Community development in health

Overview Community development is both a philosophy and an approach to practice, aimed at improving the health and well-being of communities. The Alma Ata Declaration for Primary Health Care (WHO, 1978) (see Chapter 2) and the Ottawa Charter for Health Promotion (WHO, 1986) (see Chapter 8) provide foundations for community development in health, as does Paulo Freire's (1972) work on participatory approaches and empowerment of people through their active involvement in self-learning and community action. From community development perspectives, participatory research, education and health promotion are based on the premise that a community's insights into their own problems, and community involvement in solution-building, are critical for sustainable social change. It is that change that eventually produces health-creating circumstances and environments. The purpose of this chapter is to unpack the conceptual frameworks of community development as they relate to community nursing and health promotion. Objectives When you have read this chapter, you should be able to: examine concepts of participation and engagement, partnership and collaboration, empowerment and health development, and their relationship to community development approaches; recognise that outcomes of community development need to address the social determinants of health; become familiar with the policy context that supports community development in health; describe how community nurses can use political processes to facilitate community health and contribute to policy and political action.