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PubMed2001

High tuberculosis notification and treatment success rates through community participation in central Sulawesi, Republic of Indonesia.

SETTING: Central Sulawesi Province, Republic of Indonesia. OBJECTIVE: To increase tuberculosis case notification and maintain high treatment success rates through community participation in a tuberculosis field programme. DESIGN: Comparison of tuberculosis case notification and treatment results in a community based tuberculosis programme (CBTP), before and after introduction of the programme and between areas where the programme was and was not introduced. RESULTS: During 1998, the CBTP was introduced in two of the four rural districts of the Central Sulawesi province, covering 224 (29%) of the 772 villages and 362,700 (33%) of the 1,109,100 population in these districts. In the CBTP villages the notification rate of new smear-positive patients per 100,000 population increased from SI in 1996 and 48 in 1997 to 166 in 1998. In the 548 non-CBTP villages the rates were 62, 60 and 70, respectively. The sputum conversion rate at the end of the first 2 months of the treatment was over 85% in both the CBTP and the non-CBTP villages. In the CBTP villages the treatment success rate (cure and treatment completion) was 90.4%, 89.5% and 93.7% in 1996, 1997, and 1998. For the non-CBTP villages these rates were respectively 85.4%, 86.8% and 85.9%. In 1998 the sputum conversion and treatment success rates were significantly higher in the CBTP villages than in the non-CBTP villages. CONCLUSION: Through community participation, the notification of new smear-smear positive patients increased substantially, while sputum conversion and treatment success rates remained high.

Community Participation↗
PubMedDate not supplied

[Community participation in Dengue prevention: an approach from the perspective of different social actors].

OBJECTIVE: To explore the perceptions about community participation in dengue fever control during formative research for a community project. MATERIAL AND METHODS: This study was conducted in three health areas of the Santiago de Cuba municipality during the year 2000. Qualitative and quantitative techniques were used to explore the opinions of health professionals, community leaders and a random sample of 200 people living in the community. RESULTS: The health professionals who were interviewed judged that difficulties in Aedes aegypti control were due to lack of participation of the community and to limited knowledge of prevention methods. Community leaders considered that the population was poorly motivated. The randomly selected subjects who were interviewed did associate Aedes control with technological intervention. The authors identified barriers to acceptance of control program activities. In general, the concept of "participation" was interpreted as "collaboration". CONCLUSIONS: Our findings show that the community has transferred the responsibility for Aedes aegypti control to the health sector. There is an evident need for unifying the concepts of community participation, as well as for matching the interests of users and health care providers, in order to attain a significant social mobilization.

Community Participation↗
PubMed1991

Community participation in research and action against alcoholism.

An epidemiological study of sickle cell disease in the Gadchiroli district of India established it as a major problem but resulted in no public initiative or action. In contrast, research and action against alcoholism using the participatory approach resulted in massive community participation and proved highly successful. Public health programmes need community participation, yet most research in this field is self-defeating because it alienates lay people.

Alcoholism↗
PubMedDate not supplied

[Community participation patterns in health programs].

The study of some Latin American experiences of participation of the community in health programs allows us to consider the following as minimum requirements to establish interrelationships between local health organisms and the community: a) To have a local health system. b) To have a participating health them. c) To show respect for the community. d) To have contact with community organizations. e) To have contact with private and government organizations at a local level. The models for participation of the community in health are manifold and the experiences have been countless. For teaching purpose and based on Latin American experiences, some considerations are made regarding: 1) Community health volunteers. 2) Local health councils. 3) Local councils for community development. 4) Health brigades. Finally, it is concluded that the active participation of the community organized in health activities is the best guarantee of success in implementing integral health programs.

Child Care↗
PubMed2006

Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort.

OBJECTIVE: To examine whether home and community environmental barriers and facilitators are predictors of social and home participation and community participation at 1 and 6 months after discharge from an acute care or inpatient rehabilitation hospital. DESIGN: Cohort study. SETTING: Postacute care. PARTICIPANTS: Adults (N=342) age 18 years or older with a diagnosis of complex medical, orthopedic, or neurologic condition recruited from acute care and inpatient rehabilitation facilities. The mean age +/- standard deviation of participants was 68+/-14 years; 49% were women and 92% were white. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participation in social, home and community affairs as assessed with the Participation Measure for Post-Acute Care. RESULTS: Adjusting for covariates, 1 month after discharge a greater presence of home mobility barriers (P<.01) was associated with less social and home participation; whereas greater community mobility barriers (P<.01) and more social support (P<.001) were associated with greater participation. At 6 months, social support was the only environmental factor associated with participation after adjusting for covariates. CONCLUSIONS: This study provides new empirical evidence that environmental barriers and facilitators do influence participation in a general rehabilitation cohort, at least in the short term.

Activities of Daily Living↗
PubMedDate not supplied

[Community participation in health at the Instituto Mexicano del Seguro Social in Jalisco].

This paper describes the achievements and problems of a community participation model in health care, developed by the Mexican Social Security Institute since 1985. The health team involved between 10 and 20 percent of the personnel due to the slow adoption this program requires in new of the cultural change it implies. The community's answer has been satisfactory, as it can be seen by the ware of 100 neighbours and school committees, and around the 2,000 housewives and school students who are been working as promoters. This figures stand monthly. The self-care groups on chronic diseases constitute another form of participation. The community activities are progressively focused on causes of health and disease, embracing our 70 per cent of health promotion and disease prevention actions. The work realized by the community over cause one third of that realized by the preventive medicine personnel. This health community participation model represents a valuable and viable alternative.

Community Health Services↗
PubMedDate not supplied

Community participation in national family planning programs: some organizational issues.

Increasing the involvement of communities in implementing national family planning programs has been advocated as a means of increasing the acceptability, availability, and sustainability of services provided. This article reviews the nature and extent of community participation in the national programs of Bangladesh, China, the Republic of Korea, the Philippines, and Thailand by analyzing the structures and processes through which participation is organized. Across all five countries a similar pattern of participation has emerged in which a community-based delivery system is supported by the involvement of community leaders in activities that promote family planning. Active participation in planning and management functions is, however, virtually nonexistent. This limited form of participation is attributed to the bureaucratic organization of national family planning programs that seek to implement policies with explicit demographic goals. Given these goals and organizational structures, however, the pattern of organizing participation observed is probably the most appropriate. Consequently, policymakers should be wary of expecting greater involvement by community members in program implementation activities or in contributing resources unless consideration is given to reorienting the goals and organizing programs that meet needs that are directly relevant to families and communities.

Attitude↗
PubMedDate not supplied

Mass diethylcarbamazine chemotherapy for control of bancroftian filariasis through community participation: comparative efficacy of a low monthly dose and medicated salt.

The efficacy of 2 strategies for the control of bancroftian filariasis using diethylcarbamazine (DEC) mass chemotherapy delivered through community participation was evaluated and compared in 2 endemic communities in Tanzania with pre-treatment microfilarial (mf) prevalences of 34.7% and 31.0%, and mf geometric mean intensities (GMI) of 1122 mf/mL and 933 mf/mL, respectively. In the first community, all individuals aged > or = 1 year were offered treatment for one year with a low monthly dose (50 mg DEC to children aged < 15 years and 100 mg DEC to adults aged > or = 15 years; given independently of body weight), and in the second community all households were offered 0.33% w/w DEC-medicated cooking salt for one year. Both treatment strategies resulted in dramatic reductions in the mf loads. Among those microfilaraemic before treatment, the low monthly dose and the DEC-medicated salt gave mf clearance rates of 55.3% and 92.1%, respectively, and the pre-treatment mf GMIs were reduced by 99.4% and 99.9%, respectively, one year after starting treatment. At community level, the mf prevalences were reduced to 15.8% and 2.4% (reductions of 54.5% and 92.3%) and the mf GMIs were reduced to 100 mf/mL and 32 mf/mL (reductions of 91.1% and 96.6%), one year after starting treatment with the low monthly dose and DEC-medicated salt respectively. Males with hydrocele before treatment improved remarkably one year after the start of treatment. Since both strategies were simple to administer and well accepted by the communities, they appear highly feasible for integration into large scale control programmes based on community participation.

Adolescent↗
PubMed1998

[Community participation and control of endemic diseases in Brazil: problems and possibilities].

Community participation (CP) is considered one of the most important elements for the control of endemic diseases in poor countries, particularly for prevention and epidemiological surveillance. Mainly affecting the poorest segments of the population, endemic diseases are costly and require specific government action aimed at efficient, egalitarian, universal health system, where CP acts in a guardian, monitoring capacity and entails other specific tasks. Despite its rationality, CP has not been encouraged in countries like Brazil, due to the highly centralized nature of political power and activity. Several examples and situations of CP in Brazilian endemic diseases are described and discussed in the article. CP for endemic disease control should be seen as an ongoing social process, a profound social exercise, and a great challenge for the country as a whole and the new Unified Health System now being implemented in Brazil.

Brazil↗
PubMed1992

Community participation in malaria surveillance and treatment. I. The Volunteer Collaborator Network of Guatemala.

The Volunteer Collaborator Networks (VCNs) of Latin America are one of the oldest and most successful examples of community participation in malaria control. They are made up of unpaid community volunteers, known as Volunteer Collaborators, who are selected by their neighbors and are trained and supervised by a member of the National Malaria Service (NMS). When a febrile patient visits the home of a Volunteer Collaborator, the volunteer worker takes a thick blood smear, completes a patient report form, and administers a presumptive treatment for malaria. The blood smear is examined in an NMS laboratory, and if malaria parasites are found, a radical or curative treatment is forwarded to the Volunteer Collaborator so that it can be administered to the patient. There is no charge for either the blood smear or the antimalarial medication. The VCN of Guatemala was established in 1958. Currently, more than 5,000 Volunteer Collaborator posts are operating throughout the malarious areas of the country. The volunteers range in age from 12 to 76 years old and 61% are men. Approximately 15% have no formal education, and only 27% have a sixth grade or higher education. The median length of service is 35 months (range three months to 26 years); 33% have worked for five or more years. Male Volunteer Collaborators had significantly lower turnover rates than females, as did married Volunteer Collaborators when compared with single volunteers. An inverse relationship was noted between the amount of education a Volunteer Collaborator had and his length of service. With modifications tailored to meet the objectives of a malaria control program and the local epidemiologic setting, the VCN can serve as an excellent model for community participation in malaria case detection and treatment in other regions of the world. In particular, in areas where the primary goal of the malaria program is to prevent mortality and morbidity through the provision of readily accessible, appropriate drug therapy, VCNs are an attractive alternative to self-medication and an effective adjunct to treatment of malaria at health posts which are often located at a considerable distance from the patient's village. Experience gained with this system can be valuable in developing approaches to community involvement in other efforts to improve the health of villagers in developing countries.

Adolescent↗
PubMed2006

Community participation in AIDS vaccine trials: empowerment or science?

For future AIDS vaccines to be successfully tested and implemented, extensive participation in vaccine trials will be necessary. Central to the challenges associated with such participation is concern for protection of participant wellbeing. This short report examines the tension that is sometimes found between the pragmatic need for recruitment into trials, and a more general social good concerning community participation in health. Community empowerment and trial participation are sometimes assumed to go hand in hand, but are potentially contradictory. Recognizing the possible disjunction between empowerment and trial participation allows for clearer discussion of and planning for ethical, scientifically valid trials.

AIDS Vaccines↗
PubMed1985

Community participation in mental health training.

In the Pacific, training in mental health counseling skills must be culturally sensitive, adapted to the needs and resources of the specific emerging island countries and involve community participants in all phases of the training. A context is developed for viewing mental health problems and needs in Micronesia and American Samoa. The paper highlights the process the trainer encounters in preparing the community for the training. The concept of community participation is developed and operationalized. A two-phased training model suggests one way to implement WHO's mandate for partnership and participation.

Community Mental Health Services↗
PubMed2004

An alternative approach to social capital: exploring the linkage between health consciousness and community participation.

In recent years, social capital has received a great deal of attention in health communication. The fundamental premise behind the increased attention to social capital is the positive health outcome of social capital. Social capital is treated as an antecedent to health. Building on recent research that points out the role of trait-level variables in the production of social capital, this article examines the role of health consciousness in the production of social capital. The central idea here is that health conscious individuals choose to participate in their communities because of the positive health benefits of such participation.

Adult↗
PubMed1998

[The political context for community participation in Latin America].

This article reviews the overall significance of the concept of community participation in health with respect to endemic diseases. It also observes how changes in Latin American society during the past forty years have forced radical changes in the notion of participation. The article describes changes in society and analyzes participation in the Cold War context, with four modalities of participation: as ideological manipulation, as cheap labor, as medical care facilitation, and as subversion. It then reviews participation in the context of the crisis of ideologies and describes two modalities: participation as a grassroots movement and as popular promotion. Finally, it interprets the forms participation takes in the context of economic adjustment programs, and from there it describes participation as both a complement to the State and a form of privatization. The article concludes with a proposal for participation as a mechanism to expand and extend democracy; in this sense, it highlights participation as a means of criticism of power, a fomenter of democratic organization, and a mechanism of transformation for the health sector.

Communicable Disease Control↗
PubMed1994

[Primary health care and community participation: strategic approaches].

This article gives technical orientation to health institutions for the promotion of community participation and sets forth the challenge of constructing a health system for Chile, according to the needs and problems of the country and based on the principles of solidarity, equity and social participation. It presents the governmental objectives and actions towards the development of social participation as an axis of Primary Care. The adoption of this concept requires a change in health teams internal management and relationship with the local community. The formation of interdisciplinary work groups, the formulation of a community health program, a work based in specific projects and the establishment of an operational sequence are suggested as requirements to start this process.

Chile↗
PubMed1975

Community participation in primary health care.

A two and a half year's experience of a community participation group has shown that this can have a valuable role in suggesting practicable improvements in a group practice. Topics discussed by the group (which is composed of one representative from every known organization in the area) have included problems of receptionists; the role of the individual ancillary worker; and teaching in general practice. The high attendance rate at the group's meetings testifies to the community's interest in primary health care services.

Allied Health Personnel↗