Is it consumer or community participation? Examining the links between ‘community’ and ‘participation’
In writing about community participation in health, the term 'community' is used loosely and ambiguously. On analysis, it appears that there is a conceptual shift in health policy to thinking about involvement of consumers in health planning and programs rather than communities. This shift is consistent with a managerialist approach to planning health service delivery. Participative processes are perceived as being initiated and directed by health administrators. Participants in the processes are to be 'representative' of health service consumers, rather than whole communities. However, in many Australian rural communities, there are enduring traditions of community participation in providing governance for local hospitals, developing infrastructure for general practice services, and providing in-kind support. Participation in health services is embedded in the way the community functions. Acknowledging and understanding the ways in which 'community participation' and 'consumer participation' are different may result in more effective participative processes.
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