PEOPLE S PARTICIPATION IN RURAL HEALTH SERVICES A Study of Development of the concept

Abstract

In most developing countries primary health care is not yet a reality; self-reliance and partnership between local communities and governmental agencies are necessary to make health programs successful. The determinants of standards of health include 1) purchasing power (dependent on incomes and prices of goods and services); 2) health environment (both the climate and the standards of public sanitation and the prevalence of communicable disease) and 3) peoples understanding of nutrition health and hygiene. Recently the emphasis has been on a broader approach to health policy including an emphasis on universal low-cost basic health care. 4 key areas that affect human development programs are political support finance administration and demand. The Community Development Programme organized in India is an example of emphasis on community participation in development of health programs and support for agriculture health sanitation and education services. Critical appraisal of the program found it wanting in actually developing educated self-reliant self-stimulating citizens able to make decisions about their future. There seems to be a tendency among villagers toward dependence on offical agencies for the solution of day to day problems. As a result certain principles were adopted by the Development Committee appointed by the government of India: 1) no individual should go without adequate medical care because of inability to pay; 2) health programs must place special emphasis on preventive medicine; 3) to ensure maximum benefit to rural communities health services should be placed as close as possible to the people; and 4) health education should be provided on a wide basis with encouragement of individual participation in local health programs. By choosing villagers for a Village Health Committee and training committee members in individual areas of responsibility such as sanitation registration of villagers and compilation of vital statistics a spirit of self-help is engendered and spread throughout the community.