Crisis of Legitimacy and Community Mobilization in Health: A Case Study in Burkina Faso

Abstract

The objective aim of this article is to understand the low level of community mobilization for health by questioning the legitimacy of the Community-Level Health Committees (CLHCs) and their leaders. In other words, it will focus on the process of judging the CLHCs and their leaders by the local population, identifying and analyzing all the elements that serve as references for the construction of their legitimacy. Data were collected from 9 CLHCs’ members and 60 heads of households recruited in three villages, through individual interviews. All interviews were recorded, transcribed and entered into Word files. Data processing was done using NVIVO10 software. The results of the study indicate that the CLHCs, which are supposed to facilitate community mobilization, do not work like they are supposed to do. As an effect of this situation, the populations do not trust the CLHCs and its first officials. Through analysis, we note that the criteria used for their implementation did not take into account the real needs and expectations of the communities. This community structure does not have the expected support. Both their composition and their mode of operation did not meet the social norms and aspirations of the populations. The CLHCs were not perceived as community structures that help to improve the conditions of access to health care, but rather as a mechanism put in place by health agents with the complicity of certain members of the population so as to use the resources of the health facilities for their own interests. Hence the lack of trust in them.