Chapter One: What is a Community-based Organization? (John W. Murphy, University of Miami)
The focus of community-based work is local knowledge and community control of health projects. To deliver services in accordance with these principles, community-based organizations must be instituted. What these organizations require, separate from the past, are a different management style and unique division of labor. Most organizations that are employed to provide health services in a community-based manner, however, have a traditional structure, and thus have difficulty fulfilling their aims. A new organization must be created that is consistent with the philosophy that underpins community-based work. Such an organization, for example, would be less hierarchical and not focused on a specific division of labor as in the past.
Chapter Two: Establishing Community-based Partnerships (Karen A. Callaghan, Barry University)
Community-based health services are not provided by stand-alone organizations. Simply put, a network of providers must be available. Accordingly, a variety of organizations must enter into partnerships. This arrangement is not necessarily novel, but traditionally these associations have been fraught with conflicts and struggles for power, thus undermining their effectiveness. Community-based partnerships, on the other hand, must be predicated on dialogue and mutual respect. Instead of fighting for dominance in a community, these new organizations must be integrated around the plans established by communities. A new way of conceptualizing and carrying out this process must be established.
Chapter Three: Community-based Funding and Budgeting (Jung Min Choi, San Diego
State University)
Often funds are directed to community organizations in ways that are either irrelevant or difficult to use. Additionally, budgets are formulated by agencies that are disconnected from the communities where services are needed. Community-based funding and budgeting, accordingly, are beginning to receive serious attention. Communities, accordingly, are given the latitude in some cases to establish budgets and spending strategies, along with identifying and pursuing sources of funds that are consistent ethically with these priorities and desires. Community-based funding and budgeting, in this way, are vital to supporting interventions in a community-sensitive manner.
Chapter Four: Training Community-based Health Workers (Tashina Vavuris, University of
California at Santa Cruz)
Health practitioners receive a significant amount of training before and after they enter the field. But often this education is mostly pragmatic, that is, focused on how to conduct needs assessments, evaluate interventions, or implement accreditation standards. Of course, these tasks are important. But this education does not necessarily begin from the philosophy that sustains community-based work. When beginning with the principle that community knowledge matters, training must be initiated with how to enter the world constructed by a community’s members. Every task, accordingly, must be thought of as a mode of engaging a community, instead of simply gathering data or making observations. Valid knowledge, communities, and norms, for example, must be rethought in the training process to produce persons who can work effectively in community-based interventions. This shift in orientation is not often currently the centerpiece of training.
Chapter Five: Developing a Community-based Curriculum for Health Worker Training (Dawn Graham, Ohio University)
The previous chapter explored the use of community-based health workers in interventions and the importance of integrating local experts into planning. In this chapter, the experience of developing a training curriculum for the State of Ohio will be shared. Given new rules regarding certification in different areas of the United States and internationally, developing a curriculum that can be approved and disseminated is of increasing importance. In these programs, significant institutional support is needed to develop curricula and train additional trainers, so that training can be shared with communities interested in adopting community health workers into their programming. The goal of this chapter is to present the challenges faced in creating a certified training curriculum and the potential for future curriculum development efforts.
Chapter Six: Technology and Community-based Work (Eric Kramer & Elaine Hsieh,
