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Healthy Villages - A Guide for Communities and Community Health Workers
Foreword
Document aims and target audience
This guide was developed to support the Healthy Villages
approach for improving the health of rural communities. It provides local
community leaders with a model of the type of information they may need to
consider in their roles as current or prospective managers of a Healthy Villages
project. Community leaders include not only elected officials, but also the
health staff, respected elders and others who work to improve the health of
rural communities. We outline the type of information that Healthy Villages
managers could provide to their communities, as well as the basis for developing
material that is specific to regions or to entire countries. Because this guide
was designed to be used in many different countries, it is likely that
modifications will be required at local levels to ensure that local conditions
and practices are taken into account.
It is recognized that many excellent locally-developed solutions
for village health problems are already being practised. This guide is not
intended as a global prescription for promoting improved health in rural
communities, but rather as source material from which readers can develop local
solutions to local problems. The purpose of this guide, therefore, is to provide
a model of the type of information and approaches for promoting healthier
villages that readers can use when implementing village-level activities.
The Healthy Villages project
Many countries are developing stronger partnerships between the
health sector and local government organizations to promote local "settings"
initiatives for health. A Healthy Villages project assists in this by putting
concepts such as hygiene education, environmental health, health promotion and
environmental protection into action in rural communities. A Healthy Villages
project enables a village to mobilize the human and financial resources needed
to address many health and quality-of-life issues. The process works as a
communication strategy that develops political and popular health awareness and
support for health issues.
Settings are major social structures that provide ways of
reaching defined populations. Each setting in a village has a unique set of
members, authorities, rules and participating organizations, each with interests
in different aspects of the village life. For example, work settings include
agriculture and small-scale industry; other settings include the food-market,
the housing setting or the school setting. Generally, these structures are
organized for purposes other than health. Interactions are frequent and
sustained in these settings and are characterized by patterns of formal and
informal membership and communication. These qualities create efficiencies in
time and resources for health education programming, and offer more access and
greater potential for social influence.
Villages are often defined in terms of arbitrary administrative
definitions. A village may be a small group of people living in a settlement who
practise subsistence agriculture, with no specialization or division of labour,
and who are isolated from national development agencies. A village may also be a
large and differentiated conurbation where some people work in agriculture, some
work in small-scale industries and others provide education, health care,
administration and a variety of services. This guide is directed towards the
larger and more differentiated village. It is also recognized that many villages
do not operate independently from cities, in that cities require sustained
interaction with rural communities for their food and natural resources
(including land for waste disposal). Often, too, the district agencies that set
policy and administer the villages are located in cities. Under these
circumstances, a Healthy Villages programme has a greater chance of success if
the linked city is participating in a similar type of programme for cities - a
Healthy Cities Programme1 - and if the district-level staff implement
Healthy Villages as part of the health policy for all the towns and villages in
the district.
1 Werna E et al. Healthy city projects
in developing countries: an international approach to local problems.
London, Earthscan,
1998.
