Abstract

PIP: The regional Intergovernmental Meeting on Health and Development, convened by the Economic and Social Commission for Asia and the Pacific (ESCAP) in collaboration with the World Health Organization (WHO) and the UN International Childrens Emergency Fund (UNICEF) in 1983, discussed in detail the rationale for community participation in multidimensional health care programs. In reporting on the discussions that occurred, focus is on some experiences in which the community approach is used in selected countries of the ESCAP region. Program implementation is divided into 2 distinct forms of effort to involve the individual, the family, and the community. The first of these is health education which forms an integral part of the activities of all health workers. On their visits to homes and communities, health workers educate the individual and the family to enable them to take voluntary action to prevent disease and maintain health. Health workers also educate individuals and families when the latter visit health centers and outpatient departments or are admitted as impatients. This kind of education is the 1st item in the package of primary health care services prescribed by the Alma Ata Declaration. The 2nd form of effort is organized educational effort to ensure the participation of the larger community in the planning, implementation, and evaluation of health care services. Bangladesh has recognized the need for a strong community organization and has launched a movement for integrated rural development. Here, the responsibility for education concerning prevailing health problems and for community participation is vested in the hands of village level health workers. Other health professionals supervise, guide, and support them. In Maldives the education mechanism is community self development. The responsibility for education concerning prevailing health problems in Mongolia is shared equally by all health personnel at every level of its health organization. Nepal employs village health workers, volunteers, panchayat health leaders, ward health volunteers, and others for education concerning prevailing health problems as well as for community participation in primary health care. Thailand has trained about 20,000 village health volunteers and 200,000 village health communicators. A review of these efforts indicates that health staff at the village level, supported by village health volunteers, educate individuals and families concerning prevailing health problems.