Community participation for perinatal health in Istanbul.

This study aimed to evaluate the success of a project in achieving community participation in efforts to improve perinatal health. A 10-step structured process was used to work with a community in Istanbul, Turkey. To evaluate the success of the project in achieving community participation, five key indicators were selected: (i) participation of the community group in decision making; (ii) gains in knowledge and skills of the community group; (iii) continuity of the community group; (iv) continuation of the health program by the community group; and (v) initiation of new support and advocacy activities. From the beginning, community members participated in all decisions regarding the group activities. In the early months, project staff had more of a guiding role, but, over time, the community members became active decision-makers. Over the course of the project they learned how to identify community health problems, and to design, implement and evaluate interventions to address those problems. Four years later, meetings and activities of the group are continuing. The antenatal education course developed by the group continues to be offered at a local community centre. Community members are now completely responsible for promoting the course, communication with participants, planning the courses, making preparations for the sessions, as well as teaching non-technical topics. Course participants have developed ongoing support networks and have begun to advocate for better perinatal health services in the community. Working with a community is an intensive, time-consuming process. The results of this project indicate that the benefits, both in terms of health outcomes and in terms of increases in community capacity, can be well worth the effort.