Community participation as myth or reality: a personal experience from Zimbabwe

Abstract

‘Community participation’ in health, as a slogan, is often abused. This paper argues that the attitude of most hearth workers to the causes of ill-health is influenced by their class aspirations, which are often different from those of the poor and unhealthy. Ill-health, and lack of development in general, is seen as the result of a struggle between the ‘haves’ and the ‘have-nots’ at all levels. Projects and anecdotal examples from meetings with communities in a rural area in Zimbabwe highlight the problem. Promotion of community participation in health programmes is time consuming and needs a lot of patience, tact and concern for the communities served. A plea is made to health workers and donor agencies not to be paternalistic.