(July 2006) Although advances in health have contributed to improvements in quality of life worldwide, persistent health problems remain in developing countries—particularly for poor, marginalized, and rural populations, and especially in regard to neonatal mortality, preventable childhood illnesses, and adolescent reproductive health issues.

Cost-effective interventions are available to address many pressing health problems such as these. But sustaining healthy populations and creating a context that facilitates health may require a broader perspective such as that embodied in community participation—a process that increases a community’s capacity to identify and solve problems that lead to equitable and sustainable improvements in health. Examples of this approach include:

  • Obtaining support from elected officials for health studies and using village health workers to play key roles in neonatal interventions in rural India;
  • Working with grassroots organizations and local elected officials to decide placement of latrines and standpipes in Kerala State, India; and
  • Using community members as researchers in a study of adolescent reproductive health in Nepal.

But some health specialists think that community participation is time-consuming and does not really improve health outcomes. Participatory processes can be protracted and progress toward health goals delayed, requiring heavy time and resource investments that may not be matched by the achievement of desired results.

This Health Bulletin explores community participation in health, using five case studies of participatory processes and their role in instigating important health and well-being benefits. Written by Kristina Gryboski, a medical anthropologist; Ricardo H. Dios, technical director for the UNI Trujillo Project in Peru; and Nancy V. Yinger, Fariyal F. Fikree, and Heidi Worley of the Population Reference Bureau, this Bulletin is the third in a series that seeks to understand and convey the important qualitative issues that determine health status—disparities, communication, and community participation.