Rethinking community participation: prospects of health initiatives by indigenous self-help organizations in rural Bangladesh

Abstract

This paper illustrate the process of implementation of a project, aimed at discovering ways of achieveing community participation in health matters, through indigenous village-based self-help organizations in Chakaria, a remote rural area of Bangladesh. The lessons learned during the first two years of project operation have also been presented in this paper. THe project strategies included establishment of a confident relationship with the participatory needs assessment, bringing health on the agenda of the self-help organezations, participatory planning, aaction, monitoring and evalution. The promotion of preventive health messages has been the major input from the project. Volunteers from the self-help organezations have also been trained by the project staff to disseminate health message among the community members, including women and school children. As a result of the project input, health could be brought on the agenda of the self-help organizations. Health message could be disseminated among the villagers through volunteers, without any maternal support from the project. In some villages, the self-help organizations have established village health posts to carry out growth monitoring, nutrition counselling, and prescription services by trinned village health care providers. During implementation, the project faced various problems. These included issues related to motivation of the project staff, relief mentality of the villagers, access to women, and suspicion against outside agencies. Appropriate steps taken had helped overcome the problems effectively. It was concluded that the existing village-based self-help organizations can be activated to take on health-related initiatives. However, the identification of a minimum level of external input, without which the organizations will not be optimally activated and the organizations will become dependent on external agencies, remains to be one of the future challenges.