CONTENTS
HIGHLIGHTS
November, 1996 |
To serve people who move, new approaches are needed that emphasize community involvement and participation (225). Strategies limited to providing reproductive health care to refugees and internally displaced persons in camps, for example, are of only temporary help. Unless the strategies include measures that the refugees and internally displaced persons can continue to carry out once they leave camps, benefits will be only short-term (223). Some observers warn that relief agencies should not introduce health practices or standards that cannot be maintained once people leave the camps and return home (336). To be effective, programs must find out what the people in the community want. Whereas community involvement in health care was once considered politically sensitive and difficult to accomplish, it is widely recognized today that the active participation of community leaders is needed in planning and providing reproductive health care information and services (10, 25, 95, 170, 223, 246, 308, 311, 313, 325, 335, 344). Community participation gives clients a sense of ownership and helps assure that services are acceptable, appropriate, and sustainable (256, 299, 310). In contrast, lack of community support and opposition from community leaders discourages people from using services (158). Many migrants are resourceful and want to be involved in programs that assist them. In fact, where programs have not sought or acted on community advice and have failed to meet community needs, community-based organizations have sometimes emerged to provide needed services. For example, in poor urban areas of Lima, Peru, lack of social services has spawned a variety of community development efforts, including sex education, under the auspices of Peru Mujer, a national women's organization (192, 204). Both women and men should be involved. At all levels of planning, carrying out, and monitoring reproductive health care, the participation of women is particularly important (194, 242, 246, 257, 303, 313). Programs should consult with individual women and with women's groups in migrant, refugee, and internally displaced communities (228, 312). In Palestine refugee camps women's groups and networks have increased use of reproductive health services and improved women's well-being (150) (see sidebar, Palestine: Providing Care for Women, by Women). Because men often are the primary reproductive decision-makers, and their sexual behavior affects not only their own health but also that of their partners and families, men's participation and support are important (170, 318). Among refugees and internally displaced persons, men often express support for reproductive health programs and want to be included, as in camps for internally displaced persons in Azerbaijan. Because of cultural constraints, male health workers conducted training for the men, while female health workers did so for the women (117). |