Areas of Work
Life Course and Community Health
The maintenance of good health is a concern at all stages of a person’s life course--a dynamic chronological and biological process that runs from conception, pregnancy, birth, infancy, childhood, adolescence, adulthood, to old age. Each stage is associated with specific health risks and influenced by specific individual, family, and community determinants including access to quality health services. The life course and community health approach to health issues focuses on risks and the social and environmental determinants of health specifically associated with age, gender, ethnicity, and culture. Communities can shape individual and collective behavior, including health-seeking behavior, through a system of exchange and influence thus significantly influencing their health status and quality of life.
There is a need to ensure that the individual and the family have access and receive quality health care that considers not only the health of the individual but also addresses family and community conditions and interactions. An effective community health approach considers the vital role of social and environmental determinants of health (i.e. socioeconomic status, shelter, sanitation, work opportunities, access to basic necessities, security, etc.); respects community values; and provides opportunities for a participatory model in the social management of health care. Those goals are achieved through a health care strategy guided by the principles of primary health systems organization and universal health coverage.
Several important steps must be taken to ensure a successful approach to community problem solving and empowerment:
(1) At the outset, it is essential to identify community leaders who legitimately represent the best interests of the community and the identification of general priority health, socioeconomic, and development issues,
(2) This is followed by a detailed diagnosis of the community's health situation involving the active participation of key community members to identify and define the most important health problems that are amenable to intervention,
(3) Next, a decision on possible alternatives for intervention should be made based on priorities, resources, and the known effectiveness of the various possible lines of action.
(4) Finally, the selected interventions are implemented and their results evaluated. Actions taken and their impact must be closely monitored and reviewed. It is also sensible to conduct operational research studies within the community since the information obtained by those can be used to improve the effectiveness and efficiency of current and future interventions.
Examples of proven community interventions include promoting key family and community health practices; screening for diabetes and hypertension; training health care workers; and linking families, households, and community institutions with the critical components of primary care services and the overall health system.