Community Positive Health (CPH) is Stema’s unique framework for advancing health in marginalised settings. Rooted in inclusive and meaningful participation, CPH brings communities and decision makers together to understand the systems, resources and aspirations that support community positive health outcomes.
CPH can be applied broadly to strengthen overall community health, or used to design more effective, locally relevant interventions focused on specific areas such as maternal health, mental well-being, nutrition, or disease prevention.
Through the CPH approach, we support communities to:
CPH offers a practical, people-centred pathway to more inclusive, adaptive, and effective health interventions.
Through extensive research conducted with communities in Kenya, we have identified common strengths and resources that contribute to positive health, as well as risk factors that can negatively affect it. These findings have been grouped into five thematic areas: health services; basic needs; social relationships and governance; materials in the natural and built environment; and awareness and knowledge.
We have developed a participatory process that supports communities in identifying their values, strengths, and assets that contribute to their health, while also exploring how these interact with the challenges they face. This process enables communities to design and prioritise interventions that maximise their existing resources, ultimately enhancing health and well-being.
Having developed this approach across several regions in Kenya, we are now working to refine it further with new partners in Zambia and Kenya, while exploring opportunities for scaling. We also aim to test its adaptability across a range of thematic fields. Through this process, we seek to continuously strengthen the model while generating evidence on the impact of community-driven, participatory approaches in improving health and well-being.
Over the coming 18 months, we will:
Positive Health: Many conceptions of health focus on a negative or deficit-model of health, which defines health as the absence of disease and assesses it predominantly through biomedical statistics. Positive health extends beyond this to examine factors contributing to wellbeing and flourishing – ‘health assets’ or ‘salutogens’. These include social, environmental and economic determinants influencing the wellbeing of communities.
Community health: Community health is an approach to health promotion that takes the community as the unit of analysis, rather than the individual. In particular it involves understanding the health of the community as a system, rather than simply aggregating the biomedical data of individual community members each in isolation.
Agentic Approaches: Agentic approaches focus on supporting communities to achieve their own health goals, rather than imposing top-down objectives. Examples include assets-based approaches which focus on the tangible and intangible resources individuals and groups possess to improve their wellbeing; the capabilities approach developed by Amartya Sen and Martha Nussbaum, which focuses on the capabilities of individuals and groups to achieve valued life outcomes, and resourcefulness, an agentic approach developed by Stema, building upon capabilities and assets-based approaches with particular application to community health.
Taken together, a Community Positive Health approach involves collaborating with communities to understand the system of resources supporting positive health in the community, and the health goals and priorities of community members. The aim is to identifying resource gaps and opportunities to use existing resources more effectively, and co-design interventions to promote positive health aligned with the goals of community members.
Some early examples of Community Positive Health in action include our fieldwork projects in Peru, Sierra Leone, East Pokot (Kenya) and South Africa.
The Peru and Sierra Leone projects are documented as case studies in our 2019 presentation, Building Resourcefulness: Case Studies of Building with Communities in Peru and Sierra Leone.
Most recently, Stema has been conducting a multi-site fieldwork research project in Baringo, Siaya and Nakuru Counties, Kenya. In collaboration with local partners, we used a mixture of qualitative, participatory and data driven approaches to understand community conceptions of positive health and collaboratively define the building blocks that shape positive health.
For more information on these methods see our recent presentation at Futures Conference 2022, "Building Blocks of Positive Community Health: The Contribution of Kenyan Communities", as well as our ICSD conference poster, "Developing a measurement framework for positive community health in Kenya".
If you're interested in using the CPH approach, contact us! We are currently developing a measurement framework and toolkit to help other organisations use CPH methods and would be delighted to hear from you.