Towards the measurement of community participation

Abstract

A description is given of the initial stages in the development of a methodology for assessing community participation in health schemes. A study in Nepal indicates that the approach adopted will be useful to planners who wish to evaluate involvement in primary care programmes.

PIP: Activities, rather then processes, have been looked at in measuring community participation in health programs. However, many times planners need information about the processes that influence change. 200 case studies were gone over and things that influence community participation were analyzed. They are: 1) leadership; 2) needs assessment; 3) organization; 4) management; and 5) resource mobilization. Community participation is a social process in which groups with shared needs living in a certain geographical area actively undertake needs identification and "take" decisions and set up mechanisms to meet them. Questions can be asked about the breadth of participation. Diagrams are given for assessing community participation, baseline assessment of health program, and changes between 1st and 2nd assessments. This was tested in Nepal. The national health system is set up according to the district health care approach. The situation was discussed with various people. A ranking scale for process indicators of community participation is shown. It was expected that the assessment could be used to describe changes in participation from the start of the program. However, many people could not remember the previous period. Therefore, this will be used as a 1st assessment.