Abstract
IntroductionCommunity participation is rapidly being viewed as a requirement for the successful acceptance of health services; it integrates a complicated process which involves customs, beliefs, culture and power relations, not only structures and policies. Yet, there is a wide knowledge gap and changes favouring community participation in primary health care is still minimal. This study aims to assess the process indicators and other factors influencing community participation in the delivery of primary health care.MethodsThis descriptive cross-sectional study using qualitative methods was conducted in Ibadan South East Local Government Area of Oyo State, Nigeria between July and September, 2015. The interview and Focus Group Discussion guides centred around five participation indicators of needs assessment, leadership, resource mobilization, organization and management was used to collect data. A total of 12 in-depth interviews and four FGDs were conducted among male and female respondents consisting PHC service providers and community members purposively selected from four wards of the LGA. Spidergrams were constructed to visualize the levels of community participation from respondents' opinions.ResultsAbout 51.1% of the 45 respondents (with mean age 45.5 ± 8.09 years) were males. The respondents view community participation in the delivery of PHC in the LGA as being wide (open). Majority of the service users believe and agree that the level of community participation in their wards is about average while the service providers believed that participation was very high. However, respondents identified female representation, collaboration with pre-existing community structures, top-down and bottom-up approach to service delivery as factors affecting community participation in PHC delivery.ConclusionThis study provides a baseline data on community participation in the delivery of primary health care. Community participation is still an important principle in the delivery of primary health care and it guarantees the positive changes desired in the uptake and sustainability of primary health care programmes.
Highlights
Community participation is rapidly being viewed as a requirement for the successful acceptance of health services; it integrates a complicated process which involves customs, beliefs, culture and power relations, structures and policies
According to a female community development committee member; community participation is very important in needs assessment as community members are the ones directly involved whenever a need arises' (IDI 2, female, W1)
Another respondent opined that; Community participation cannot be overemphasized because PHC services is a healthcare service that is close to the grassroots and the community members have to be involved if not, they will not have a sense of belonging for that particular program (IDI 1, DSNO, male)
Summary
Community participation is rapidly being viewed as a requirement for the successful acceptance of health services; it integrates a complicated process which involves customs, beliefs, culture and power relations, structures and policies. The declaration at the Alma-Ata identified community participation, one of the pillars of primary health care; as the process by which individuals and families assume responsibility for the health and welfare of both themselves and the community thereby developing capacity to contribute to the growth of their community [1] It is widely interpreted as the collective involvement of indigenous people in assessing their needs and strategizing to meet those needs [6]. Community participation is rapidly being viewed as a precondition for the successful acceptance of health services [10] It integrates a complicated process which involves customs, belief, culture and power relations, structures and policies [11]
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