Assessing the level of community participation in health development programmes

Abstract

It has been recognised that a number of health development projects and programmes have failed as a result of the unreflecting way in which community members have been left out of development processes and treated as mere recipients. These failures have raised much debate about community participation. Despite the controversy about the meaning and means of achieving community participation, it has been widely recognised and accepted that wider participation of community members in planning, implementation, management and evaluation of projects produces better results in health programmes. Community participation can be assessed by first recognising that participation occurs at different levels and by finding ways of measuring participation.

This study examines indicators that have been developed for assessing the level of participation in development projects. Using seven indicators which strongly influence the process of community participation, an analytical framework is presented with which participation is measured. These indicators are; needs assessment, leadership, organization, management, resources mobilization, action orientation and evaluation. An illustration of how the framework might be used is given with two case studies of health projects, one done in Nigeria and the other in Kenya.

The method provides a tool to assist those involved in a project to describe participation in such projects and to base future actions on their assessment. The method is descriptive, giving a visual presentation of the participation process. It is demonstrated that the framework is useful in understanding participation as a process.