Involvement of Community in Health Systems Management: An Experience from Sindh, Province of Pakistan

Summary The community is the ultimate barometer of success or failure of an intervention. Involvement of community members in health care programmes, decision?making, evaluation and implementation is a major means for achieving the necessary fit between the programme and its beneficiaries. The World Bank?funded Family Health Project was launched in Sindh Province of Pakistan, in 1992. It aims to strengthen the existing health system and improve the health status of the population. To achieve sustainable results, FHP focused on engaging community participation. Village Health Committees were formed at Basic Health Unit and Rural Health Centre levels under an Area Focus Approach. Village Health Committee members were trained to understand the basic concept of FHP, be able to identify factors which affect the health of the community, and suggest local methods for combating these problems. The Village Health Committee's main objective was to ensure community participation, improve utilisation of outreach health services, improve accountability of the service providers through community involvement, and decentralisation of power at the community level. This article reflects on the experience of the FHP in implementing these objectives.