The concept of community health workers (CHWs), inspired by China's ‘barefoot doctors,’ combi... more The concept of community health workers (CHWs), inspired by China's ‘barefoot doctors,’ combined health service delivery and agent of change. It expanded rapidly in 1978 when Primary Health Care was adopted as health policy for the member states of the World Health Organization. The translation of theory into practice identified five issues critical to the development of CHWs, which are explored in detail in this article. These issues are: (1) Who is the CHW? (2) Can CHWs be both service extenders and facilitators for community improvement? (3) What training and support do CHWs need? (4) Are CHW programs effective? and (5) Are CHW programs sustainable?
This article reviews, in the opinion of the author, the 10 most influential reading on community ... more This article reviews, in the opinion of the author, the 10 most influential reading on community participation and health development. The introduction notes that some of the articles do not address health directly but still do bring crucial interpretations to the topic. All articles view community participation as an intervention by which the lives of people, particularly the poor and marginalised can be improved. In addition, they all address the issue of the value of participation to equity and sustainability. The article considers the readings under four heading: concepts and theory; advocacy; critiques and case studies. It highlights the important contributions each reading makes to the understanding of participation in the wider context of health and health development. In conclusion, the article argues that participation has not met the objectives of planners and professionals, in good part, because it is questionable as to whether viewing participation as an intervention enables them to make correct assessments of its contribution to development. The bottom line is that participation is always about power and control, an issue planners and professionals do not want explicitly to address.
WHO Library Cataloguing in Publication Data Rifkin, Susan B. Community participation in maternal ... more WHO Library Cataloguing in Publication Data Rifkin, Susan B. Community participation in maternal and child health/family planning programmes: an analysis based on case study materials. i.Community health services - organization & administration 2.Consumer participation 3.Maternal ...
In Section I of this paper we present an analytical paradigm by which to evaluate health and medi... more In Section I of this paper we present an analytical paradigm by which to evaluate health and medical care services in underdeveloped countries. In Section II, we apply this framework to an analysis of the health policies of one developing country, China. In Section III, we ...
This article discusses the origin of the concept of primary health care (PHC) and compares and co... more This article discusses the origin of the concept of primary health care (PHC) and compares and contrasts it with the concept of selective primary health care (SPHC) as it relates to programs devoted to improving child health. PHC came to encapsulate a health policy that emphasized basic health services particulary for the poor and focused attention on the relationship of health improvements to socioeconomic factors, which incorporated such things as education, nutrition, employment, and overall standards of living. SPHC narrowed the focus of health to a limited number of cost-effective medical/technological interventions that were believed to improve health rapidly and dramatically. Health planners developing child survival strategies must choose which approach to follow. Those who emphasize the importance of process do not reject the value of specific medical interventions, just as those who follow specific programs recognize the importance of considering the broader processes that determine health. However, entry points, work methods, and goals of the 2 approaches are very different. Whether the choice is conscious or unconscious, the one which is taken will have wide implications for the allocation of money, material, and manpower.
Primary Health Care (PHC) is an investment in the future because it does more than cure sickness ... more Primary Health Care (PHC) is an investment in the future because it does more than cure sickness it invests in the community and prevents a great deal of sickness. The World Health Organization (WHO) has been working to implement effective PHC through out the world. The Alma-Ata declaration in 1978 was a significant point in the history of PHC because it allowed all involved parties to closely examine the context in which PHC operates. The main principle of PHC is equity. Accessibility and confidence in quality are what the people of a community need for PHC to work. Prevention is another necessary feature of PHC because investing in the quality of life for the people in a community will reduce their need for medical treatments. Because PHC involves quality of life the issues of social life economic life and environmental quality are all brought together. This intersectoral action has made PHC a political issue as well as a medical one. Community participation has proven to be the deciding factor in the success or failure of any particular PHC program. In areas where the community looks favorably upon its PHC system the system will flourish. But in communities where there is distrust or apathy the system will die. The lessons of the past have shown several important issues that directly impact PHC. There has not been 1 replicable model for PHC delivery which means that PHC is context dependent. Unlike disease eradication programs which can be implemented anywhere PHC must adapt to the local needs of the community. The end must remain the same but means must be flexible. PHC is a process that needs to develop over time in concert with the changes in the community. PHC must also be based on a high level of quality service and commitment both from the health care providers and the community itself. PHC must be built with dialogue and information or else the process will fail. The health care providers and the members of the community must communicate with each other in constructive ways. It is very important that health care providers do not exclude the lay person because this will lead to failure.
The concept of community health workers (CHWs), inspired by China's ‘barefoot doctors,’ combi... more The concept of community health workers (CHWs), inspired by China's ‘barefoot doctors,’ combined health service delivery and agent of change. It expanded rapidly in 1978 when Primary Health Care was adopted as health policy for the member states of the World Health Organization. The translation of theory into practice identified five issues critical to the development of CHWs, which are explored in detail in this article. These issues are: (1) Who is the CHW? (2) Can CHWs be both service extenders and facilitators for community improvement? (3) What training and support do CHWs need? (4) Are CHW programs effective? and (5) Are CHW programs sustainable?
This article reviews, in the opinion of the author, the 10 most influential reading on community ... more This article reviews, in the opinion of the author, the 10 most influential reading on community participation and health development. The introduction notes that some of the articles do not address health directly but still do bring crucial interpretations to the topic. All articles view community participation as an intervention by which the lives of people, particularly the poor and marginalised can be improved. In addition, they all address the issue of the value of participation to equity and sustainability. The article considers the readings under four heading: concepts and theory; advocacy; critiques and case studies. It highlights the important contributions each reading makes to the understanding of participation in the wider context of health and health development. In conclusion, the article argues that participation has not met the objectives of planners and professionals, in good part, because it is questionable as to whether viewing participation as an intervention enables them to make correct assessments of its contribution to development. The bottom line is that participation is always about power and control, an issue planners and professionals do not want explicitly to address.
WHO Library Cataloguing in Publication Data Rifkin, Susan B. Community participation in maternal ... more WHO Library Cataloguing in Publication Data Rifkin, Susan B. Community participation in maternal and child health/family planning programmes: an analysis based on case study materials. i.Community health services - organization & administration 2.Consumer participation 3.Maternal ...
In Section I of this paper we present an analytical paradigm by which to evaluate health and medi... more In Section I of this paper we present an analytical paradigm by which to evaluate health and medical care services in underdeveloped countries. In Section II, we apply this framework to an analysis of the health policies of one developing country, China. In Section III, we ...
This article discusses the origin of the concept of primary health care (PHC) and compares and co... more This article discusses the origin of the concept of primary health care (PHC) and compares and contrasts it with the concept of selective primary health care (SPHC) as it relates to programs devoted to improving child health. PHC came to encapsulate a health policy that emphasized basic health services particulary for the poor and focused attention on the relationship of health improvements to socioeconomic factors, which incorporated such things as education, nutrition, employment, and overall standards of living. SPHC narrowed the focus of health to a limited number of cost-effective medical/technological interventions that were believed to improve health rapidly and dramatically. Health planners developing child survival strategies must choose which approach to follow. Those who emphasize the importance of process do not reject the value of specific medical interventions, just as those who follow specific programs recognize the importance of considering the broader processes that determine health. However, entry points, work methods, and goals of the 2 approaches are very different. Whether the choice is conscious or unconscious, the one which is taken will have wide implications for the allocation of money, material, and manpower.
Primary Health Care (PHC) is an investment in the future because it does more than cure sickness ... more Primary Health Care (PHC) is an investment in the future because it does more than cure sickness it invests in the community and prevents a great deal of sickness. The World Health Organization (WHO) has been working to implement effective PHC through out the world. The Alma-Ata declaration in 1978 was a significant point in the history of PHC because it allowed all involved parties to closely examine the context in which PHC operates. The main principle of PHC is equity. Accessibility and confidence in quality are what the people of a community need for PHC to work. Prevention is another necessary feature of PHC because investing in the quality of life for the people in a community will reduce their need for medical treatments. Because PHC involves quality of life the issues of social life economic life and environmental quality are all brought together. This intersectoral action has made PHC a political issue as well as a medical one. Community participation has proven to be the deciding factor in the success or failure of any particular PHC program. In areas where the community looks favorably upon its PHC system the system will flourish. But in communities where there is distrust or apathy the system will die. The lessons of the past have shown several important issues that directly impact PHC. There has not been 1 replicable model for PHC delivery which means that PHC is context dependent. Unlike disease eradication programs which can be implemented anywhere PHC must adapt to the local needs of the community. The end must remain the same but means must be flexible. PHC is a process that needs to develop over time in concert with the changes in the community. PHC must also be based on a high level of quality service and commitment both from the health care providers and the community itself. PHC must be built with dialogue and information or else the process will fail. The health care providers and the members of the community must communicate with each other in constructive ways. It is very important that health care providers do not exclude the lay person because this will lead to failure.
Uploads
Papers by Susan Rifkin