Participation and empowerment in Primary Health Care: from Alma Ata to the era of globalization

Authors

  • Pol De Vos (1) Institute of Tropical Medicine, Public Health Department, Antwerp
  • Geraldine Malaise (2) Intal, Health Department, Brussels
  • Wim De Ceukelaire (2) Intal, Health Department, Brussels
  • Denis Perez (3) IPK, Epidemiology Department, Havana
  • Pierre Lefèvre (1) Institute of Tropical Medicine, Public Health Department, Antwerp
  • Patrick Van der Stuyft (1) Institute of Tropical Medicine, Public Health Department, Antwerp

Keywords:

Participation, Empowerment, Community organization, Social class, State

Abstract

With the 1978 Alma Ata declaration, community participation was brought to the fore as a key component of primary health care. This paper describes how the concepts of people’s participation and empowerment evolved throughout the last three decades and how these evolutions are linked with the global changing socio-economic context. On the basis of a literature review and building on empirical experience with grass roots health programs, three key issues are identified to revive these concepts: The recognition that power, power relations and conflicts are the cornerstone of the empowerment framework; the need to go beyond the community and factor in the broader context of the society including the role of the State; and, considering that communities and society are not homogeneous entities, the importance of class analysis in any empowerment framework.

Author Biographies

Pol De Vos, (1) Institute of Tropical Medicine, Public Health Department, Antwerp

medical doctor, researcher on public health policies and health sector reform at public health department

Geraldine Malaise, (2) Intal, Health Department, Brussels

staff member of south department

Wim De Ceukelaire, (2) Intal, Health Department, Brussels

medical doctor, staff member of south department

Denis Perez, (3) IPK, Epidemiology Department, Havana

psychologist, researcher on social medicine at epidemiology department

Pierre Lefèvre, (1) Institute of Tropical Medicine, Public Health Department, Antwerp

sociologist, researcher at public health departement

Patrick Van der Stuyft, (1) Institute of Tropical Medicine, Public Health Department, Antwerp

Epidemiologist, Epidemiolgy and Disease Control Unit, Public Health Department

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Published

2009-06-26

Issue

Section

Themes and Debates