Development of a health programme in a peri-urban informal settlement in Besters, KwaZulu-Natal.
OBJECTIVE
The demographic, socio-economic and environmental status of the peri-urban informal settlement of Besters and its inhabitants' health, welfare and disability profiles were investigated for the development of a community-based health intervention programme.


METHODS
A cross-sectional study using a structured household questionnaire assessed community health status in July 1991 in order to identify specific health and development needs through focus group discussions and community consultations. A health and development programme was established during 1992. Community participation in this programme was then assessed by measurement of the components of the health and development programme, categorised as inputs (resources), processes (activities), outputs (effects) and outcomes.


METHODS
Besters, an informal peri-urban settlement north of Durban, KwaZulu-Natal.


METHODS
Residents of Besters.


RESULTS
The demographic, environmental and morbidity profiles of Besters were consistent with both South African and international studies of informal communities. Patterns of health service utilisation reflected inappropriate use of the tertiary hospital in the city centre, grossly fragmented patterns of utilisation--both for preventive and curative care and for antenatal and maternity services--and, finally, a discordance between community health needs and ability to pay for services. The interaction between input, process and output measures of community participation are discussed.


CONCLUSIONS
Integration of health service provision with other infrastructural development, based on community perceptions, enhances health development and community participation. Important lessons emerged about the strengths and limitations of community participation and its relevance for other communities.
Jinabhai
C C
CC
Department of Paediatrics, University of Natal, Durban.
Mametja
D
D
Coovadia
H M
HM
Gouws
E
E
D018672:Community Health Planning / Q000379:methods*; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation / Q000639:trends; D003430:Cross-Sectional Studies; D003710:Demography; D006801:Humans; D012959:Socioeconomic Factors; D013019:South Africa; D011795:Surveys and Questionnaires; D014505:Urban Population