in health is a long-standing policy of WHO
Community involvement in health
(CIH), or participation, has been promoted by WHO for many decades.
The 1976 Alma Ata declaration made participation a central feature
of primary health care. The Harare declaration of 1987 outlined
CIH as a process of direct public involvement in health systems,
not only strengthening people's organization and skills, but
also reorienting political and health systems to support such
In the 1970s, CIH was based
on the belief that the socio-economic and political determinants
of ill health demanded wider inputs beyond health systems. In
the 1980s, a focus on district health systems located the community
as an important actor in organizing health sector interventions
at district level. A WHO review of CIH in 1999 summarizes this
history and the wide range of actions undertaken under CIH (Kahssay
& Oakley, 1999).