Providing Health Care
When planning health care interventions, it is important first to understand current health practices, as well as community needs: which health care services are available, what type of service the community wants and where health facilities should be located.
Abstract
In any community, people become ill and require access to health care facilities and treatment. The problem may be physical, such as diarrhoea, fever or injury, or mental, e.g. psychosis, epilepsy or a learning difficulty. Women have special needs related to pregnancy and childbirth, and children require immunization against common diseases. Regardless of the nature of the health issue, the health outcomes depend to a large degree on individuals' ability to access health care services. Unfortunately, health services are often planned without consulting the community members who use and pay for such services, particularly in rural areas. To counter this, and to meet community demands for accessible, affordable services, community members should be actively involved in their planning. Health centres should attract the community (see Figure 10.1). The way in which people deal with illness is also an important factor in health care. Most people initially treat ill-health within the home and seek outside help only when the problem continues or becomes severe. Such help may not necessarily come from qualified medical personnel; it can also come from local pharmacists or medicine sellers, traditional healers, religious leaders and friends. Often, seeking medical advice from qualified personnel is the last resort. This can happen for many reasons, such as that an individual does not consider the problem to be severe or " medical " in nature, or that the value of medical advice is not appreciated. Sometimes, there is simply mistrust of the medical profession. Consequently, when planning health care interventions, it is important first to understand current health practices, as well as community needs: which health care services are available, what type of service the community wants and where health facilities should be located. This can be achieved through community discussions using participatory learning techniques with different community groups—defined by age, gender, wealth and ethnic/reli-gious affiliation. The purpose is to generate a reliable picture of community needs and ensure that the services provided will be equitable, accessible and affordable.