Patterns and Determinants of Community Participation in Community Clinics in Rural Bangladesh
Md. Faruk Shah, Rafid Abrar Miah, Md. Fazlul Haque
Abstract
This paper aims to assess the pattern, determinants, and magnitude of local people's involvement in community clinics (CCs) in rural Bangladesh. We endeavor to show how these clinics function in reality in rural settings, taking account of local socio-economic and political contexts, and additionally to explore how community members perceive their participation in the activities of CCs. To this end, an ethnographic approach has been used as a methodology. Drawing on ethnographic data from rural settings, we argue that rural health provision may be usefully examined in light of a community-based approach. This paper finds that CCs have played a crucial role in providing primary healthcare among rural women, poor, and marginalized people; however, the utilization of healthcare services is still low compared to the target set in the policy. The extent of local engagement in community clinics is influenced by several contextual factors, including social stratification, power dynamics, and the possession of social and cultural capitals. Conversely, there has been an observed rise in the extent of community engagement; nevertheless, it has not yet reached the intended level. Sociocultural dynamics, political and economic factors, and a lack of awareness are the key barriers in this regard. More specifically, both structural arrangements and cultural factors within the local community determine the success of CC programs. The effectiveness and sustainability of CCs are believed by local people to be greatly enhanced by the implementation of a community-participatory strategy, provided that the goals behind this approach are really adhered to and put into action. Despite the implementation of several policies and initiatives, conducting comprehensive research is necessary in order to develop future action plans that may improve the quality, magnitude and level of community engagement in CCs.