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On-line version ISSN 2223-6279
Print version ISSN 0379-8577

Curationis vol.32 n.1 Pretoria  2009




The levels of Community Involvement in Health (CIH): A case of rural and urban communities in KwaZulu-Natal



GG Mchunu

PhD. University of KwaZulu-Natal, School of Nursing





The study aimed to describe the practice of community involvement in health programmes. The study therefore explored the nature and practice of community involvement in health programmes in the two communities in KwaZulu Natal. The study was guided by the conceptual framework adapted from Arnstein's,( 1969) Ladder of Citizen Participation. This framework shows different levels and steps in community participation. A case study method was used to conduct the study. The two cases were one urban based and one rural based community health centers in the Ilembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in the study. The sample comprised 8 registered nurses, 2 enrolled nurses 13 community members and 8 community health workers. Data was collected using structured individual interviews and focus group interviews, and was guided by the case protocol. Community involvement in health largely depended on the type of community, with rural community members being in charge of their health projects and urban community members helping each other as neighbours in times of need.

Key words: Community involvement in health, ladder of participation, Primary health care, and health programmes



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ABELSON, J 2001: Understanding the role of contextual influences on local health-care decision making: case study results from Ontario, Canada. Social Science & Medicine 53 (6), 777-793.         [ Links ]

ARNSTEIN, SR 1969: A Ladder of Citizen Participation. JAIP 35 (4), 216-224.         [ Links ]

BHUYAN, KK 2004: Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries. BMC Public Health, 4:11 accessed on 027/02/2009 via         [ Links ]

BROWN, ER; HOLTBY, S; ZAHND, E & ABBOTT, GB 2005: Community-based Participatory Research in the California Health Interview Survey. Prev Chronic Dis. 2(4). 1-8        [ Links ]

BUKENYA, D 2008: Community Partnering - the missing link. AMREF news        [ Links ]

BURNS, N & GROVE, SK 2001: The Practice of Nursing Research Conduct, Critique and Utilization (4th edition). Philadelphia: WB Saunders.         [ Links ]

CLARK, MJ 2003: Community Health Nursing: Caring for Populations (4th edition). USA: Prentice Hall        [ Links ]

CRABTREE, BF & MILLER, WL 1992: Doing qualitative research. Newbury: Sage.         [ Links ]

DENNILL, K; KING, L & SWANEPOEL, T 2002: Aspects of primary health care: community health in Southern Africa. South Africa: Oxford.         [ Links ]

DEPARTMENT OF HEALTH 1997: White Paper for the Transformation of the Health system in South Africa. Government Notice No. 17910 , Pretoria. accessed on 23/02/2009        [ Links ]

DOLAMO, BL 2009: Transforming Health Services Delivery: The Leadership Perspective Accessed on 25/02/2009 via        [ Links ]

GERRING J 2007: Case study Research: Principles & Practices. USA: Cambridge University Press        [ Links ]

GLASER, BG & STRAUSS, AL 1967: The Discovery of grounded theory. New York: Aldine.         [ Links ]

KAHSSAY, HM & OAKLEY, P 1999: Community involvement in health development: A review of the concept and practice. Geneva: WHO.         [ Links ]

LAVERACK, G 2007: Health Promotion Practice : Building Empowered Community. London: Open University Press        [ Links ]

MCHUNU, GG & GWELE, NS 2005: The meaning of community involvement in health: the perspective of primary health care communities, Curationis. 28(2), 30-37        [ Links ]

MILES, MB & HUBERMAN, AM 1994: Qualitative data analysis. Thousand Oaks: Sage.         [ Links ]

MORGAN, LM 2001 : Community participation in health: perpetual allure, persistent challenge. Health Policy Planning. 16(3), 221-230        [ Links ]

NKASA, GA & CHAPMAN, DW 2006: Sustaining community participation: What remains after the money ends? Review of Education. 52, 509-532.         [ Links ]

PADARATH, A; NTULI, A; SIBIYA, Z et al 2006: Community Participation in HIV Services, South African Health Review. Durban: Health Systems Trust        [ Links ]

POLIT, DF & BECK, CT 2004: Nursing Research: Principles and Methods, 7th ed Philadelphia: Lippincott Williams & Wilkins        [ Links ]

POLIT, DF; BECK, CT & HUNGLER, BP 2001: Essentials of nursing research: methods, appraisals and utilization. 5th edition. Philadelphia: JB Lippincott.         [ Links ]

PORCHE, DJ 2004: Public & Community Health Nursing Practice: A population- Based Approach. Thousand Oaks: SAGE Publications        [ Links ]

REID, NJ 2000: Community Participation. USDA Rural Development. Accessed on 27/02/2009 via        [ Links ]

REPUBLIC OF SOUTH AFRICA 2004: National Health Act (Act No. 61 of 2003), Government Gazette. 23, No. 26595        [ Links ]

RIFKIN, SB 1990: Community participation in maternal and child health/family planning programs: an analysis based on case study materials.., World Health Organization, 9-15.         [ Links ]

STANHOPE, MS & LANCASTER, J 2004: Community & Public Health Nursing. St. Louis: CV Mosby. Please try to use the latest edition        [ Links ]

VILIOEN R; HEUNIS, C; JANSE VAN RENSBURG, E; VAN RENSBURG, D; ENGELBRECHT, M; FOURIE, A; STEYN, F & MATEBESI, Z 2000: The National Primary Health Care Facilities Survey 2000. Durban: Health Systems Trust.         [ Links ]


WORLD HEALTH ORGANIZATION 1978: Primary health care: report of the international conference on primary health care Alma Ata, USSR, 6-12 September 1978. Geneva: WHO.         [ Links ]

WORLD HEALTH ORGANIZATION 1988: From Alma Ata to the Year 2000: Reflections at the Midpoint. Geneva: WHO.         [ Links ]

WORLD HEALTH ORGANIZATION 2006: Community Involvement in Healthg. Addis Ababa        [ Links ]

WRIGHT, J; PARRY, J & MATHERS J 2005: Participation in health impact assessment: objectives, methods and core values. Bullet of the World Health Organization. 83(1), 58-63.         [ Links ]

YIN, RK 2003: Case study research: design and methods. Newbury Park: Sage.         [ Links ]



Dr Gugu Mchunu
University of Kwa Zulu -Natal
School of Nursing
Desmond Clarence Building
4th Floor, Room 416
Durban, 4041
Tel:(031)2601075; Fax: (031)2601543

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