The Community Health Club Approach is a development process which uses  the consensus of the whole community to effect behaviour change.

By getting all households together in a club we have a strong group rather than just a loose collection of households within a geographical area.

We enable them to share a ‘common unity’ of understanding on health and most importantly,  the capacity to act together effectively to improve family health.

Basic Assumptions: Two important observations underlie the reasons for using this approach:

1. Most women are primarily interested in caring effectively for their family and will therefore be interested in the opportunity to improve their ability as mothers.

2. There is an intellectual starvation in developing communities, and many people have not had sufficient opportunity to learn, so they will respond to health information.

This manual is a guideline for those planners looking for a practical methodology for conducting a health promotion project at District Level.

The Manual is divided into 3 Sections

Section 1

Thinking Globally – Acting Locally

This section outlines the conceptual framework of the Consensus Approach, summarising core concepts such as the importance of ‘common unity’ as opposed to individual action, and the creation of a ‘culture of health’. It shows how health clubs can empower women through information sharing and participatory activities, which according to research do meet an identified cognitive need. Having introduced the participatory PHAST approach, it describes how this training has failed to alter behaviour to any degree, but how the adaptation of this method combined with a more structured programme in Community Health Clubs has produced significant results. The importance of the membership card is emphasized and a brief description of the six month health promotion programme is given. The section ends with some frequently asked questions, which may also be answered in Section 3 with concrete examples.

Section 2

Acting Locally: District Health Promotion

This section describes how to start up Community Health Clubs. It begins with a simple calculation to establish how to meet the MDGs in the district, halving the population without sanitation within 10 years. The four prerequisites to start the programme are then discussed in some length. This includes a discussion on which facilitators are the most suitable, the importance of mobility for field staff, the vital need for a pre-prepared toolkit of culturally appropriate visual aids, and the type of training that is needed to set up the programme. It then briefly describes the programme for a one year health promotion campaign. A final section is dedicated to the importance of monitoring and measuring behaviour change – given the dearth of well-reported studies available in the sector. It encourages districts to advocate at a National level using lessons learnt from the pilot project and provides rough guidelines to enable practitioners to publicise their findings internationally, so as to contribute towards more rigorous health promotion studies in the academic field.

Section 3

This section presents 12 reasons why the Consensus Approach is a feasible health promotion strategy at District Level. It demonstrates that Community Health Clubs can prevent a range of diseases, address multiple risk practices and achieve high levels of behaviour change. The approach provides an effective way to disseminate knowledge and invariably produces a strong demand for sanitation. It can be extended to a further stage where water supply is managed by the health club, and if taken to its full potential can go on to alleviate poverty and deal with fundamental social needs such as illiteracy, social support networks and human rights.  Extension workers have found the approach rationalises their work-load and provides an easy way to interact with the community.