Table 1. Selected programmes promoting community involvement in primary health care, worldwide, 1994–present.
| Characteristic | Programme |
|||
|---|---|---|---|---|
| CORE Group Polio Project19 | Ethiopia’s health extension programme20 | Sierra Leone’s participatory community-based health information system21 | Local health administration by communities (CLAS)a22 | |
| Timeframe | 1999 to present | 2003 to present | 2015 to present | 1994 to 2008a |
| Context | Rural and Muslim communities in Uttar Pradesh, India | Rural communities in Ethiopia | Slums in Freetown, Sierra Leone | Nationally in Peru |
| Challenge | Low vaccination rates associated with communities’ lack of trust in a polio eradication campaign and in the government health system | Lack of healthy behaviour change by households despite the deployment of a national cadre of professional CHWs | Routine health records and information incomplete and underutilized | Health priorities and resource allocation had been established without local input |
| Main actors | CORE Group Polio Project (a consortium of NGOs with national technical input) and community leaders | Government of Ethiopia and a large volunteer women’s development army | Government of Sierra Leone, NGOs and community development groups | Government of Peru and legal local entities created to oversee health budgets and activity (i.e. CLASs) |
| Community’s role | Sharing community concerns and collaborating with community leaders to identify solutions | Volunteers work with their neighbours to teach and provide a role model for basic health and sanitation behaviours | CHWs collect health information, which is reviewed by community data review committees at bimonthly meetings | Community control over budgeting and the distribution of funds |
| Outcome | Increased participation in and understanding of polio eradication activities, expanded health services and greater government responsiveness to community health needs | “Model household” status achieved by many throughout the country | Increased community capacity to use data and take the appropriate actions | Transparent financial management and decentralized priority-setting |
CHW: community health worker; CLAS: comunidades locales de administración en salud; NGO: nongovernmental organization.
a The programme was modified from its original form in 2008.