National policies and government strategies in Saudi Arabia are adequate for the promotion of community involvement in health development (CIH). The system of government is decentralized and has ample scope for intersectoral cooperation. In Ha'il and Oasim regions active efforts are being made to realize intersectoral coordination through regional committees in which community leaders are involved, unfortunately, however, such mechanisms are lacking at the central level Decision-makers and community leaders adequately recognized and interpreted the importance of CIH. Most of the respondents advocated community participation in planning and evaluation, while less than 50% thought that communities could participate in the implementation of health services.
A survey in Ha'il and Oasim regions of 2417 residents indicated that community participation in health activities was in its infancy and that considerable effort is still needed at the central, regional, and peripheral levels to achieve meaningful community involvement in health.
In recent years community participation has assumed an increasingly important role in societies. This has been emphasized in the health sector, where, within the framework of primary health care (PHC), it has been asserted that communities have both the right and responsibility to be involved in the planning, implementation and evaluation of their own health programmes.
Although there is general consensus about community involvement for health development (CIH), there are differences in the approaches adopted, depending on the sociopolitical situation in a particular country and on the extent of community organization. Also, the perception of community involvement by high-level decision-makers and health workers varies from one country to another.
WHO promotes community participation in PHC, and the WHO Regional Office for Europe has reported the result of an analysis of various forms of community articipation in PHC in nine countries.' Also, the WHO Regional Office for Africa has completed a study of the essential features of CIH in the African Region. A similar study has also been carried out for the WHO South-East Asia Region.'
In Africa it has been reported that "passive" community participation was achieved but that active" participation remains a challenge 1). The results of a study in rural India that involved existing public and private health systems demonstrated the importance of socioeconomic and political factors for CIH (2). Finally, a study in Kenya of volunteers who took part in a community-based health development programme addressed the issue of community leadership and participation (3, 4). Because growth monitoring has been recommended as an entry point to PHC (5), community development has been considered to be a starting point for community participation in health programmes (6). Efforts to encourage community participation in health are being carried out in the Arab countries of the WHO Eastern Mediterranean Region.f Saudi Arabia has adopted the strategy of Health for All by the Year 2000 as well as the resolution taken in 1978 adopting the Declaration of Alma-Ata (7, 8). Supported by a 5-year plan, the Saudi Ministry of Health embarked in 1985 on nationwide implementation of PHC, including community participation. g," Objectives of the study The objectives of the study were as follows: - to determine whether the current government
and Ministry of Health policy and strategy are
optimum, practical, and suit the situations in
Saudi Arabia with respect to CIH; - to appraise the present level of community
support at central and regional levels in disseminating
relevant information about PHC and interaction
between health and other related sectors; - to define the types, patterns, and level of community
participation that support the PHC team;
and - to elucidate the attitude of individuals about
future community participation activities and
their impact. …