Tackling health inequalities has become a key focus for health policy and practice across Europe. In the UK, there is increasing awareness of the capacity of community development approaches to improve health. Jane Naish, policy advisor with the Royal College of Nursing, UK, describes one successful project.
Jenny Gough is an experienced public health nurse and health visitor who has worked in a socially deprived area of the UK’s West Midlands for several years. She quickly recognised the multiple health needs and very poor mortality and morbidity record in her community relative to adjacent areas. She was also aware that many health problems were not located at an individual level, that is not simply the result of individual behaviour and "lifestyles", but the result of poverty and life circumstances.
Because she is a nurse, Jenny is trusted and has access to lives and homes within her community in a way which other statutory agencies, such as social services and the police force, did not. The community development project which she founded began by engaging some of the key stakeholders in the community in looking at the problems as they defined them.
Initially a key issue raised by the community was the lack of community based facilities, especially for families with young children (the area had a high proportion of single parent families). Jenny carried out some small-scale research with single parents on their needs and through this was able to demonstrate to health managers the need to develop further community based services for families. From this flowed a commitment from some employers and some limited resources. With these resources, Jenny was able to develop a range of initiatives with the community, including:
shopping trips to local markets with mothers followed by cooking skills sessions at the local community centre (Jenny organised the transport and paid for the shopping);
breakfast clubs at the local primary school whereby children could arrive early and have breakfast together at school;
a range of family learning activities whereby parents and children learn together, especially around reading and mathematics;
literacy classes including English as a foreign language for women whose first language was not English;
weight management sessions (which Jenny joined in!);
"drop-in" health sessions at which any member of the community could access Jenny on any health related issue without an appointment or any bureaucratic process.
Much of the day-to-day running of the above activities was later taken over by the community indicating the sense of community ownership of this project and ensuring sustainability. Other aspects of Jenny’s project was also very positive. For example, the breakfast clubs, in addition to improving children’s nutritional status, led to increased attendance at school and teachers reporting greater concentration and application to learning by the children. In fact, the project was so successful that she was asked to join the Wolverhampton Health Authority public health management team. She is also involved in a UK policy initiative in England "New Deal for Communities" which aims to attract local investment into communities including that from private enterprise.
This is a shortened version of a longer article by Jane Naish on community development. If you would like a copy of her complete article, please e-mail Update editor, Diana Smith at diana@gsmith.com.fr.
Info:
Jane Naish, Policy Adviser
Royal College of Nursing
20 Cavendish Square
UK-W1M OAB LONDON
UNITED KINGDOM
Phone: +44 207 40 93 333, Fax: +44 207 6473413
E-mail: susan.williams@rcn.org.uk
Website: http://www.rcn.org.uk
