Healthy Communities & Community Health 

The terms Community Health and Healthy Communities help us to look beyond health as an individual or medical issue towards seeing health in holistic way, as a community concern.

When we think about a “healthy community”, besides medical issues, we think about other, non-medical factors that influence individual and community health – for example, the environment, cultural customs and traditions, and the ability of people to make decisions that help them achieve good health and quality of life. Of course, we would also consider barriers to their ability to make those decisions.

For COL, Healthy Communities combines a broad definition of what makes up “good health” with a “community approach” to achieving it. Healthy Communities promotes a way of looking at health as part of community well-being and development. In this sense, health is an integral part of the larger community culture, environment, governance, and development.

Some definitions:

A.   Health:

“Health” is a state of complete physical, mental and social well-being.

Good health enables people to learn and to work. It enables them to participate in community life. Health gives people the ability to manage and change their surroundings. As such, it is a vital part of what we know as “community development.” Finally, health is a concept which is strongly influenced by circumstances, beliefs, culture, and the social, economic and physical environment.

A healthy community is defined as one that provides peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity. 

B. Community:

A community is a group of people with common characteristics: a common geographical location, ethnicity, age, interest, cultural group, etc. In this competition, we will be primarily looking at geographic communities. However, different types of communities – for example farmers, women and youth – may also be important in particular stories of healthy communities.

“Community” also implies a collective approach. It might be a common approach to identifying, tackling, and solving problems. The word “community” carries a sense of people looking beyond their own interests to a larger group. 

C. Healthy communities:

The concept of healthy communities takes a broad view of health. In other words, health is not simply a medical or biological condition. It also encompasses other factors that influence individual or community health.

Healthy communities are mindful of all aspects of health and endeavour to achieve good health for everyone. The idea of community implies that we are thinking about the community as a whole rather than simply each of the individuals in that community.

A healthy community is a community characterized by a strong sense of collective effort from individuals and from public and private agencies to protect and preserve the health of the community.

Here are a few examples of healthy communities:

• A community whose physical environments are planned to support healthy activities and social interactions. For example, a community that is addressing the issue of stagnant water as a source of malaria, contaminated drinking water as a source of waterborne illness, or safe environments for girls, women and elders.
• A community in which there is adequate access to basic health and other services. For example, a community in which all pregnant women have access to information about childbirth and access to health care, and where mosquito nets are available to everyone.
• A community with a sense of community safety – pollution-free, violence-free and crime-free. For example, a community that has addressed the issue of waste, found peaceful ways to resolve conflict, and enforces safe working practices for farm workers, e.g., in working with pesticides.
• A community that informs its members about health issues and provides the means to deal with health problems. For example, community efforts to help young people learn about sexually transmitted diseases, mental health, family planning, and parenting skills.
• A community that provides opportunities for learning, skill development and participation in a healthy lifestyle, helping individuals and families to learn about nutrition, exercise and related issues.

Ideas and examples

What can individuals and groups can do to promote healthy communities?

Here are some specific examples of initiatives that contribute to healthy communities. Please note that while most of these examples highlight projects with external funding, small or informal, grassroots initiatives are welcomed and encouraged as script themes for the course and competition.

Neighbours promote healthy eating practices in rural Mozambique[2]

In rural Mozambique, unhealthy infant and children feeding practices and illnesses caused by poor sanitation are key causes of childhood malnutrition. Cultural traditions can lead to deficiencies in children's diets, even when healthy foods are available. For example, mothers normally feed plain porridge to young children, ignoring locally available vitamin- or protein-rich foods such as nuts or greens. In addition, strict traditional gender roles may prevent men from being involved in nurturing their children.

But today in four districts of Manica Province in central Mozambique, a donor-funded program run by the NGO Africare works with a network of volunteer “model families.” The program – called Crescer or "to grow" in Portuguese – selects parents whose children are better nourished than average. After training, the model families share their knowledge with neighbours. They conduct cooking demonstrations and lead discussions on choosing nutrient-rich foods, preventing diarrhea, and building latrines, which most rural households lack. Many use traditional methods of communication such as song and dance to reinforce the lessons.

The program and the volunteer groups have helped communities to move beyond strict gender stereotypes, with men now openly involved in caring for their children. Fathers attend cooking demonstrations and lead songs about enriching children's porridge with sesame oil, greens, and eggs – something that was unheard of in rural Manica just a few years ago.

Phukusi la Moyo (Bag of life)

Malawi’s maternal and child mortality rates are amongst the highest in the world.

Phukusi la Moyo is a community-based learning program that promotes community health in Mchinji District, Malawi. It was developed by MaiMwana, a community-based maternal and child health project, in response to a need for greater awareness and action on maternal and child health. The program promotes healthy communities by mobilizing women to identify maternal health issues, share experiences, and work collectively towards solutions. Some 200 groups with more than 6000 active members, mostly pregnant women and new mothers, have been established since 2004; the network covers approximately 350 villages across the district. In 2009, the women took their conversations to a wider audience by beginning a radio show in partnership with Mudzi Wathu, the local community radio.

The project is reducing maternal and child mortality by increasing women’s knowledge of health and enabling collective action. Women are learning simple ways to promote safe childbirth and good health for themselves and their children. The project harnesses the power of shared experience to promote both individual and collective action, mobilizing women to take greater control over their own health care. The program has also generated greater understanding and empathy between health workers and communities.

Affordable health care made accessible[3]

Mariama is a spokesperson for the Women’s and Children’s Development Association of Kolda, in southern Senegal. For years, she and her friends observed that women had particular difficulties accessing and paying for health care. They realized the need for a mutual health organization (MHO). With the help of a donor-funded health program, a community-based organization was set up to run the MHO. Other program partners trained the committee on how to organize and operate an MHO. Currently, the MHO has 650 members, each of whom pay $2 to enroll and 40 cents in monthly fees. The health scheme covers doctor’s consultations, dental care, hospitalization, laboratory fees, medication, and X-rays. MHO members pay 25% of the costs and the MHO covers the remaining 75%. The health centre committee gives MHO members a 10% discount on medication.

According to Mariama: “There were times when I was sick, and instead of going to get help, I just suffered through it.” Mariama recalled times before the MHO when money was in short supply. Like many others, Mariama sometimes went to see the “marabout” (religious leader) instead of consulting a nurse or doctor. But those days are over. Now, Mariama is excited about the new possibilities that the MHO brings to Kolda, and makes rounds in the neighbourhood to convince others to join.

Diane Sagbohan volunteers in anti-malaria efforts[4]

Diane is one of only six women among the 265 spray operators who participated in Benin's first insecticide residential spray (IRS) campaign in three decades. She is from Sèmè-Kpodji, one of the four communes selected for spray operations during 2008 and known for high rates of malaria transmission. Despite the fact that spray operators for IRS campaigns are mostly men from her community, she was eager to join the effort.

Her participation in the IRS campaign offers new opportunities for female leaders to combat malaria in Benin. In her community, she is viewed as a pioneer. She is an example for others to change their behaviour and adopt practices that prevent malaria.

 

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