Community Interventions

A Village Development Committee Orientation organized to allow representatives of different organizations to discuss and identify causes of low coverage and high drop-out in their community. Special emphasis was placed on monitoring the immunization drop-out rate of each health facility. Indicators for VDCs have improved in 2003, and Parsa District is now regarded as one of the highest performing districts in the region.

Current safer motherhood and newborn care programmes emphasize interventions that do not reach the poorest households. Community based interventions have been neglected and undervalued. In this article, we argue that large scale community effectiveness trials are both necessary and feasible if we are to make further progress with reducing maternal and child mortality. [author’s description]

This paper describes three examples of human resource development in community-driven HIV/AIDS programmes. The basic proposition is that acknowledgement, inclusion of and support for community based health initiatives is necessary to understand fully where health action is occurring and where potential for expansion lies. The paper calls for an expanded definition of health systems encompassing work being carried out by communities who are at the frontline in responding to the HIV/AIDS epidemic. Health care workers live in communities, and communities are providing health care.

An editorial arguing for expanding the professional category of the formal health care workers to include home-based informal caregivers, political community leaders, shop vendors of health products, and traditional health practitioners. The editorial further notes that formal health workers can become informal health workers when operating outside the rules of the health system.

The Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces.