There have been many examples
of community involvement in health. These have predominantly
taken the form of either community involvement in state health
programmes or NGOs acting as service providers. In Asia and Latin
America, civic organizations have been involved in mobilizing
effective demand for services, building awareness of community
needs and experimenting with innovative approaches that can be
replicated by the state sector.
Primary health care is perhaps
the best example of an approach that was initially pioneered
by NGOs and then taken up by government agencies. In Africa,
where new injections of resources have been made available through
debt relief, civil society organizations have worked with state
structures to use evidence-led planning and community preferences
in order to select priorities for intervention (Reid
& Kasale, 2000).
The most common NGO service
providers have been the churches, particularly in rural health
services in Africa (see
box). Examples of community group involvement include forming
community health groups or water user groups, or setting up community
home-based care initiatives.