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Printable Version
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Overview
Three activities are essential at both national and community levels. We will look at them from the specific viewpoint of community-based health care (CBHC):
SETTING UP refers to starting up new programmes where nothing effective exists. There are huge populations with no access to basic health care and in many areas there are no effective programmes working at the community level. Examples include urban slums, poor and remote communities especially in mountainous and desert areas, or rural areas where infrastructure is poor. Poor and stigmatized communities, living amongst others who are relatively affluent are often underserved. Equally important are communities where conflict, disasters or the deadly progression of HIV/AIDS have undermined or overwhelmed health systems.
STRENGTHENING refers to working with existing programmes, and building their capacity so that they have greater impact. This involves improving the knowledge and effectiveness of health workers, training new ones, improving systems, increasing quality, developing leadership skills, and enabling communities to use and trust their health services. It also involves bringing the community into planning and management so they start to see the programme as their own (preferably from an early stage).
SCALING UP refers to making effective health programmes available on a wider scale to increasing numbers of people. Although governments will need to take a lead in this we can make major contributions in CBHC. For example
· Ideas can spread from one community to another nearby.
· Health planners and practitioners can visit and learn from existing programmes then start similar activities in their own areas.
· Government officers can learn from effective CBHC approaches and implement them in other areas.
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Practices members have applied in their own situations
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This topic is convened by: |
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Dr Ted Lankester
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