Community health platforms are the partnerships formed to assess and ensure public health. They provide the context in which outside interventions should be implemented and sustained, and they offer a way to develop and maintain community-centered solutions. Although local boards of health and health departments are the official bodies with the mandate to sustain strong community health platforms, they do not always achieve their full potential (Bellagio District Public Health Workshop Participants 2016). In the absence of an effective government presence, nongovernmental organizations (NGOs) can build community health platforms.
Well-functioning community health platforms can serve as vehicles for health information and advocacy and can convene local resources to support successful public health interventions. Well-designed and well-implemented community health platforms can function as the engine in the public health cycle of convening communities to monitor, review, and act (figure 14.1). These are functional tasks that are best conducted in a partnership among public health professionals, politicians, and community members. Effective partnerships among these parties ensure that health data are collected to answer questions posed by the community, that local health data are shared with the community to guide actions, and that actions marshal all of a community’s human and capital resources as well as public revenue. Then the cycle repeats. A community that has the ability to engage successfully in the cycle shown in figure 14.1 has a platform that can support all types of community health initiatives.
The provision of legal authority for community health platforms can be traced to England’s first health law, the Public Health Act of 1848, which gave cities the option to create local health boards (Rosen 1958; Szreter 1988). In the mid-nineteenth century, functional health departments were established throughout Canada, Europe, and the United States before the development of effective medical care and drove the dramatic decline in mortality in the twentieth century (McKeown, Record, and Turner 1975). However, western governments had largely omitted the creation of functioning local health departments when they formed colonies in the Americas, Africa, and Asia; countries that gained independence in the mid-1900s faced an urgent need to catch up. By the late 20th century, the growing recognition that public health and primary care were lagging became the topic of international concern. In 1978, an International Conference on Primary Health Care in Alma-Ata, USSR, attended by nearly all member nations of the World Health Organization and the United Nations Children’s Fund, demonstrated the degree of concern about access to primary health care (Lawn and others 2008). It resulted in the Declaration of Alma-Ata.
© 2018 International Bank for Reconstruction and Development / The World Bank.