The Multiple Lenses on the Community Health System: Implications for Policy, Practice and Research

• Published in: International journal of health policy and management 2022-01, Vol.11 (1), p.9-9
• Main Authors: Schneider, Helen, Olivier, Jill, Orgill, Marsha, Brady, Leanne, Whyle, Eleanor, Zulu, Joseph, Sebastian, Miguel San, George, Asha
• Format: Article
• Language: English
• Subjects: Collective Action; Community Health; Community health aides; Community Health Planning; Community Health System; Community Health Workers; Critical Lens; Global Health; Health care industry; Health Policy; Humans; Inter-disciplinary; National health insurance; Short Communication; Sustainable Development; Universal Health Insurance; World health
• ISSN: 2322-5939; 2322-5939
• DOI: 10.34172/IJHPM.2021.73

Community health systems (CHSs) have historically been approached from multiple perspectives, with different purposes and methodological and disciplinary orientations. The terrain is, on the one hand, vast and diverse. On the other hand, under the banner of universal health coverage (UHC) and the Sustainable Development Goals (SDGs), a streamlined version of 'community health' is increasingly being consolidated in global health and donor communities. With the view to informing debate and practice, this paper seeks to synthesise approaches to the CHS into a set of 'lenses,' drawing on the collective and multi-disciplinary knowledge (both formal and experiential) of the authors, a collaborative network of 23 researchers from seven institutions across six countries (spanning low, middle and high income). With a common view of the CHS as a complex adaptive system, we propose four key lenses, referred to as and . The lenses represent different positionalities in community health, encompassing macro-level policy-maker, front-line and community vantage points, and purposes ranging from social justice to instrumental goals. We define and describe the main elements of each lens and their implications for thinking about policy, practice and research. Distilling a set of key lenses offers a way to make sense of a complex terrain, but also counters what may emerge as a dominant, single narrative on the CHS in global health. By making explicit and bringing together different lenses on the CHS, the limits and possibilities of each may be better appreciated, while promoting integrative, systems thinking in policy, practice and research.