TY - JOUR
T1 - Chasing the dragon
T2 - Developing indicators for the assessment of community participation in health programmes
AU - Draper, Alizon Katharine
AU - Hewitt, Gillian
AU - Rifkin, Susan
N1 - Funding Information:
The authors would like thank Phil Harvey at A2Z for commissioning the original study that led to the paper. The study that this article is based upon was made possible through United States Agency for International Development (USAID) through A2Z: the USAID Micronutrient and Child Blindness Project managed by the Academy for Educational Development under the terms of Cooperative Agreement No. GHS-A-00-05-00012-00. The contents are our sole responsibility and do not necessarily reflect the views of USAID or the United States Government. For their help in the preparation of the manuscript we would also like to thank Madeleine Green for her invaluable assistance, Pat Pridmore, Pierre Lefevre and the reviewers for their critical comments, which were all of immense help to us.
Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/9
Y1 - 2010/9
N2 - Community participation was identified as one of the key components of Primary Health Care as articulated in the Alma Ata declaration of 1978 and is enjoying a renewal of interest in both low and high income countries. There remains, however, an on-going challenge in how to assess its role in achieving health improvements. This is largely due to the multiplicity of definitions of community participation, which has made it difficult to evaluate its impact on desired programme outcomes, such as uptake and sustainability, as well as broader health improvements. This paper addresses this challenge by first defining a continuum of community participation that captures its many forms, and then incorporates this into an evaluation framework that enables an analysis of the process of participation and links this with health and programme outcomes. The continuum of participation and framework is based upon the spidergram of Rifkin, Muller, and Bichmann (1988), but modified in the light of the growing literature on community participation and also in relation to our original requirements to evaluate the role of community participation in nutrition-related child survival programmes. A case-study is presented to provide a worked example of the evaluation framework and its utility in the evaluation of community participation. While this is a literature-based and retrospective analysis, it demonstrates how the evaluation tool enables a nuanced analysis of the different ways in which communities can participate in the delivery of health-related interventions. It could be used prospectively by those involved in programme design and implementation to further our understanding of community participation and its relationship with health outcomes, as well as key programme outcomes, such as sustainability.
AB - Community participation was identified as one of the key components of Primary Health Care as articulated in the Alma Ata declaration of 1978 and is enjoying a renewal of interest in both low and high income countries. There remains, however, an on-going challenge in how to assess its role in achieving health improvements. This is largely due to the multiplicity of definitions of community participation, which has made it difficult to evaluate its impact on desired programme outcomes, such as uptake and sustainability, as well as broader health improvements. This paper addresses this challenge by first defining a continuum of community participation that captures its many forms, and then incorporates this into an evaluation framework that enables an analysis of the process of participation and links this with health and programme outcomes. The continuum of participation and framework is based upon the spidergram of Rifkin, Muller, and Bichmann (1988), but modified in the light of the growing literature on community participation and also in relation to our original requirements to evaluate the role of community participation in nutrition-related child survival programmes. A case-study is presented to provide a worked example of the evaluation framework and its utility in the evaluation of community participation. While this is a literature-based and retrospective analysis, it demonstrates how the evaluation tool enables a nuanced analysis of the different ways in which communities can participate in the delivery of health-related interventions. It could be used prospectively by those involved in programme design and implementation to further our understanding of community participation and its relationship with health outcomes, as well as key programme outcomes, such as sustainability.
KW - Child survival programmes
KW - Community
KW - Evaluation
KW - Micronutrient programmes
KW - Participation
KW - Primary health care
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U2 - 10.1016/j.socscimed.2010.05.016
DO - 10.1016/j.socscimed.2010.05.016
M3 - Article
C2 - 20621405
AN - SCOPUS:77955569572
SN - 0277-9536
VL - 71
SP - 1102
EP - 1109
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 6
ER -