Health promotion

Track 1: Community empowerment

7th Global Conference on Health Promotion: Track themes

Community empowerment refers to the process of enabling communities to increase control over their lives. "Communities" are groups of people that may or may not be spatially connected, but who share common interests, concerns or identities. These communities could be local, national or international, with specific or broad interests. 'Empowerment' refers to the process by which people gain control over the factors and decisions that shape their lives. It is the process by which they increase their assets and attributes and build capacities to gain access, partners, networks and/or a voice, in order to gain control. "Enabling" implies that people cannot "be empowered" by others; they can only empower themselves by acquiring more of power's different forms (Laverack, 2008). It assumes that people are their own assets, and the role of the external agent is to catalyse, facilitate or "accompany" the community in acquiring power.

Community empowerment, therefore, is more than the involvement, participation or engagement of communities. It implies community ownership and action that explicitly aims at social and political change. Community empowerment is a process of re-negotiating power in order to gain more control. It recognizes that if some people are going to be empowered, then others will be sharing their existing power and giving some of it up (Baum, 2008). Power is a central concept in community empowerment and health promotion invariably operates within the arena of a power struggle.

Community empowerment necessarily addresses the social, cultural, political and economic determinants that underpin health, and seeks to build partnerships with other sectors in finding solutions.

Globalization adds another dimension to the process of community empowerment. In today’s world, the local and global are inextricably linked. Action on one cannot ignore the influence of or impact on the other. Community empowerment recognizes and strategically acts upon this inter-linkage and ensures that power is shared at both local and global levels.

Communication plays a vital role in ensuring community empowerment. Participatory approaches in communication that encourage discussion and debate result in increased knowledge and awareness, and a higher level of critical thinking. Critical thinking enables communities to understand the interplay of forces operating on their lives, and helps them take their own decisions.

This track of the conference will focus on the conceptual and practical issues in building empowered communities. Through examples and case studies it will analyse how successful partnerships with communities can be forged even in the environment of vertical health programming. It will examine how empowerment oriented health promotion can be practiced both in local and global settings.

Community empowerment in action: Self-Employed Women’s Association (SEWA)

SEWA website

SEWA is a trade union of nearly a million self-employed women in Gujarat, India. Like most self-employed vegetable vendors, cart pullers, embroidery workers, these women would live in poor conditions and practice their trade in vulnerable conditions. Frequently harassed by local authorities, with no insurance or other social security and forced to take loans at exploitative rates, these women got organized to increase control over their lives. Vegetable sellers and growers linked together to start their own vegetable shop, cutting out the exploitative middle man, to mutual gain.

SEWA women started their own bank, and solved the problem of access to credit, avoiding the huge interest rates demanded by private loan agents. Collectively organized health insurance is used to pay for health costs, which earlier used to drive them further into poverty. SEWA women also organize child-care, running centres for infants and young children, and campaign with state and national level authorities for child care as an entitlement for all women workers.

(Source: Adapted from the Final Report of the WHO Commission on Social Determinants of Health)


Sources

1. Labonté R. and Laverack G. (2008) Health promotion in action: from local to global empowerment
2. Baum, F. (2008) Foreword to Health promotion in action: from local to global empowerment
3. Waisbord S. (2005) Five key ideas: coincidences and challenges in development communication, in Hemer, O. and Tufte, T. (eds) Media and Glocal Change: Rethinking Communication for Development, Nordicom and CLASCO
4. Concept of 'Accompaniment' taken from the Malaria Community Competence methodology www.malariacompetence.org

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