Heenan Deirdre
Faculty of Social Sciences, University of Ulster, Derry, Northern Ireland.
Health Promot Int. 2004 Mar;19(1):105-13. doi: 10.1093/heapro/dah111.
In recent years there has been a renewal of interest in community development and partnership approaches in the delivery of health and social services in Northern Ireland. The general thrust of these approaches is that local communities can be organized to address health and social needs and to work with government agencies, voluntary bodies and local authorities in delivering services and local solutions to problems. Since the Ottawa Charter was launched in 1986, government in Northern Ireland has stressed that community development should no longer simply be added on to key aspects of Health and Social Services, but should instead be at the core of their work. There is increasing consensus that traditional approaches to improving health and well-being, which have focused on the individual, are paternalistic and have failed to tackle inequalities effectively. Partnerships within a community development setting have been heralded as a means to facilitate participation and empowerment. This paper outlines the policy background to community development approaches in health promotion and delivery in Northern Ireland. Drawing on evidence from a case study of a community health project it highlights the benefits and difficulties with this approach. The findings suggest that partnerships can positively influence a community's health status, but in order to be effective they require effective planning and long-term commitment from both the state and the local community.
近年来，北爱尔兰在提供卫生和社会服务方面，人们对社区发展及伙伴关系方法的兴趣再度兴起。这些方法的总体主旨是，可以组织当地社区来满足卫生和社会需求，并与政府机构、志愿团体及地方当局合作，提供服务及解决当地问题的方案。自1986年《渥太华宪章》发布以来，北爱尔兰政府一直强调，社区发展不应再仅仅附加于卫生和社会服务的关键方面，而应成为其工作的核心。越来越多的人达成共识，即传统的改善健康和福祉的方法，由于侧重于个人，是家长式的，且未能有效解决不平等问题。社区发展背景下的伙伴关系被誉为促进参与和赋权的一种手段。本文概述了北爱尔兰卫生促进与服务提供中社区发展方法的政策背景。借鉴一个社区卫生项目的案例研究证据，它突出了这种方法的益处和困难。研究结果表明，伙伴关系能够对社区的健康状况产生积极影响，但为了有效发挥作用，它们需要国家和当地社区进行有效的规划并作出长期承诺。
