Community involvement in health development: an evaluation of rural health facility management committees in Nyeri District, Kenya

Abstract

Community participation it is a fundamental principle of Primary Health Care to ensure the IUCCSSS of the strategy of 'Health for All' in the twenty-first century. The importance of individuals,families and communities being involved in their own health development and care is now widely accepted. The main focus of this study was to examine the implementation of community participation within the framework of rural health facility management committees, in public health facilities of Nyeri District, Kenya. The study sought to establish the stage where the implementation of community participation has reached in Nyeri District and examine the relationship between the health workers and the community who are beneficiaries of the public health system. A cross-sectional descriptive study spanning three months was conducted in Othaya division of Nyeri district. Structured and pretested questionnaires were used to obtain information about activities and processes pertaining to community involvement in health care provision which are taking place in health centers and dispensaries in Nyeri district. The study population included those of the district health management team, the rural health facility management committees and those of the community members served by a particular public health facility. Four hundred respondents were interviewed from fourteen health facilities and the results analyzed. The community knew their role in provision of health services in their respective health facilities and gave financial contribution towards improvement of their health facilities. Most of the community leaders had never held a managerial position. Most health workers were happy about the assistance received from the RHFMC in provision of the necessary drugs and materials to run the health facilities. On staging community involvement in health care provision, needs assessment, leadership, community organization and resource mobilization were the indicators. Rural health facility managemen tcommittees were the main structures studied within the community. The following are the conclusions; the health professionals had the narrow view of community involvement limited to resource mobilization. The community on the other hand saw their involvement in terms of empowerment .The community studied indicated that formal meetings might not be the best way to effect the necessary mobilization. In rapid assessment surveys, one may use the information gathered using social scientific methods such as key informant interviews and focus group discussions to stage community Involvement for different groups within one program.