A community-led approach to health improvement is now a significant feature of health improvement policy and practice, both in the UK and internationally. This paper sets out to explore the character of this approach and the contribution that it makes to health improvement and addressing health inequalities. It gives particular emphasis to understanding the central role of development support that seeks to empower communities as architects of actions that impact on their own health. At the heart of the exploration lie models that illustrate the logic of the way in which, to achieve desired outcomes, resources are deployed, development support is offered and action is taken.
This paper began by describing community-led health as now being part of the landscape of health. The arguments and models developed for this paper are intended to illustrate the value of investment in this sector. Given national ambition to reduce health inequality, the primary contribution of a community-led approach is the support, development and liberation of collective community capacity and the building of social capital by disadvantaged communities to create and access the resources needed for health and challenge risk conditions. For this contribution to be realised investment is required at various levels, not least at the level of health improvement policy.
“The empowerment of disadvantaged communities as we understand it, is inseparably intertwined with principles of state responsibility. This point has fundamental implications for policy-making. The empowerment of marginalised communities is not a psychological process unfolding in a private sphere separate from politics. Empowerment happens in ongoing engagement with the political, and the deepening of that engagement is an indicator that empowerment is real. The state bears responsibility for creating spaces and conditions of participation that can enable vulnerable and marginalised communities to achieve increased control over the material, social and political determinants of their own wellbeing. Addressing this concern defines a crucial direction for policy action on health equity. It also suggests how the policymaking process itself, structured in the right way, might open space for the progressive reinforcement of vulnerable people’s collective capacity to control the factors that shape their opportunities for health”
Click the link below to read the full paper