Community capacity building in practice: constructing its meaning and relevance to health promoters.

摘要

Community capacity building (CCB) is held up as a benchmark for sustainable health promotion, reflecting the empowering discourse of the Ottawa Charter (WHO 1986). In light of concerns that this language may be that of the presiding bureaucratic elite rather than the realities of those working directly with communities (Laverack & Labonte 2000), we question whether CCB reflects the work of New Zealand health promoters. The aim of this study is to assess what CCB means to health promoters and how relevant it is to their work in New Zealand. Focus groups and interviews were carried out with 64 health promoters between January 2008 and March 2009. The results of this qualitative study indicated that, while the terminology of CCB is poorly established in New Zealand, the overwhelming majority of participants felt that, to be an effective health promoter, they needed the buy-in and support of the communities in which they work. As a result, community-driven approaches have emerged as a core component of good health promotion practice in New Zealand. Yet, the concept of CCB was applied loosely with health promoters adopting language and practices corresponding more with the nuances of community development. The limited use of systematic approaches to building community capacity was accompanied by few successes achieving sustainable health promotion programmes. In prioritising community relationships many health promoters were placed in an ideological bind whereby achieving community ownership over health promotion meant compromising the evidence base of their programmes. Academic discussions of CCB appear to have gained little traction into the realm of health promotion practice in New Zealand highlighting the need for relevant research with a strong grounding in practice.