Very often in programmes planned and controlled by the central authorities or by foreigners, the reaction of the communities is passive. This attitude should be seen as a signal that the community does not expect any real progress from the programme.

- Describe the mechanisms that exist for community involvement in health at regional/district level.

- How have these mechanisms been mobilized for health activities?

- How do they influence planning (give examples), utilization of services and drugs?

In the health facilities visited during the evaluation, some questions can be raised;

- Is there a development committee in the area? If yes, do health workers regularly participate?

- Is there a community health committee? If yea, does it meet regularly? Does it discuss health activities? Disseminate health information? Raise and collect contributions for health activities (drugs)?

- Does the community help in identifying individuals and groups with specific health problems?

- Does the community participate in the identification of health problems, e.g., lack of essential drugs, etc.?

A more in-depth study will need to be developed for interviews of community leaders.