RETHINKING COMMUNITY PARTICIPATION IN HEALTH; THE SOUTH ASIAN EXPERIENCE

Abstract

The concept of community participation gained universal attention with its formalization in the Alma Ata Conference focusing on Primary Health Care held in 1978. Thereafter the concept has attracted many a health planners, activists and policy makers. Following Alma Ata declaration, global frameworks on health, especially the Ottawa charter for Health promotion, 1986 and Jakarta Declaration, 1997 gave thrust to the concept of community participation in health. The participating countries of these conferences and member nations of WHO were urged to frame national programmes and policies on health focusing on community participation. Furthermore, the debates and discourses around social capital and civic engagement within the development community supported by the international agencies like World Bank made community involvement through civic participation an integral part of any development efforts, especially in health promotion. Community participation was thus identified as the ‘grant panacea’ for all the problems relating to health promotion, especially for poor access. So this paper, taking into consideration the concept of community participation in health, within the framework of social capital discusses the country level experiences around community participation in health across South Asian countries and tries to analyse the lacunae in viewing community participation as built through ‘civic engagement’ and ‘social networking’, without taking into consideration, the ingrained social differentials of power on the basis of caste, class and gender.