Health, apartheid and the frontline states

Abstract

Community involvement in health (CIH), a central concept in health development, is a participatory approach to health care that is organized from the perspective of the recipient. Putting CIH into practice represents a learning experience for the community, the health professionals involved and those responsible for the national climate in which this change takes placeThe CIH process was operationalized over a two-year period in a black township in South Africa. A community survey identified the health needs and capacities related to the elderly, their families and their support system. Community groups and individuals, in partnership with the researcher, prioritized the needs that had been identified and then implemented four programs related to those needs. A process model was developed that provided the structure for initiating and maintaining these programs.The model helped people who were new to the community organizing to focus on general principles. It was flexible so that programs could be interpreted and implemented in the context of local culture and resources. The model was functional in guiding community nurses, lay community members and employees in health-related programs through the process of starting new programs. This approach empowered participants to move beyond only hoping for change or being puzzled by its elusiveness.