Addressing the African Civil Society Forum 2007 held at the United Nations Conference Centre under the theme "Democratizing Governance at Regional and Global Level to meet the Millennium Development Goals" yesterday, she said that civil societies need to give their unconditional support to sustainable development with a view to exerting maximum effort to achieve MDGs by 2015.