Literacy Workbook 1: Assessment of Community Health Program Lessons

This essay examines the crucial role of community participation in health programs, emphasizing the principles of the 1978 Alma-Ata Declaration. It explores how community involvement, including activities like needs assessment, planning, and implementation, fosters individual, family, and community health and wellness. The essay delves into the challenges of community participation, such as the dominance of the bio-medical paradigm and lack of understanding of community health workers' roles, while also highlighting its positive impacts, particularly in low-economic areas. The essay discusses the benefits of community participation, which include increased trust in health services, changes in risky health behaviors, and the acquisition of skills and information. It also addresses challenges like apathy, conflicts, poverty, and lack of effective programs. The essay concludes with lessons learned and the importance of working with community leaders and health workers to ensure successful and sustainable community health programs.

Running head: Literacy Workbook 1
Assessment 1: Literacy Workbook
Lessons from Community Participation in Health Programs
(Author’s name)
(Institutional Affiliation)

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Lessons from Community Participation in Health Programs
The 1978 Alma-Ata Declaration recommended that community participation in matters
related to health services should be encouraged across the globe as it promotes the health and
wellness of individuals, families, and communities. According to the World Health Organization
(WHO), community participation is the involvement of individuals in community health
programs and projects in order to solve their own problems. Community participation can take
place during activities such as needs assessment, planning, mobilizing, training and
implementing(Rifkin, 2009). From the article, community participation can be difficult due to
various reasons. The first reason is due to the fact that most health programs are dominated by
the bio-medical paradigm as the primary planning tool making community participation as an
intervention. Secondly, the use and roles of the community health workers have not been well
understood by many people making them less active(Rifkin, 2009). The last challenge is lack of
proper programs that demonstrate how community participation can really work. However,
despite these challenges, community participation has proven to have positive impacts in terms
of community health, especially in low economic areas.
Community participation is one of the major principles of primary health care as
advocated by WHO. This principle reflects social justice in essence that all individuals have the
right to be involved in making decisions that affect their lives especially matters related to health.
Therefore, community participation is one of the key determinants of health that allows
individuals and their families to set boundaries and limits of how their health should be. In
addition, people are more likely to respond and use health services positively if they were
involved in determining how those services should be delivered. This, in turn, will lead to
positive outcomes on the matters related to diseases prevention, health promotion, and reduction

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in mortality and morbidity rates. Active participation of individuals in planning and making
decisions about health resources allocation and utilization makes people gain trust to health
services provided thus they are able to seek medical and non-medical advice from the healthcare
professionals at ease.
Other than that, people tend to change risky health behaviors when they have been
involved in deciding how those changes might take place. Most people tend not to follow
instructions that were made in their absence. For instance, involving the community on
discussions about avoiding junk food rather than just asking them not to take can improve
people’s perception and increase understanding of the risks involved. Therefore, active
community participation allows individuals to adapt to advantageous healthy activities as
compared to communities who just go to the hospital when sick. This, in turn, promotes diseases
preventions and reduce diseases cost burden.
In addition, community participation allows individuals to gain skills, information, and
experience that make them improve their own lives and be able to challenge social problems and
the government where needed. Through community participation, people are able to receive
health education concerning basic home infection control strategies and skills like proper hand
hygiene and proper use of toilets. In addition, individuals are able to learn about the current
trends of diseases control and prevention strategies available, air their views and also form part
of the implementation strategies. Community participation allows individuals to experience
different circumstances in health care, therefore, becoming the witnesses of various scenarios
making them be able to make judgments and challenge the government and other social systems.
People who actively participate in issues affecting their health have an upper hand in determining

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the type of health services they receive, resources they are allocated therefore enhancing health
equity and social justice.
Other than that, evidence shows that active community participation on matters
concerning health has an impact on the cost of health services incurred. This is due to the fact
that people have various resources during participation such as materials, energy and even
money to contribute to community health improvements(Rifkin, 2009). Due to this reason, the
government tends to spend little resources regarding issues such as primary prevention and thus
they are able to provide enough resources on other health care concerns like the building of
advanced hospitals with enough technologies and equipment’s, providing enough human
resources and catering for the aged population. The collective contributions from a given
community boost their health status thus increasing life span and quality of life.
Despite that community participation is a major health determinant and can contribute to
health improvements for the people, there are vast challenges that may hinder the active
involvement of people on the matters that concern their health. This includes apathy and lack of
enough power, conflicts and division, poverty, cynicism, and lack of effective programs. The
past experience, have indicated that to taught people about community participation can be very
difficult as the above challenges mostly affect mobilizing people. Such challenges need to be
understood and addressed accordingly in order to make sure community participation is learning
smoothly with few limits.
There is a great challenge in involving people who are not used in making health
decisions on their own or those who feel that they are powerless and often depend on health care
professionals and the government. Therefore, those in authority may be feeling that health is a
medical concern and fail to involve the community. This might be influenced by religions,

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political or commercial interests .Such issues may prevent and hinder people from making
decisions concerning their health.
Large numbers of communities may include people from a wide geographical area,
different social and economic status, rich and poor, different needs and interests, young and old,
different ethnic backgrounds, men and women thus providing various gaps which may lead to
conflicts and divisions. A community project may be designed to promote health improvements
for all people but it may be hindered if seen as benefiting certain people most. Where paid
allowances are involved, there may be conflicts due to jealousy and self-interest among people.
Such conflicts and divisions may be the major factor that prevents effective participation of
individuals in a community project. Providing a program that may allow all individuals to feel
the impact of community participation is also a big challenge.
People from low social economic status, poverty, diseases and lack of resources may
keep people from participating in community work. Such individuals may be working for long
hours a day or even for a whole week and thus getting time to participate may be a problem. As
the poorest members in the community, those are always the most affected people but they might
also be the most dominant when it comes to community participation. Special efforts have to be
made in order to make them actively engage in community activities.
The past experiences have shown that community participation has been misused a lot.
People have been asked to participate in community projects just for the purpose of passing some
laws or government and political official plans. To make it worst, some have been asked to
contribute or provide the labor force. When people notice and gain such experiences it becomes
difficult for them to provide any more effort for other community projects. This has made
community participation to become less and less popular in various communities.

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From the past experience, there are major issues that researchers, medical and public
health professional, government and other involved stakeholders have learned about community
participation(Rifkin, 2009). Largely, it is very difficult to separate community participation and
politics or government entities. Effective participation is always control by issues concerning
power and control over decisions specifically those related to resources allocation and utilization.
Other than that, studies have shown that it is not possible for community participation programs
that involve health services alone. People and different communities have other problems such as
lack of enough food, poor shelters, low incomes and education that need to be addressed. Health
is usually a priority when people get sick but on other occasions, it might not be that important.
Finally, due to the diversity of people, and various challenges involved in creating a community
health program, it is difficult to create a perfect community health program. Culture and history
can be used to provide basic elements and values that can help to create a sustainable program.
However, despite such challenges, many communities who actively involve themselves in
making decisions about their health showed improvements regarding their community health
status.
A proven and convenient method of achieving community participation is by working
with people who can bring the community together. This includes political and religious leaders
who must be practicing their full official and authoritative capacities. Different leaders will be
identified to represent a specific population in a given community in order to promote
participation. Once the leaders are identified, further training may be required which not only
include health-related issues but also skills like encouraging and sharing responsibilities,
listening, and planning. In addition, to increase the chances of participation, it is always better to

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work with people with strong political, religion or commercial influences in order to avoid
obstacles to participation.
Any community-based project will need the support of health workers and educators.
This will also require the support of both local and national government. Health workers need to
take their own time in discussing risks and any possible methods of reduction before engaging
the community. In order to prevent issues such as conflicts of interest, health workers must first
understand the social economic status of the community, its divisions, and the past history of
other community projects. The proper social analysis must be employed to make sure other
community needs are well understood.
In conclusion community participation is the involvement of people in community health
programs and projects in order to solve their own problem and other health issues. Most of the
activities that may be involved in community participation include needs assessment, planning,
mobilizing, training and implementing. There are various benefits of community participation
which include the development of trust between individuals and the health care services,
reduction of risky behaviors that may lead to the development of diseases, and pooling together
relative resources thus reducing the cost. There may be various challenges affecting community
participation such as apathy and lack of enough power, conflicts and division, poverty, cynicism,
and lack of effective programs. From the past experience there are a number of key lessons
learned which include the fact that political and religious leaders cannot be separated from
community participation, Other matters other than health that are affecting the community need
to be addressed along with health issues and it is difficult to produce a community-based
program that is completely perfect. However, community participation has proved to be of
importance especially in areas of low economic status.

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Reference
Rifkin, S. B. (2009). Lessons from community participation in health programmes: a review of
the post Alma-Ata experience. International Health.
https://doi.org/10.1016/j.inhe.2009.02.001