Health promotion, education and community participation in the Americas. Reality or myth?

The concepts and understanding of community promotion, education and participation for health have many interpretations and applications in the countries of the Americas. Even though many of the countries have written policies indicating that these are important strategies, very few have developed ways to make them effective and operational. In most cases they are not defined, nor have countries developed concrete objectives and goals. Although the Primary Health Care strategy has been adopted in principle by countries of the Americas, they are encountering serious difficulties in implementing the concept, particularly within large-scale national health programmes. In actuality, the community promotion, education and participation concepts in the health arena are vague and often misunderstood.