Origin and Concept
The Ottawa Charter defines participation as a basic principle for the practice of health promotion. The underlying assumption is that projects are more effective and sustainable if individuals are actively involved in change processes. This understanding is based on findings gathered throughout many years of experience with community projects and citizens' initiatives which have shown that sustainable changes for the benefit of citizens are more likely to happen when the people are actively involved in their situation.
Participation refers to getting people actively engaged in planning and implementing projects of health promotion. What does engagement mean? While the frequently quoted phrase "empowering those involved" is well known, it doesn't mean the same for everybody. When members of a target group are interviewed about their needs, when their opinions are asked in the process of developing concepts or when they are active in boards and committees, do we call all this participation? These questions indicate the need for a more detailed definition of what participation means.
We speak of true participation when individuals or groups have the power to decide, which means, the more power they have to decide, the higher their level of participation. For project management this means delegating or sharing power to decide, questioning one’s own ideas and having planned projects reviewed one more time. Yet situations like those are not easy in everyday life, especially when project managements are frequently confronted with pressures to succeed and to present results. A reflexive approach to participation is therefore inevitable. At the beginning of a project the project management needs to make a conscious decision as to what kind of participation would be feasible and how it would be best implemented and adequately communicated to all those involved. Promising a clear input in decision-making while the project reality only allows a say, will only frustrate and demotivate participants.
To make participation manageable and operational as well as to be able to assess to what degree participation should be implemented, models have been developed that allow the level of participation to be determined.Two are briefly introduced:
Model: funtasy projects
This model was developed in Switzerland and results from experiences with participatory youth projects (Funtasy Projects). The model includes five steps. The first two steps, "information" and "having a say", are rated as pseudo-participation yet considered as major requirements for participation. The next three steps, "co-decision", "active involvement" and "self- administration", are defined as real forms of participation.
Model: Health Berlin
The second model was developed by the Social Science Research Center of Berlin (WZB) in cooperation with Health Berlin. It consists of nine steps of integration divided into four forms of participation:
- Non-participation: instrumentalization (1), educating and treating (2)
- Preliminary stages of participation: information (3), hearing (4), integrating (5)
- Participation: codetermination (6), partial decision-making authority (7), power to decide (8)
- Far beyond participation: independent organization (9)
These models facilitate the decision as to which level of participation can be implemented or is intended in a project.
- Committee on Assuring the Health of the Public in the 21st Century (2002).The Future of the Public's Health in the 21st Century. The National Academies Press. Washington. [Link/Download]
- Frehner, P.; Pfulg, D.; Weinand, Ch.; Wiss, G. (2004). Partizipation wirkt. [Link/Download]
- IUHPE (Hrsg) (2007) Promotion & Education Supplement: Community Health Promotion- creating the necessary conditions for health through community empowerment and participation.
- True participation is considered time-consuming and hard to implement.
- The relationship with representatives of the target group is ambivalent.
- There is insecurity in terms of the methods.
Including the representatives of the target group in the project planning early on will increase the chance that your goals, strategies and measures are in line with these target groups and that your project is effective, that you will find better solutions for your interventions, fostering a good relationship between project team and target groups, thereby laying the groundwork for successful implementation.
- Consider participation as a key element to your project's success.
- Use the available models.
- Make a conscious decision about the desired level of participation and define the people you want to address
- Prepare yourself for a developmental process and seek methodical support if necessary.
- Are or were representatives of the target groups involved in the planning process, the implementation or the evaluation of your project?
- Is there an understanding for participation in your project as well as an agreement on the forms of participation?
- Are there additional possibilities for extending the target groups' participation?