A critical examination of the many conceptual and practical issues that need to be understood before the concept of community involvement in health development can move from theory into practice. Noting the widespread conviction that successful development requires community participation, the book challenges readers to consider why the concept has so very rarely been translated into a fundamental principle of formal health care. Throughout the book, examples of experiences in different countries are used to show how community involvement, when properly understood, planned, and implemented, can work to accelerate health development. The book opens with an historical overview of changing theories of the development process that led to the view that participatory development is the most reliable route to better health for all. Readers are also given a list of the main reasons why previous development strategies, linked to the notion of community involvement, met with so little success. The main part of the book is devoted to a step-by-step analysis of practical problems that are likely to arise when a health service seeks to enlist community support as a fundamental principle of its health development activities. Points covered include characteristics of communities that can influence their successful involvement in health activities, the impact of different support mechanisms at both national and local levels, and the sweeping changes in health service training required when the commitment to community involvement is taken seriously. Readers are also given a review of methods for developing community involvement in health in particular situations, followed by a discussion of indicators that can be used in evaluation and monitoring. The final chapter outlines an agenda for the future development of community involvement in health, including a summary of conditions that must be met in order to foster the adoption of this essential health strategy on a larger scale.

eng fre spa.

WHODOC

WHO monograph

4