POST 00933E : COMMUNITY HEALTH PLANNING

POST 00933E : COMMUNITY HEALTH PLANNING Follow-up on Posts 00888E, 00893E, 00907E, 00916E and 00922E 8 May 2006 _______________________________________________________ The following contribution comes from Makhaya Ndlangisa (mailto:[email protected]) from South Africa. As others on this topic it is cross-posted from The Connection network (mailto:[email protected]). __________________________________________________________ I would like to comment on a technical discussion raised by Dr. Koku Awanoor in Post 00916E on the joint possibilities. In post 00922E Dr. Anthony Theophilus Seddoh commented on the consistency of the denominator and numerator issues. As an epidemiologist, I would support Dr. Awanoor and agree with him on his explanation that is scientifically correct and does not have any inconsistencies regarding denominator and numerator. Regarding the CBHS I would say that the approach described in Dr. Awanoor's contribution is sound and based on primary health care (PHC) principles that are proven to be effective through many operational research throughout its implementation. I personally find Ghana experience as working "with" the community which is the key in attaining success as documented in the paper. Unfortunately, we witness many activities for rural communities that is not based on these principles and function mainly as working "for" the community. Fixed sites, even difficult to sustain, have many advantages compared to all other alternative methods of service delivery especially on the "acceptance" by the local communities. We have many examples that when the support is over such alternative initiatives despite demonstrating good results in short period of time have the tendency to decay fast. I agree with all counter arguments that fixed sites require more effort and resources, but once communities are the "owners" they defend their case. This is why in some ex-USSR countries even health workers are not paid (or extremely under-paid) for months - they never ever shut the doors of the health centre. Every morning they come to serve their communities. We should ask ourselves what makes these health workers to come to work every morning regardless they are paid or not. The answer is the "community". Community provides support to these health workers to survive as a return. Because these health workers are the ones who work "with" the community. The community gives support not to lose what they have invested in - that is the community's future: their health. Community based initiatives are the key, they are critical, but these initiatives should never be used as an excuse by the government (state) to invest less and less every year to health field and human resources. We need more commitments from the governments for their own people. Warm regards and greetings from South Africa, Dr. Makhaya Ndlangisa Epidemiologist ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de internationale en sant, Canada (http://www.ccisd.org) ______________________________________________________________________________