Leprosy-control methods.

BACKGROUND: The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a window of opportunity for promoting self care and community participation for health promotion. DISCUSSION: A broad outline is proposed for designing a health promotion programme in developing countries, following key strategies of the Ottawa Charter for health promotion and principles of self care and community participation. Supportive policies may be framed. Self care clearinghouses may be set up at provincial level to co-ordinate the programme activities in consultation with district and national teams. Self care may be promoted in the schools and workplaces. For developing personal skills of individuals, self care information, generated through a participatory process, may be disseminated using a wide range of print and audio-visual tools and information technology based tools. One such potential tool may be a personally held self care manual and health record, to be designed jointly by the community and professionals. Its first part may contain basic self care information and the second part may contain outlines of different personally-held health records to be used to record important health and disease related events of an individual. Periodic monitoring and evaluation of the programme may be done. Studies from different parts of the world indicate the effectiveness and cost-effectiveness of self care interventions. The proposed outline has potential for health promotion and cost reduction of health services in the developing countries, and may be adapted in different situations. SUMMARY: Self care, community participation and health promotion are emerging but dominant areas in the developed countries. Elements of a programme for health promotion in the developing countries following key principles of self care and community participation are proposed. Demonstration programmes may be initiated to assess the feasibility and effectiveness of this programme before large scale implementation.

Community Health Workers↗

PubMed2004

The adapting healer: pioneering through shifting epidemiological and sociocultural landscapes.

While it is true that healers selectively adopt and/or refashion aspects of biomedicine, the influence is not unidirectional with information flowing exclusively from hospitals into the workplaces of healers. This article examines healers in Tanga, Tanzania to explore the reciprocal relations between practitioners of indigenous medicine and biomedicine. An abbreviated ethnography of one healer in coastal Tanzania is used to illustrate some of the relevant influences and possible adaptations of contemporary healers. His experiences illuminate how multiple factors, especially sociocultural changes, biomedicine, AIDS, and related research(ers) can influence healers' adaptations. In his case, biomedical health workers from a non-profit HIV organization call upon him not only to act as a liaison between their services and the community, but more importantly, to provide treatment for opportunistic infections and counseling for patients and to participate in biomedical and scientific projects. Reflecting on his experiences as a healer who has negotiated a position that straddles the world of biomedicine and the world of healers facilitates examination of important issues affecting healers today, including their relationship to biomedical health workers, bioprospectors, governments, non-profit organizations, and professional organizations of healers. Although the healer featured in this article is a pioneer in his own town, there are other examples in Africa where healers and biomedical practitioners are interacting. Therefore, he may represent a trend in healer adaptation.

Community Health Workers↗