Revisiting community participation.

Community participation in health is a complex entity that has been examined extensively in the literature and continues to be of great interest among community health workers. The genesis of the idea and its conceptual development are primarily attributed to large multinational health institutions, particularly the World Health Organization. However, the implementation of community participation is the ultimate responsibility of local health programme initiators. It is therefore at the local level where day to day realities of incorporating community participation into health service delivery are confronted. This paper reviews the value of community participation in health and provides a detailed examination of the challenges facing its implementation and sustainability. In 1978, the World Health Organization placed community participation squarely at the centre of their strategy to achieve Health For All By The Year 2000. As the year 2000 nears, it is time to critically re-examine the notion of community participation and the most pressing challenges to its viability.