Primary health care in Southeast Asia: Attitudes about community participation in community health programmes

Although community participation in health has become a major plank in WHO's Primary Health Care platform, comparatively little concrete programme data has been collected which helps to define its potentials and problems. In an effort to expand knowledge in this area, a study of three Church-related community health programmes in Southeast Asia was undertaken. All three programmes have the stated goal of 'having the community take responsibility for its own health care' and as a concrete step in this direction, have developed training programmes for community health workers (CHWs). Starting about the same time, 1973-1975, they provide data for comparative examination of the development of community participation. As part of the study, a questionnaire was designed to elicit information from three categories of programme participants (the medical professionals, the community development workers and the CHWs) in community health programmes. It sought to discover their attitudes about the objectives of community health programmes; impact and measurements of success of these programmes; the role of health services; the role of medical professionals and community development workers in community health programmes; the role and training of community health workers; and financing community health programmes. The hypothesis of the investigation was that all three categories of programme participants in one programme share attitudes distinct from participants in the other two programmes. Although, due to technical reasons, it was not possible to test this hypothesis, the survey produced other conclusions. One was that the categories of professional people (the medical and community development workers) in all three programmes share attitudes which are distinct from the CHWs in all three programmes. Secondly, participants in the same programme most often exhibit the same attitudes when a programme has initiated an activity which enables the CHW to gain experience in health work.