How do health workers and community members perceive and practice community participation in the Bamako Initiative programme in Nigeria? A case study of Oji River local government area.

The objective of this study was to assess the perceptions and practices of health workers and households in relation to community participation in the Bamako Initiative programme (BI). The study was conducted in Oji River local government area of South-East Nigeria where the BI program has been operational since 1993. A pre-tested questionnaire was used to collect information from 20 health workers charged with operating the BI in 20 health centres. In addition, focus group discussions were conducted with members of the district and village health committees. Community participation from both health worker and community perspectives seem to have been enhanced by the introduction of BI, despite some constraints. However, the communities were not involved in core areas of community participation, and the health workers seem to be resisting their participation fully. It is concluded the community participation in BI could be improved if expectations were made explicit. This improvement should take into consideration the desires and priorities of the communities and issues impeding participation should be addressed. Copyright 2003 Elsevier Ltd.