title: The dynamics of community and NGO partnership: primary health care experiences in rural Mali.
abstract: Utilizing ethnographic research methods, this case study examines the experiences of an NGO-sponsored health care program in rural Mali. The findings indicate that while, in principle, the organization operates from an alternative development base, it has been unable to decentralize the decision-making process and facilitate community dialogue and participation. Numerous problems resulted, including superficial forms of local participation, lack of community ownership, non-remuneration of health workers and midwives, inadequate training, and ultimately, limited program gains. The analyses highlight the complexity and dynamic nature of health program implementation in a developing context, and suggest several factors important to project success. These include drawing on diverse local perspectives, promoting broad-based participation, and providing culturally appropriate ways to include all community members, particularly women.
authors.affiliation: Women's Research Institute, Brigham Young University, Provo, UT 84602, USA. yodit@byu.edu
authors.forename: Yodit
authors.initials: Y
authors.lastname: Solomon
authors.forename: Bonnie
authors.initials: B
authors.lastname: Ballif-Spanvill
authors.forename: Carol
authors.initials: C
authors.lastname: Ward
authors.forename: Addie
authors.initials: A
authors.lastname: Fuhriman
authors.forename: Kacey
authors.initials: K
authors.lastname: Widdision-Jones
mesh_terms: D000884:Anthropology, Cultural; D003153:Community Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003659:Decision Making, Organizational; D006293:Health Promotion; D006801:Humans; D008302:Mali; D009938:Organizations / Q000458:organization & administration* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data