1. COMMUNITY PARTICIPATION
OBJECTIVES
At the end of this lesson, the leaners shall be able to:-
Define a community
Define community participation
Discuss the aims of community participation
Discuss the differences between community participation and involvements
Determine the community participation process
Identify factors that influence community participation
WHAT’S A COMMUNITY?
It is a social entity made of people or families who have the following characteristics:
 Live in the same geographical area
 Share common goals or problems
 Share similar development aspirations
 Have similar interests or social network or relationship at local level
 Have a common leadership and tradition
 Have common system of communication
 Share same resources-water, school, e.tc.
 Are sociologically and psychologically linked
COMMUNITY PARTICIPATION
DEFINE
A process by which a community mobilizes its resources, initiates and takes responsibility for its
own development activities and share in decision making for and implementation of all other
development programmes for the overall improvement of its health status.

2. The key to the successful organization of PHC is community participation, through the process;
the people gain greater control over the social, political, and economic environmental factors
determining their health
AIMS OF COMMUNITY PARTICIPATION
 The community develops self-reliance
 The community develops critical awareness
 The community develops problem solving skills
TYPES OF PARTICIPATION
Passive – (Manupulation)
Active – (consultation)
Involvement – (Community control)
PASSIVE PARTICIPATION
In this type of participation, individuals or families are mere spectators
ACTIVE PARTICIPATION
In this type of participation, they may be carrying out some tasks in a programme but are not
involved with the final decision making in what is to be done. The final decision in such cases
are made by people who are not members of the community, in such situations, the
community does not develop a sense of self-reliance.
COMMUNITY PARTICIPATION AND INVOLVEMENT
In this type of participation, the community is involved in all aspect of a programme. This type
of approach enables the community to participate willingly to improve its own health status, it
is important for a community to participate in every stage of the health programme for it to
have long lasting results i.e., thinking, planning, acting and evaluating
Community participation and involvement empowers or enables the community to make
informed decisions in matters affecting their health or development

3. INVOLVEMENT
This entails involving the community in planning, implementation and evaluation of
programmes
This is important because, it contributes towards a feeling of responsibility and involvement in
such programmes. In other wards we could refer to the process as that by which active
partnership is established between developmental programmes within the community and the
community itself. Thus community participation and involvement contributes to the attainment
of community responsibility and accountability over all development programmes. Therefore
preventing a community from alienating itself from such a programme. The community
develops self-reliance and social control over its own infrastructure.
DIMENSIONS OF COMMUNITY PARTICIPATION
Community participation has three dimensions;
 Involvement of all those affected in decision making about what should be done and
how
 Mass contribution to the development efforts i.e. to the implementation of decisions
 Sharing in the benefits of the programme (World Bank, 1978)
COMMUNITY PARTICIPATION IN DIFFERENT SITUATIONS
Top-down – approach
Bottom-up – approach
TOP-DOWN – APPROACH
The traditional approach in health care planning the decisions to be made by senior persons in
health services, the so called “experts”. Research may be carried out through surveys to what
the community thinks or believes to be the problem, but in the end it’s usually the health
worker who makes the decisions on what goes into the programmes based on medically-
defined needs.
Traditional education is often indoctrinating we make decisions and expect them to follow. This
is a way the case and you will need to look carefully to find out what is really going on. All the
decision-making and priorities are set by the external agency.
BOTTOM-UP – APPROACH

4. In this approach members of the community make decisions.
FACTORS WHICH INFLUENCE THE DEGREE OF COMMUNITY PARTICIPATION
• Relevance and accountability
• Educational status of the community
• Community infrastructure (including communication network)
• Economic status
• Social and cultural factors
• The level of intersectoral collaboration
• Suppression of involvement and initiative by projects which create dependency
• Political stability
• Good leadership
• Motivated community
• A sense of ownership
• Locally available resources
THE PARTICIPATORY METHODS USED IN RAPID ASSESSMENT OF SITUATIONS
• Daily routine schedule
• Seasonal calendar
• Time trends
• Direct observation
• Transect walk
• Venn diagram
• Key informants interviews of individuals from the community
• Focus group discussion (FGD)

5. BENEFITS FROM COMMUNITY PARTICIPATION
Justification for community participation come from a variety of sources, including lessons
learned from the failures of conventional top-down planning as well as the achievement of
community based programmes
1. THE NEED FOR A COMMUNITY APPROACH
The need to shift the emphasis from the individual to the community. This is because
many influencies on a behavior are not the community level or not under the control of
individuals, these include
- Social pressure from other people through norms
- Shared culture of the local social economic situation
Even when the influences are at the national level, it is often through pressure from
communities that governments will change. Furthermore oil budgetary resources can be
complemented by the efforts which can be made within local communities, but they go
well beyond this
2. DRAWING ON LOCAL KNOWLEDGE
Communities often have detailed knowledge about their surroundings. It makes sense
to involve communities in making plans because they know local conditions or the
possibilities for change
MAKING PROGRAMMES LOCALLY RELEVANT AND ACCEPTABLE
If the community is involved in choosing prioritirs or deciding on plans, it is much more likely to
become involved in the programme or take up the services
DEVELOPING SELF-REHANCE, SELF CONFIDENCE, EMPOWERMENT AND PROBLEM – SOLVING
SKILLS
The enthusiasm that comes from community participation can lead to a greater sense of self-
reliance for the future e.g. communities are usually willing to participate in water programmes
because they see that benefits will come. The feeding of community socialarity or self-reliance
from participating in decisions over, their own future through a water project can lead to future
activities
BETTER RELATIONSHIP BETWEEN HEALTH WORKERS AND COMMUNITY

6. Community participation leads to a better relationship between the community or health
workers instead of a servant master relationship, there is trust and partnership
PRIMARY HEALTH CARE
The Alma-Ata declaration on PHC-1978extended the notion of approiate health care beyond
that of simply providing decentralized services, it also considered the need to tackle economic
and social causes of ill-health.
Health education and community participation are essential ingredients of PHC (WHO)
TYPES OF COMMUNITY GROUPS
SELF-HELP GROUPS
Run by people for their own benefits e.g. co-operatives, church saccos etc
REPRESENTATIVE GROUPS
Elected and answerable to the community e.g. community associations
PRESSURE GROUPS
A group of self-appointed citizens taking action on what they see to be the interests of the
whole community putting on pressure to improve the school, get garbage collected, do
something about a dangerous road etc
TRADITIONAL ORGANIZATIONS
E.g Njuri Njeke in (Meru), these are well established groups, usually meeting the needs of a
particular section of the community, others rotary, club, mothers union parent-teacher
associations, and church groups.
WELFARE GROUPS
Exist to improve the welfare of a group; merry go round, feeding programmes etc.

7. Community participation leads to a better relationship between the community or health
workers instead of a servant master relationship, there is trust and partnership
PRIMARY HEALTH CARE
The Alma-Ata declaration on PHC-1978extended the notion of approiate health care beyond
that of simply providing decentralized services, it also considered the need to tackle economic
and social causes of ill-health.
Health education and community participation are essential ingredients of PHC (WHO)
TYPES OF COMMUNITY GROUPS
SELF-HELP GROUPS
Run by people for their own benefits e.g. co-operatives, church saccos etc
REPRESENTATIVE GROUPS
Elected and answerable to the community e.g. community associations
PRESSURE GROUPS
A group of self-appointed citizens taking action on what they see to be the interests of the
whole community putting on pressure to improve the school, get garbage collected, do
something about a dangerous road etc
TRADITIONAL ORGANIZATIONS
E.g Njuri Njeke in (Meru), these are well established groups, usually meeting the needs of a
particular section of the community, others rotary, club, mothers union parent-teacher
associations, and church groups.
WELFARE GROUPS
Exist to improve the welfare of a group; merry go round, feeding programmes etc.