Sense of community and participation in urban primary health care: A preliminary investigation from city markets in Tegucigalpa, Honduras
Description
Citizen participation is central to the sustainability of development projects. It is difficult to achieve any level of community participation in programs, especially those offered in urban settings. This study investigates the relationship between participation and psychological sense of community in an urban primary health care project that operates in the city markets of Tegucigalpa, Honduras. This study employs a cross-sectional survey design to test the central hypothesis that a sense of community among market women is related to their participation in the urban primary health care project, Proyecto Alternativas. The survey, based on the work of McMillan and Chavis (1986) and other community psychologists, includes measures of a sense of community, locus of control, and demographic and health status/use characteristics. The principal research question is whether a relationship between participation in Proyecto Alternativas (i.e., community participation) and psychological sense of community among mothers who are vendors in the city markets of Tegucigalpa, Honduras exists A factor analysis of the sense of community construct yields a four-factor solution. Results indicate that mothers have a strong sense of community and that it is highly correlated with level of participation. A market-level analysis reveals that mothers from smaller markets have a stronger sense of community. Important predictors of participation are age, education, fees paid, the number of children working in the market, use of the nearest health center, having family in the market, the mothers' opinion of the administration, and the influence factor of the sense of community construct An important strength of the study is the investigator's familiarity with the markets, vendors, and the project and staff in Honduras. A limitation is the adaptation of measures developed for U.S. neighborhood studies to the markets of Tegucigalpa, as well as using mothers and children's participation in the project as a proxy for participation in community development. The results demonstrate, however, that the markets are close-knit communities whose members have a strong sense of community and willingness to participate in organized activities. This has implications for municipal governments and organizations in urban areas seeking local participation for sustainable development