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What is Community Positive Health?

Community Positive Health (CPH) is an alternative framework for health promotion in low resource settings. CPH is intended to help communities and decision makers identify the best opportunities for health promotion by:

  • Prioritising interventions that drive systemic improvement
  • Making better use of existing community resources
  • Leveraging alternative sources of information
  • Aligning support with local needs and priorities

The main facets of a Community Positive Health approach are:

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.

What are the benefits of this approach? 

A Community Positive Health approach can enable community members and decision makers to:

  • Co-design interventions that align with community priorities
  • Focus on projects with potential for systemic impact (rather than short term fixes)
  • Overcome gaps in traditional health data by leveraging alternative data sources and commonsense or low-fi assessments of health assets on the ground
  • Identify opportunities to promote health beyond the formal healthcare system

Putting Community Positive Health into practice

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.

More resources and information

Could you benefit from our work, or help us to build our roadmap? We're looking for collaborators.