Few battles are won alone. Cambodia’s ongoing fight with malaria has grown in force over the years, becoming stronger and more successful with each person that joins the effort.
But a study on Cambodia’s approach to health notes that greater community participation is needed to ensure that wellness is not a quick fix but an ongoing state of mind.
Community participation is critical to ensuring that a sick public not only receives needed treatment but is engaged and aware of the decisions being made to develop their physical and mental health.
And this must improve in Cambodia, according to “Talking the Same Language? Evaluating Community Participation,” a report presented by the Australian Center for Tropical and International Health and Nutrition last December at the Mekong Malaria Symposium in Siem Reap.
The study found that health sector reforms in Cambodia often develop a single sector, like health care staff, rather than multiple sectors, like an entire community.
Health center workers often prioritize the provision of public and private clinic services and the implementation of national programs. This plan helps develop health care staff with limited training, but does little to incite local initiatives to achieve wellness, the report found.
An example of this disconnect between staff and society is the Health Center Management Committees, which are established to integrate community voices into the planning and implementation of health services. The report found that the limited health experience of many committee members stirred doubt in the health care staff reviewed by them, ultimately weakening community communication rather than strengthening it.
The report noted that many committee members considered a “good” model of community participation to be the compliance of health center staff with health center programs—essentially one’s ability to follow instructions from above and inform communities that the health center provides good services.
Because reform of Cambodia’s health sector is part of a larger effort to decentralize health services and implement national programs, health care becomes precariously entwined with politics.
“There is a ‘built-in’ tension between improving the salary and conditions of health staff and meeting the needs of the poor, and although cost-recovery schemes and community participation have improved the transparency of health charges, costs are still too high,” the report said.
To overcome the disconnect between health workers, the bureaucracy they work under and the people they work for, it is important that both public and private sectors broaden their vision of community health development, the report stated.
“Community participation makes health services more cost-effective, drawing on the financial and personal resources available in communities,” the report said.
The benefits of community participation extend beyond accomplishing a simple task, however, the report said. The development of self-reliance and a sense of equality are offshoots of a collective effort to get ahead.
