The result of multiple determinants is health. The predisposing factors that can contribute to the health of people and communities are individual biology and behaviors, physical and social environments, policies and interventions, and access to quality healthcare. These are often interdependent and interrelated, creating a complex web of causation.
The World Health Organization identified the centrality of communities in health planning and decision making in 1978, yet three decades later, conceptualizations of rural communities as disempowered and distanced from urban centers of power continue. Calls for meaningful multi-sectoral partnerships with communities recognize that collaboration is central to ensure acceptable, appropriate and effective responses to start to tackle entrenched rural inequities. Internationally, social, political and economic changes in rural environments, particularly associated with ‘mechanization, modernization and downsizing’ in agricultural industries has impacted on rural social cohesiveness and contributed to the ‘circle of decline’ being experienced in many rural locations.
Upgrading or binding community capacity is integral to developing locally responsive health services and is in the interest of communities and government as it portray together rural social capital, maximizes the innate, adaptive, inventive and innovative nature of rural people and directs to empowered communities capable of developing local solutions. There are shared advantages for communities and government in terms of rural town survival, resilience, sustainability, and fiscal responsibility, but consistently, it’s been recognized that there’s a lack of knowledge on how to make effective community/policy maker partnerships that allow communities and encourage citizen control and responsibility in local decision making.
Declination in real per capita public budget allocations for...