Community participation: lessons for maternal, newborn, and child health

Mikey Rosato, Glenn Laverack, Lisa Howard Grabman, Prasanta Tripathy, Nirmala Nair, Charles Mwansambo, Kishwar Azad, Joanna Morrison, Zulfiqar Bhutta, Henry Perry, Susan Rifkin, Anthony Costello

Research output: Contribution to journalReview articlepeer-review

260 Citations (Scopus)


Primary health care was ratified as the health policy of WHO member states in 1978.1 Participation in health care was a key principle in the Alma-Ata Declaration. In developing countries, antenatal, delivery, and postnatal experiences for women usually take place in communities rather than health facilities. Strategies to improve maternal and child health should therefore involve the community as a complement to any facility-based component. The fourth article of the Declaration stated that, "people have the right and duty to participate individually and collectively in the planning and implementation of their health care", and the seventh article stated that primary health care "requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care". But is community participation an essential prerequisite for better health outcomes or simply a useful but non-essential companion to the delivery of treatments and preventive health education? Might it be essential only as a transitional strategy: crucial for the poorest and most deprived populations but largely irrelevant once health care systems are established? Or is the failure to incorporate community participation into large-scale primary health care programmes a major reason for why we are failing to achieve Millennium Development Goals (MDGs) 4 and 5 for reduction of maternal and child mortality?

Original languageEnglish
Pages (from-to)962-971
Number of pages10
JournalThe Lancet
Issue number9642
Publication statusPublished - 2008
Externally publishedYes


Dive into the research topics of 'Community participation: lessons for maternal, newborn, and child health'. Together they form a unique fingerprint.

Cite this