|Education for Health (WHO, 1988, 274 p.)|
|Chapter 6: Health education with communities|
One way to achieve community involvement is to encourage the establishment of health committees. Their members will help you to know what the people feel are their priority needs, and in turn you can guide them towards appropriate action. Let us see in more detail what is the purpose of a health committee and how it can be established.
Purpose of a health committee
It is difficult to imagine 50 or 100 people meeting together to plan the details of a community health programme. Not everyone would get a chance to speak. Much time would be spent trying to make sure that everyone understood and participated. Some people would not want to waste time and would possibly try to force the group to make quick decisions. This might make others angry and then arguments would start.
In order to avoid these problems, smaller groups called committees are often chosen. The committee is given a specific task or job. It carries out that task and then reports back to the larger group with some suggestions for action. The committee's investigations and plans make it easier and quicker for the larger group to make decisions.
Although every individual, family, and group in the community is responsible for health, as we have said before, it is often useful to have an organized groupa committeewhose special purpose is
to reflect the needs of the people and to help the community look after its health. Each community would need to decide on the exact duties of its own health committee, but here are some general tasks on which a health committee would work:
- Collecting information about the health of the community.
- Identifying community health problems and the reasons for them.
- Proposing solutions and plans for solving the problems.
- Discussing these solutions and plans with the health workers who will help them (a) decide on priorities, (b) develop realistic goals, and (c) locate resources.
- Mobilizing the community to achieve the goals set and solve its own problems.
- Keeping the community up-to-date on progress and on problems encountered.
Establishing a health committee
First, you must find out if the community sees a need for a group to look especially into health and related problems. The idea needs to be thoroughly discussed with community members and leaders. They must decide for themselves whether or not they want a health committee. If they do, the committee can either be formed within an existing group or be a completely new body.
There may already be groups in the community that are concerned with, and responsible for, the health and development of the community. It is easier to work with existing groups if the people in the community accept these groups and are satisfied with the work that they have been doing. If there are too many committees and groups, especially if they are doing similar things, time and resources are wasted and people will lose interest.
Perhaps there is already a large village or community council that is involved in many activities. Such a council may not have time to look at health matters, in which case several of its members could be nominated to form a health committee that would report back to the larger council for final decisions.
If there is no existing group that could serve as a base, then a new committee could be formed. There are several steps to follow in forming a new committee.
First, who shall be the members? If the committee is to be helpful to the community, it must contain people who are respected and who are willing to work hard for the improvement of their community. Another thing to consider is whether the health committee will be able to look after the interests of all sections and groups in the community. A community is often made up of different professional, political, religious, and other groups. If one group or section of the community is left out of the health committee, people belonging to that group may not cooperate on a community health programme suggested by the committee.
Secondly, how do you select committee members? Remember that each community has its own culture and ways of doing things. There are many possible ways of selecting health committee members. Three are listed here:
- Hold a community meeting where members could be nominated, appointed, or elected, or could volunteer, whichever way is acceptable.
- Community leaders could appoint the people they feel are best for the job.
- The various interest groups in the community could be asked to select people to represent them on the committee.
Think of other ways to establish a health committee, and follow the one that is most likely to be acceptable to people in your community. If members are not selected in an acceptable way, people will not respect the work of the committee. It would probably be helpful for any health committee to include people who practice either traditional or modern medicine.
The next question to consider is: how many members should the committee have? A health committee should be large enough to represent the main interests in the community, but small enough for all the members to participate, discuss, and work together easily. The ideal number of members might be around ten.
Finally, to whom does a health committee report? The committee should report regularly to the community leaders on its activities and progress. It should also be constantly in touch with health workers to inform them of problems and plans and to obtain guidance and support from them. The committee should be open to ideas and suggestions and to receiving help from any members of the community at any time.
From your experience you probably know that it is often difficult to obtain the participation of every member, even in small groups. Participation by the whole community is still more difficult. Here are some reasons people may give for not participating in a community project.
- 'No one told me about the project.'
- 'I was angry: they only told me a few days in advance.'
- 'They never thanked me for the work I did the last time.'
- 'I did not agree with the plan.'
- 'The date was the same as the big market in the district town, so we couldn't come.'
- 'No one told me exactly what I was supposed to do.'
- 'They never asked me what I thought, so why should I help?'
Have you heard other reasons being given for not participating'
To encourage participation, you should try to:
- Keep people informed about activities that are being planned.
- Encourage suggestions to be made, directly or through a representative, to the planning committee.
- Set out specific tasks and jobs for everyone. You will need to explain the tasks and maybe provide some training. People should also understand how important their own job is to the success of the whole project.
- Find out on what date most people will be able to participate.
- Give praise and show appreciation to all who help. For example you could take a photograph of everyone who helped with a project and display it where it can be seen by members of the community.
For a community-wide clean-up campaign to be successful, individuals, groups, and whole neighborhoods must participate. Efforts should be made to see that the clean up activities continue throughout the year.