Primary Health Care, Community Participation and the Urban Poor: A Review of the Problems and Solutions

Community participation is seen as the key to Primary Health Care (PHC) but to date is the most difficult and least understood principle. To assist health planners to implement PHC programmes, three simple questions can be asked: why participate? who participates? how do they participate? This paper explores in detail the latter question by asking how communities can be mobilised and what structures can be developed to support community participation. An analysis is made of community participation in programmes for the urban poor to examine the answers to these questions. Case studies from Asia are given to illustrate various points. The study concludes that if PHC has a chance of succeeding then all social services must be integrated, planning and management mechanisms must be developed, agency work must be coordinated and finally, planners must have flexible responses to programmes.