Participation

In our understanding, participation means not only taking part but also having ownership, that is, decision-making power. The power to define and thereby, the possibility of being able to (co)determine the health problem to be tackled using health promoting or preventive measures is an integral part of participation. The more influence someone has on a decision-making process, the greater his/her participation.

This principle resonates with WHO Ottawa Charter on Health Promotion which defines self-determination on the part of citizens as being at the core of health promotion. Participation as ownership has also been promoted in the context of urban development and in the field of development work in low-resource countries. The American Sherry Arnstein, wrote a seminal article in 1969 article in which she describes key elements of a participatory approach to activating citizen involvement in urban renewal programs. She argues that sustainable improvements in urban areas which impact the daily lives of the can only be achieved when the residents have the opportunity to (co)determine their own living conditions.

Participatory Quality Development places a particular emphasis on the participation of the target groups and frontline staff in community-based organizations, because these actors generally have a wealth of local knowledge at their fingertips which can contribute significantly to the success of interventions. At the same time, these very people are those actors who are often not involved in the development of quality assurance procedures and setting the success criteria for their work.

Participation is not an either/or option, but rather a developmental process. Depending on the working conditions in the local health project and the living conditions of the target group being served, participation is feasible at different levels. The task here consists in finding the level of participation appropriate for the local situation.