الفهرس 
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Abstract
Among the basic principles underlying the primary health care approach, which has been identified as the key to achieving health for all is community participation. Community participation is the process by which individuals and families assume responsibility for their own health and welfare and for those of the community, and develop the capacity to contribute to their and the community’s development. In recent years, community participation has assumed an increasingly important role in any development activity and the community becomes an important partner of the health workers at every level. In addition, health work cannot be carried out in isolation or by effort of paid officials alone and it has come to be realized that the provision of health services require essentially the involvement of the community. The sustainable participation is possible only when the decision-making power is handed over to the community. The basic requirement of CP is that the people should be involved in conceiving, planning, implementing and evaluating all developmental programs. The aim of the present study was to assess CP in urban PHC services in Hodiedah through assessment of: 1. The level of knowledge, attitude and practice of community participation among primary health care team members in Hodeidah primary health care centers, as well as among members of local health committees. 2. The level of knowledge, attitude and practice of community participation among the consumers attending primary health care centers. 3. The available resources for community participation in primary health care centers. The research consists of conducting knowledge, attitude and practice (KAP) studies in Hodiedah urban PHC centers, on three types of categories namely: PHC personnel, members of the local health committees and consumers attending PHC centers. The three main PHC centers (Tahreer, Ghuleil and Salakhana) were included in the study. Additionally, one of the accessory sub-centers was chosen randomly for each of the three main centers and included in the study sample. The categories of the study sample were: 1. PHC team members: All physicians, pharmacists, nurses, midwives, laboratory technicians, and ”murshidaat” of the study PHC centers. The total number for this group was 90. 2. The consumers: One hundred consumers attending each PHC center to give a total of 600 consumers. 3. The LHCs members: All members of LHCs in the study PHC centers. The total number amounted to 35. A suitable set of KAP questionnaire was developed for each category. In addition, a checklist was designed to assess the existing standards and activities for CP in the study PHC centers. The collected data was subjected to suitable statistical analysis and interpretation. The results obtained in the present study could be summarized as follows: - 1. The majority of PHC personnel had fair knowledge and indifferent attitude while, half of them had poor practice regarding CP in PHC services. 2. About half of LHCs members had good knowledge and most of them had positive attitude and partial practice regarding CP in PHC services. 3. Most of consumers attending PHC centers had fair knowledge, indifferent attitude and partial practice regarding CP in PHC services. 4. Although CP is in itself an important principle for the integration of other PHC principles within the health system, no plan for integration of CP in context of PHC principles as well as on implementary levels of PHC. 5. The main supporting mechanisms for CP mentioned by the health personnel were community conviction about their role in health development, formation of health committees and bodies and participation of non-governmental organizations. LHCs members added to that, the political commitment and participation of other health-related sectors. 6. The lack of community awareness about the role of community in health development was the main obstacle for CP as mentioned by the health personnel, whereas members of LHCs added the lack of political commitment and the lack of NGOs in supporting health activities. 7. Most of health personnel showed indifferent attitude towards improvement in health center catchment area by CP, conviction that members of LHCs were representing the community; benefits of LHCs and their activities. 8. The majority of members of LHCs and most of health personnel were convinced about the importance of intersectoral cooperation for health promotion but both of them showed poor practice with other health related sectors. 9. The role of PHC personnel and members of LHCs in CP exists in motivating the community members towards the optimum use of health center services. Participation of community members exists in the form of utilization of health services provided and advising others to utilize PHC services. Moreover, community leaders participate in PHC program activities by providing money to run the activities of the health centers in the afternoon. 10. Regarding the consumers attending PHC centers, many constraints were found to impede their participation in health development activities. These include: (One) Low level of education. (Two) The lack of awareness about the importance of CP in improving community health status. (Three) The lack of awareness about the existence of LHCs in PHC centers. (Four) The unwillingness to join the health committees. (Five) The feeling that the health team will not welcome their opinions and suggestions regarding health centers activities. 11. The resources available for CP in PHC centers were LHCs; defined catchment area and defined population, health education materials and functioning cost recovery program. Unfortunately, no plan for integration of CP in context of PHC principles as well as on implementary levels of PHC, no budget from cost recovery program used for community mobilization and no place (room) for LHC meetings. 12. The main focus for most of LHCs during their meetings was in the distribution of the money collected from cost recovery program in the running cost of the health centers activities, whereas the basic role for LHCs was not performed during such meetings.