Community Health Development Programmes and Projects PDF

Community Health Development programmes and Projects PUHH 4101 Lecture 3b Dr. Loveline Lum Niba 1 Outline  Health  Community initiative  Community imposed and oriented projects  Community projects...

Community Health Development programmes and Projects PUHH 4101 Lecture 3b Dr. Loveline Lum Niba 1 Outline  Health  Community initiative  Community imposed and oriented projects  Community projects 2  Health  The real measure of health is the ability of an individual to function in a manner acceptable to him/her in his /her community.  WHO defines health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.  Health and well-being are determined by factors such as clean water, enough food, good roads, employment, habitat etc.  It is the economic growth of a society together with its social improvement such as health, education, housing, water supply, good roads etc 3 A healthy population in a healthy environment has:  A healthy labour force  Reduces absenteeism from various activities  A healthy school population free of all predicaments to foster its development. 4  Community Initiatives  Community initiatives are development projects or activities or programmes initiated and managed (planned, executed and evaluated) by the community to achieve goals.  Community initiated activities and projects are either: community imposed, community oriented or community based 5  Community imposed and oriented projects  Community imposed programmes, activities, and projects are planned and decisions made at the higher level by professionals and imposed on the community (Top-Down Approach).  Community imposed and oriented projects are very often not long lasting because; 1. The population concerned usually fails to identify itself with and own the project (rejection phenomenon). 2. The mobilization of local resources is usually little or inexistent. 3. The project will continue on external funding sources. It is not sustainable as the project dies when external funding ends. 6  Community based programmes or projects  These are initiated in the community with the community members actively involved in all the aspects of its realization.  Community based projects use a bottom-up approach with lots of support and initiatives from the bottom (the community itself).  They have the following characteristics: 1. They are people from the concerned community. 2. The project is naturally and socially an appropriate solution to identified community problems. 3. The community appropriates the project and ensures its sustainability through the mobilization of local resources. 4. Adequate utilization of services is assured. 5. Successful community based projects easily gain support from government and other external agencies. 7 Criteria for selecting Real needs and problems Community supportive programmes, activities and needs are:  Those which when realized will have meaningful impact upon the lives of the majority of the population especially the disadvantaged.  Those which favourably influence the long-range welfare of the community  Those which help the community stand on its feet.  Those which genuinely encourage responsibility, initiative, decision making, and self-reliance at the community level.  Those which build upon human dignity. 8  Criteria for prioritizing needs  Due to limited resources and considering the complex nature of some projects, it is not advisable to plan to execute one project at a time.  There is therefore need to prioritize and set targets for the selected projects.  The criteria for setting priorities can include: 1. Which of the needs/projects is more pressing? Is there a threat to health or life? 2. The ease to have resources for the realization of the project 3. Is there a plausible or likely explanation for the programme, activity or need? Can lessons be drawn from it? 4. Are there conflicts of interest? 9 5. The ability of the community to sustain the project when realized?  The role of development associations and the community  The management of resources generated by the state and the community in partnership is carried out by the Management Committee of the dialogue structure.  The state is represented at each level by the technical team and the community by the community representatives at that level.  The management committee is responsible for all management duties including planning. Its role in project execution includes: 1. Selecting the priority project 2. Setting targets for execution 3. Draws general plan of action 4. Regularly draws a work (by project committee) plan 5. Draws the budget for execution 6. Plans how to mobilize resources for execution 7. Forms a project committee (this should as much as possible include members of10the development team based on their expertise) Concrete examples of community initiatives  Promotion of health activities  Construction, renovation and rehabilitation of health units  Purchase and maintenance of medical equipment  Environmental hygiene and sanitation  Agricultural/food production and transformation  Construction and maintenance of improved physical accessibility structures  Training and education of other community members. 11  Sustainability  Sustainability is the ability to maintain a project functioning after the initial investment funds for its realization have been exhausted. A sustainable project is therefore a project, which after it has been realized could become financially self-sufficient after the initial investment of funds. Health care is sustainable when there is a long term ability to mobilize and allocate sufficient resources for producing the desired services. Finances generated through cost recovery from a well-managed health establishment can effectively sustain that establishment. Some health programmes are part of larger integrated development projects, which provide productive activities to finance those which are not self-supporting. Eg the dialogue structure of MHC Nkwen. 12  Project committee  It is a subcommittee of the health committee, in charge of a project.  Membership is reinforced with competent staff from other sectors, and competent members of the community including the development team 13  Terms of reference of Project Committee  It is responsible to the management committee, the general assembly and the community. 1. It ensures that a plan is drawn and approved for the project 2. It recruits workers (skilled and unskilled) 3. It mobilizes resources for the project 4. It draws a work plan from the plan of action 5. It purchases the necessary materials 6. It monitors the project regularly 7. It maintains proper records for the project 8. It reports about the project each time the management committee is meeting 14 9. It writes a detailed report about the project when it is realized.  Composition of the Project Committee  It is an ad hoc committee whose members depend more on competence, honesty and trust in the community than on membership of the dialogue and management structures. Once the project is realized and its report presented and adopted, it ceases to exist. Health Area Chairperson: Community representative (a retired technician if available) Secretary: the staff representative in the dialogue structure Treasurer: Community representative who is eligible. Members:  The District Chief of Service Public Health or his representative  One member of the traditional authority (representative of all the traditional rulers)  Two community representatives from the general assembly. 15  The District Service  Chairperson: A community representative from the District Service Management Committee  Secretary: The Chief of Bureau Health  Treasurer: A community representative who is eligible  The District Chief of Service Public Health  The Director of the District Hospital  The District Supervisor from the regional level  The Representative of the Divisional Officer(s)  The Representatives of the Mayor(s)  One Community Representative 16 Conclusion and recommendations  Factors which can stimulate active community participation include among others: Dynamic leaders Community initiated (based) projects Accountability/transparency Motivation  In partnership, the active involvement of all the partners is essential. Self-reliance is not shifting government responsibility to the community.  In community participation, unrealized projects or those which collapsed after they have been realized, hindering the 17 community from participating in other projects S 18