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Community-Based Primary Health Care

Health services will have more impact if they are based not only in the health facility but also in the community itself, through a wide variety of providers, and through complete engagement of community members to be actively engaged and empowered to improve their health. Community health workers play a large role in this effort. These resources provide history and examples of community based primary health care.

Online Courses

Health for All through Primary Health Care 

John Hopkins Bloomberg School of Public Health, Dr. Henry Perry.  

This five week course explores Health for all through Primary Health Care in the context of global health, their origins and meanings, the principles upon which they rest, and examples of how these principles have been implemented both at small scale as well as at large scale. The course also explores some ultra-low-cost approaches to Health for All through primary health care and the promise that primary health care holds for eventually achieving Health for All. 

The course consists of six one-hour lectures with readings and opportunities for discussions among those taking the course and interactions with the professor.

This course is taught each semester. Check website for the next course offering dates.


Case Studies in Primary Health Care

This course introduces the origins, concepts, and development of community-based primary health care through case studies from both developing and developed countries. It  uses real cases to help students develop problem-solving skills in practical situations. It also discuss participatory approaches in the organization and management of health services and other factors such as equity, socio-cultural change, environmental protection, and the process of community empowerment.

Included among this course's lecture materials are several recorded presentations by Carl Taylor, a giant in the field of international health. Dr. Taylor recorded the presentations for this course in January of 2008, just 2 years before he passed away in February of 2010. Click here for lecture materials


Health Communication Capacity Collaborative

This strengthens the capacity of organizations to implement their own social and behavior change communication (SBCC) programs. Online courses in Social and Behavior Change Communication can be located at: https://learning.healthcommcapacity.org/sbcc/default.asp.


Books

Just and Lasting Change:  When Communities Own Their Futures 

Authors: Daniel TaylorCarl E. Taylor; Pub. Date: February 2002; Publisher: Johns Hopkins University Press

Summary: Just and Lasting Change presents how to transform communities rapidly and in locally appropriate ways. Daniel Taylor and Carl Taylor have been present at key events and worked with key thinkers in dealing with the large forces of inequity, environmental change, and globalization. The approach they have synthesized builds on what has worked over the last century—and can now be implemented rapidly and cost-effectively in many parts of the world. It relies on a three-way partnership of "bottom-up" initiatives from the community level, "top-down" support from government agencies, and "outside-in" ingenuity and objectivity from experts. Based on both a diverse range of case studies—from the earliest attempts to promote social development in India a century ago to current efforts in Tibet, the Peruvian Andes, China, and the American Southwest—and engaging personal experiences, this book describes, step-by-step, how SEED-SCALE can be effectively implemented.

With contributions from leading international experts in community-based development and public health, Just and Lasting Change offers a hopeful description of how people have made a difference in diverse communities around the world and a practical, accessible handbook for those trying to improve the quality of life in underdeveloped communities everywhere.


Jamkhed
A Comprehensive Rural Health Project

Authors: Dr. Raj Arole, Dr. Maybelle Arole;   Publisher: Macmillan Education, Limited; Pub date: 1994.

Summary: This inspirational book provides valuable lessons on how to make “Health for All” a reality, even in the most challenging circumstances: a disenfranchised community in rural India.   It tells the story of Jamkhed, and the Comprehensive Rural Health Project, a world-renowned model of sustainable community-based primary health care.  In 1970, the authors were invited by the leaders of Jamkhed to provide health care in their community. What started out as a modest service program grew into the Comprehensive Rural Health Project (CRHP), reaching the poor, the marginalized and especially the previously unreached: women and children. Around Jamkhed, scores of men and women have come forward to acquire knowledge and skills in health and development. This empowerment has resulted in a drastic reduction in infant mortality and has improved the quality of village life.

Also available from Talc; Hesperian Health Guides

 
Setting Up Community Health Programs : A Practical Manual for Use in Developing  Countries

Author: Dr. Ted Lankester, MacMillan Books.  3rd Edition 2009

Summary: The first US edition of Setting Up Community Health Programmes  benefits from almost two decades of use, testing and revision. This detailed, simply written how-to manual covers all the basic principles of community based health care, setting up specific programs, and managing them, while reflecting post-millennium realities. Topics covered include: Health Awareness and Motivation, Learning about the Community, Setting up a Community Health Clinic, Setting up Community Programs for TB, Maternal Health, and Family Planning, A Community Development Approach to HIV/AIDS, Setting up Environmental Health Improvements, Managing Personnel and Finance. Designed for both urban and rural locations, this book addresses the needs of health workers, program managers, doctors, nurses, health planners, and all those who seek an evidence-based and practical approach to health care in the developing world.

Also available from Talc; Hesperian Health Guides


Practitioner Networks

Community Health Global Networks (CHGN). 

Founded by Dr. Ted Lankester and Dr. Nick Henwood in 2005, CHGN is a global network of individuals, community health workers, faith-based organizations, church/community leaders, academics and consultants who are passionate about empowering vulnerable communities to improve their health and wellbeing. CHGNs  goal is to strengthen community-based health care in resource poor settings.

Related Resources

SEED-SCALE

Seed is the process of activating empowerment at the community level and growing a local success. Scale is the expansion of this activity, both in geographic coverage and across development sectors for sustained improvement in quality of life.


Four principles underlie the SEED-SCALE process. When activities embody these principles, momentum for change grows and solutions evolve to fit local circumstances. The four principles are:

  1. Build from Success: Strengthen what is working
  2. Create Three-way Partnerships: Between community, government, and outside change agents
  3. Make decisions based on evidence, not opinions
  4. Seek behavior change as the primary outcome.

Using these principles, communities determine their own priorities and focus on practical solutions through the implementation of workplans


APHA International Health Community Based Primary Health Care Working Group

The current activities of the working group include promotion of Community-Based Primary Health Care (CBPHC) through regular meetings, a regular list-serv, and networking among members; a World Health Organization (WHO) funded project researching the evidence base supporting CBPHC; and administration of grants promoting CBPHC-related activities.

The Working Group currently meets twice a year -- once at the time of the American Public Health Association (APHA) annual meeting and another at the Global Health Council annual meeting (end-May/early-June).

The Working Group sponsors a workshop on practical aspects of CBPHC (for novices and experienced), on the day prior to the opening of the APHA annual meeting (usually on a Saturday in November), and it provides time for discussion and networking among those who attend (including an informal dinner after the workshop).

Between these meetings, members keep in contact by subscribing to a regular list server (join on the website or email freeman.p.a@att.net) and personal networking by email.

The website, list server and the list of training materials are dynamic in nature. All those who are interested are encouraged to comment on contents of the website including the list of training materials and to keep in touch with the Working Group through subscription to the list server and by email. Please let us know what experience you have with the materials presented and make suggestions for improvement. We are particularly interested to hear about presentations we could put on the site or additional training materials in relationship to CBPHC that you think we may all benefit from.

News: The World Health Organization has awarded a small grant to our Working Group to investigate the evidence base supporting CBPHC. This grant was only recently awarded after a thorough application process. An expert committee of world leaders in our field is to be formed to guide this evidence-based research. Additional workers willing to help with this large task are encouraged to approach the co-chairs. As the literature in this area is diffuse, we are interested to receive or hear about any studies - whether descriptive only or more advanced and whether previously published or not that - we could include in this review.

For further information, contact:

Dr. Paul Freeman, Chair at freeman.p.a@att.net or Dr. Melissa Freeman, Co-Chair  at melissa.freeman@re-vive.org 

 


Tearfund

This site has current and archived copies of Footsteps. Footsteps is for grassroots health and development workers. It is produced every three months and each issue concentrates on a main theme. Recent Footsteps themes are literacy, facilitation skills, the impact of HIV and AIDS on children and pollution.


Training Manuals

Training for Transformation

A handbook for community workers Books 1-3

Three volumes designed to assist workers in the field who are encouraging the development of self-reliant creative communities. The book has as its basic philosophy the belief that we should all participate in making this world a more just place to live in. Training for Transformation integrates the approach of Paulo Freire and how to put his method into practice, Manfred Max Neef's understanding of fundamental human needs, group methods which are essential for participatory education, organizational development, which stresses how to build structures which enable people to become self-reliant, and social analysis to help groups find the root causes of problems.


Training for Transformation: A Handbook for Community Workers, Vol. 4

Authors: Anne Hope, Sally Timmel;  Publication Date: February 2000 | Series: Handbook for Community Workers Series (Book 4)

Training for Transformation Book 4 is a practical and accessible workbook for community development workers. It recognizes that the only changes which effectively transform the lives of poor people are those in which they have been active participants--this book, and the earlier books in the Training for Transformation series, give many proved and practical ways of getting this process started. 

Book Four focuses on five issues that have become more and more prominent in the concerns of communities throughout the world:

  • The environment
  • Gender and development
  • Ethnic and racial conflict
  • Intercultural understanding
  • Building participatory governance


Each section contains a rich selection of relevant material designed to stimulate interest and debate, including simulations, real life stories, telling statistics, news articles, poetry and drama from local communities. The authors have drawn on their direct experience of working on community development programs in South Africa and the USA, as well as feedback from many other countries where the "Training for Transformation" approach has been adopted.

The book is divided into easy to follow modules which can be covered in sequence or in any order. All the exercises have been extensively tested in the field and have been used successfully with groups in many different countries.

Training for Transformation Book Four will be ideal for adult education workers, social workers, community development workers, church workers and trade union educators, and all organizations and individuals concerned with the process of transforming society.

Though part of a series, this new volume stands alone as a source of ideas and materials to develop community participation.


Videos

A Tribute to Carl Taylor 1916–2010.

A symposium  produced by colleagues at Johns Hopkins University celebrating Carl Taylor’s life given at Hopkins after his death in 2010.

Jamkhed CRHP   

The story of Jamkhed written, directed and produced by Amanda De Luis and Edwin Toone with help from all the staff of CRHP.


Powerpoint  Presentations

Comprehensive Rural Health Project: Improving the wellbeing of women throughout the lifespan with CBPHC: Jamkhed, India, experience; CCIH, 8 June 2013;  Shobha Arole, MBBS, Ratna Kamble, MSW, Pushpa Pawar, VHW , Connie Gates, MPH, Jamkhed.


Christian agencies engaged with Primary Health Care:  Community Health Global Network members are feeding in to the World Health Organisation’s thinking.  
Dec 07 and July 08 CCIH  May 2008, Dr. Nick Henwood, CHGN.

Building from Common Foundations: The World Health Organization and Faith-Based Organizations in Primary Health Care, The Reverend Canon Ted Karpf, Office of the Director-General WHO, CCIH Confernence May 2008.


Christian Contribution to Primary Health Care,
Dr. Jack Bryant, CCIH Conference, May.  2008

What is different now? A Christian Medical Commission’s Role in Health Planning, Carl E Taylor MD DrPH, Johns Hopkins Bloomberg School of Public Health; CCIH May, 2008


Systematic Review of the Effectiveness of Community-Based Primary Health Care in Improving Child Health: The Contribution of the Faith-Based Community,
Henry Perry, MD, MPH, Carl Taylor Professor for Equity and Empowerment, Future Generations; CCIH May, 2008.