Community Participation

Journal of Community & …, 2000

Journal of Health, Population and Nutrition, 2003

This paper presents a framework to explore the relationship between health equity and community empowerment. It traces the progression of the concept of participation to the present term of empowerment and the links among empowerment, equity, and health outcomes. It argues that the relationship can best be described by using the acronym CHOICE (Capacity-building, Human rights, Organizational sustainability, Institutional accountability, Contribution, and Enabling environment). Based on the concept of development as freedom put forward by Nobel Laureate Amartya Sen, the paper describes how each factor illustrates the relationship between equity and empowerment in positive health outcomes, giving appropriate examples. In conclusion, it is suggested that these factors might form the basis of a tool to assess the relationship between equity and empowerment and its impact on health outcomes.

Health and Human Rights, 2009

shows that each phase of the evolution of these concepts added important new aspects to the discussion. This article focuses on three crucial issues that relate to these additions: the importance of social class when analyzing the essentials of community participation, the pivotal role of power highlighted in the discussion on empowerment, and the role of the state, which refers to the concepts of claim holders and duty bearers included in a rights-based approach to health. The authors compare these literature findings with their own experiences over the past 20 years in the Philippines, Palestine, and Cuba, and they offer some lessons learned. The concept of "health through people's empowerment" is proposed to identify and describe the core aspects of participation and empowerment from a human rights perspective and to put forward common strategies. If marginalized groups and classes organize, they can influence power relations and pressure the state into action. Such popular pressure through organized communities and people's organizations can play an essential role in ensuring adequate government policies to address health inequities and in asserting the right to health.

Health and Human Rights, 2018

Community participation is not only a human right in itself but an essential underlying determinant for realizing the right to health, since it enables communities to be active and informed participants in the creation of a responsive health system that serves them efficiently. As acknowledged by the Rio Political Declaration on Social Determinants of Health, participatory processes are important in policymaking and in the implementation of laws relating to health. Collective deliberation improves both community development and health system governance, resulting in more reasoned, informed, and public-oriented decisions.1 More recently, attention has focused on the elements of health system governance that enable greater responsiveness to community needs. However, there is relatively little by way of interventions linking human rights approaches to governance in ways that recognize participation as a critical social determinant of the right to health. This paper provides perspective...

Health Promotion International, 2020

This article-third in a series of three-uses theoretical frameworks described in Part 1, and empirical markers reported in Part 2, to present evidence on how power dynamics shifted during the early years of a major English community empowerment initiative. We demonstrate how the capabilities disadvantaged communities require to exercise collective control over decisions/actions impacting on their lives and health (conceptualized as emancipatory power) and the exercise of power over these communities (con-ceptualized as limiting power) were shaped by the characteristics of participatory spaces created by and/ or associated with this initiative. Two main types of participatory spaces were identified: governance and sense-making. Though all forms of emancipatory power emerged in all spaces, some were more evident in particular spaces. In governance spaces, the development and enactment of 'power to' emerged as residents made formal decisions on action, allocated resources and managed accountability. Capabilities for alliance building-power with-were more likely to emerge in these spaces, as was residents' resistance to the exercise of institutional power over them. In contrast, in sense-making spaces residents met informally and 'made sense' of local issues and their ability to influence these. These processes led to the development of power within capabilities and power to resist stigmatizing forms of productive power. The findings highlight the importance of designing community initiatives that: nurture diverse participatory spaces; attend to connectivity between spaces; and identify and act on existing power dynamics undermining capabilities for collective control in disadvantaged communities.

Empowerment and Community Participation, 2018

Scandinavian Journal of Public Health, 2002

Community Development Journal

Community-based approaches are now central to international, national and local social and health policies aimed at economic, social and health improvements in populations. Although these are often described as Community Development initiatives, many do not involve people with formal qualifications and experience in community development practice. Indeed, whilst health professionals are increasingly recognizing that community development approaches can support their work, there appears to be much less recognition of community development as a specialist field of practice and research in its own right. The papers in this special issue seek to shine a light on how the two sectors can complement each other and begin to illuminate the potential benefits that could flow from the wider utilization of community development expertise and research in local action to reduce health inequities (see https://www.who.int/health-topics/health-equity# tab=tab_1). The terms health equity and health inequity have been used to frame this special issue. Health is a human right and health equity is achieved, according to World Health Organization (WHO), 'when everyone can attain their full potential for health and wellbeing'(WHO, 2023). The term health inequities refers to the unfair and avoidable differences in the experience of health, well-being and life expectancy across populations within and across nations. These inequities are caused by systems of discrimination, powerlessness and disadvantage that intersect across social class, gender, ethnicity, sexuality, age, disability and geography. Inequitable access to health care and other services also contribute. Health inequities produce

1989

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NEJM Catalyst, 2022

The Covid-19 pandemic exposed and intensified health inequities that caused disproportionately higher rates of infection,morbidity, and mortality inmarginalized and disadvantaged communities, along with greater social and economic devastation. At the same time, highly visible violence against Black people, includingmultiple killings by police, highlighted race and racismas a pivotal social determinant of health (SDOH). The authors describe the response of a community health center that serves a largely Latinx population. Brookside Community Health Center adapted and redesigned health care to better address SDOH, reaching beyond the traditional social determinants to address underlying factors, the drivers of those SDOH: fortifying social networks and social cohesion, political power, political voice, and protest. Brookside CommunityHealth Center’swork exemplifies the historicmission of community health centers, which defines health in the broadest of terms and recognizes the connections among health, human rights, and political power and participation.