Community-based Initiatives

  
 

About community-based initiatives

 

Community-based initiatives (CBI) programmes are an integrated bottom-up approach to socioeconomic development, including health, aiming at achieving a better quality of life for communities.

The initiatives address integrated socioeconomic development and the social determinants of health through community empowerment and intersectoral coordination. The programmes are self-sustained and focused on people. They address the diverse basic needs of the community and recognizes health as a key element of social cohesion.

As of early 2008, the CBI programme was implemented in 17 countries of the Region: Afghanistan, Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Jordan, Lebanon, Morocco, Oman, Pakistan, Saudi Arabia, Somalia, Sudan, Syrian Arab Republic, Tunisia and Yemen, covering 951 areas and a population of 18 190 860.

The initiatives empower communities to assess, analyze and prioritize their development needs, based on their available resources, and to generate additional resources to implement and monitor their own planned interventions.

 

There is clear evidence that community-based initiatives offer added value in bridging inequity and have positive implications for health. The most salient aspects of this approach are the organization, mobilization and enhancement of community capabilities, and involvement in micro-development of social and income-generating schemes emphasizing basic needs.

Many of the inequities in health, both within and between countries, can be understood in terms of social inequities, i.e. inequities in the social conditions in which people live and work. These social determinants, the social conditions of daily life, have a major impact on health status and on general well-being. Tackling such underlying causes of poor health can contribute to improving health and health equity, where health equity is defined as the absence of systematic disparities in health between more or less advantaged social groups.

Tackling the social determinants of health through community-based initiatives

The initiatives are seen as an appropriate grass-roots' intervention to address key social determinants of health in the Region and beyond and is recognized by the Regional Office as one of the priority programmes in the Region because it represents true investment in health at the community level.

CBI has resulted in positive impact on the health and socioeconomic indicators of the communities involved, which are empowered to prioritize their needs and plan, implement, manage, monitor and evaluate community-originated interventions aimed at a better quality of life. The impact of the programme has been evaluated in Djibouti, Islamic Republic of Iran, Pakistan, Sudan, Syrian Arab Republic and Yemen. The evaluations have demonstrated the effectiveness of the programme interventions in improving maternal and child health, increasing family planning coverage, immunization coverage for children and boosting other health and socioeconomic indicators, including income of the poorest members of the community.

Immunization of measles in the CBI implementing areas, Djibouti, Jordan, Pakistan, Sudan and Yemen

Major challenges

Future direction

Poverty and lack of access of vulnerable groups to basic services

 

  • Assist Member States to prioritize resource allocation to the poor and underprivileged areas based on defined criteria.

  • Strengthen intersectoral collaboration for health development and focus on social determinants of health and promoting health equity.

  • Community empowerment in planning and management of development projects as a key sustainability factor.

Insufficient political commitment

  • Programme advocacy and capacity-building.

  • Continue development of evidences for effectiveness of CBI and creation of replicable models based on local needs.

  • Institutionalizing the CBI programme within the national health policy programmes and health systems.

Insufficient linkages between primary health care and community-based organizations

  • Support sustainable intrasectoral coordination for comprehensive health care.

  • Streamlining programme management and monitoring systems.

  • Capacity-building of facility level health workers on community organization and mobilization.

  • Linkages of existing CBI implementing sites with primary health care centres as an integral part of their duties (including monitoring and supportive supervision to the CBI implementing sites).

Low levels of community awareness and their involvement in health-related actions

  • Implementing local health and development interventions through empowering communities in the training of cluster representatives, promoting health volunteerism, etc.

  • Strong linkages between volunteers and health staff at the local level and utilizing the community as health partners.

  • Community capacity-building as an integral part of health-related programmes.

Inadequate intrasectoral collaboration

  • Formalizing intersectoral collaboration mechanisms at the local, district and national level.

  • Introducing a disaster management component in CBI-implementing areas as an intervention needing high-level intersectoral collaboration.

  • Promoting a CBI model of intersectoral collaboration at the national level.

Insufficient partnerships and harmonized action for socioeconomic development, including health at all levels

  • Scaling up CBI expansion, promoting partnerships and linking with ongoing development goals and policies, such as the Millennium Development Gaols, Poverty Reduction Strategy Papers, etc.

  • Mapping partners and encouraging joint planning at the local and national level.

  • Promote one development plan and develop a multi-partner strategy led by the government.

 

 

 

Community-based initiatives series


The community-based initiatives series is aimed at facilitating the management of such initiatives. Users of the series may include government authorities, community representatives. 

Access the series