Refugee participation in health relief services during the post-emergency phase in Tanzania.
BACKGROUND
While community participation in health activities has been examined extensively after Alma-Ata, few studies have focused on beneficiary participation in health services in a humanitarian disaster relief programme. This research scrutinized refugee participation in encamped health services, explored its achievement, and identified the further needs of refugees in pursuit of enhanced health services in the camp.


METHODS
The study was performed at Lugufu Camp, Tanzania, where a health information team (HIT) of Congolese refugees actively participated in health services. Structured questionnaires were used for this cross-sectional observational study, covering three types of respondents: i.e. (1) systematically selected refugee community members (n=576); (2) all HIT members (n=48); and all Tanzanian health staff in charge of preventive health (n=17). Additional information was also collected through focus group discussions.


RESULTS
HIT refugees used their own health initiatives, which resulted in a growth of self-confidence. There was an evidence of benefits, especially in promoting health education, affirmed by an almost established consensus among the refugee community, Tanzanian health staff and HIT members themselves. However, refugee community members who did not know any HIT members had less positive health-seeking behaviours than those who knew one or more HIT members, thus showing a need for further dissemination of HIT services.


CONCLUSIONS
Participation in the health services led the HIT refugees to regain the sense that they could contribute to solving peers' health problems with their own knowledge and services, and by working together as a team. Beneficiary participation is a dynamic process that heightened responsibility and health consciousness, along with a concomitant gain in power over their destiny.
Tanaka
Y
Y
Department of International Community Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. ya-tanaka@jrc.or.jp
Kunii
O
O
Okumura
J
J
Wakai
S
S
D000328:Adult; D000533:Altruism; D003150:Community Health Workers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012036:Refugees; D012066:Relief Work; D013636:Tanzania