Community participation in health programmes.

No clear operational definition of 'Community Participation' has emerged over the last decade of experimentation. One reason is the markedly contrasting perspectives that exist at different levels such as Aid Agencies, Ministry of Health, Government Health Programmes and Non-Government Organizations (NGOs). A more pragmatic definition is "decision making at the community and different levels of providers". Clearly defined strategies are required for operationalizing this concept at different levels where grass-root level workers and the community are involved in managing health services. This paper provides a matrix which can be used for operationalizing this concept and evaluating participation. Strategies have been suggested for involving the community in various management processes of health delivery. The inputs required of the health system for operationalizing community participation are the same as those of an 'Information, Education Communication' (IEC) programme.

A community based surveillance system for perinatal and neonatal care.

The impact of maternal health services on perinatal and neonatal mortality depends on both the quantitative and qualitative coverage of pregnant women with obstetric services. In rural areas this becomes all the more difficult because of the requirement of a large decentralized infrastructure extending from village based health workers and subcentres to the Primary Health Centre and tertiary levels of referral. An effective introduction of socio-cultural, biomedical and managerial interventions is required to reduce perinatal and neonatal mortality. A community based surveillance and monitoring system is central to and facilitates the introduction of all other interventions. Finally, the system operated by grass-root level workers is a motivational tool for achieving expected levels of performance.