Community participation Kirivong Operational District 4 administrative districts 31 communes 290 villages 220,000 people

Requirements effective for community participation Gradual approach whereby easily achievable and visible successes are identified and achieved Health education can play initially a role but have to be followed by interventions focussing on identified needs Commune participation is facilitated when community has a history of common struggle, tradition of voluntarism and politically supportive environment Local community based organisation to lead process of CP Effective relations with politicians and government Excels in collaboration and coordination

Pagodas Are: Monasteries for Buddhist monks Temples for Buddhist religious ceremonies Social institutions: Schooling; Moral education; Community-decision making; Conflict resolution; and Spiritual counselling

Management of pagodas Monks adhere to 227 Buddhist precepts, including not allowed to possess belongings, including money Therefore Pagoda Committee manages physical needs and bookkeeping 5-7 members; pagoda Abbott, achaar (9 precepts), chas tom (5 precepts) or pritticaar Committee members elected every 3 years

Community participation structures at Kirivong Health Centre Management Committees [HCMC] established with 2 representatives per pagoda and mosque; representative commune council Village Health Support Groups comprised of 1 HCMC member and village chief Supplemented by meeting at Operational District [OD] level with Deputy District Governors, District Chief Monks and OD Directorate

Measuring degree of community participation Needs assessment (ability and participation in identifying community needs) Leadership (representativeness; acceptability; willingness) Organisation (isolated or part of community networks) Resource mobilisation (financial; in kind) Management (taking initiative; integration with other sectors)

MoH recommended approach Management Resource Mobilisation Organisation Leadership Needs Assessment 5 4 3 2 1 MoH recommended approach

KOD pre-equity fund 5 4 3 2 1 Needs Assessment Leadership Management Resource Mobilisation Organisation Leadership Needs Assessment 5 4 3 2 1 KOD pre-equity fund

Achievements Pagoda managed equity funds 20 pagoda managed equity funds; that is, 1 pagoda per health centre manages funds collected by other pagodas (and mosques) for reimbursing user fees of health centre services for 47,000 people (22% population) >US$8,000 collected from population

Management Resource Mobilisation Organisation Leadership Needs Assessment 5 4 3 2 1

Building on existing foundations Community-based health insurance Women groups to identify issues related to perinatal health and formulate and implement solutions in close collaboration with religious and administrative authorities