Rural Places and Community Participation in Health Services Development

Taylor J¹*, Wilkinson D² and Cheers B³

1. Spencer Gulf Rural Health School, University of South Australia, Whyalla Norrie, Australia
2. School of Medicine, University of Queensland, St Lucia, Queensland, Australia
3. Centre for Rural and Regional Development, University of South Australia, Whyalla Norrie, South Australia, Australia

This paper explores the relationships between rural places and community participation in health service development. Community participation in planning for health programs and services is fundamental to effective and accessible primary health care. However, there have been ongoing challenges for health professionals engaging with communities in these activities. One reason for this is that in health, the understanding of ‘community’ and ‘participation’ is not embedded theoretically. Community participation is rarely undertaken as development of place.

This paper, using an interactional perspective of ‘community’, adds a theoretical perspective to understand why some rural communities may become involved in health service development and some do not. Research explored community-initiated community participation in organising hospital and general practice services in three small rural communities. Community participants understood community participation as social interactions embedded in a community of place related to the betterment of the community.

Extensive community participation was related to:

• The existence of community and family traditions of civic engagement;
• Community-wide narratives that encouraged people to support their health services;
• A sense of the health services as community owned;
• A strong shared understanding of a community of place; and
• Community level acknowledgement of the importance of health services.

An understanding of the relationships between community functioning and community participation is essential for health professionals working with communities and for communities themselves. It may important in developing community-based initiatives in other fields such as social care and environmental management.

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