Creating Promising Futures Through Social Construction
This thesis has three purposes. One is to document the Community Action for Health Programme (CAH) in Kyrgyzstan that I have initiated in 2001 and have developed since then with colleagues into a nationwide programme and to discuss its theoretical foundations. This is done in part I of the thesis (chapters 3 and 4). The description of the programme introduces the context and the structures of the programme and includes examples of results that were achieved. The chapter on theoretical foundations of CAH in Kyrgyzstan reviews the literature on health promotion and community empowerment and tries to locate CAH in Kyrgyzstan in the different health promotion models as well as in various continuums, scales and coordinate systems that have been proposed in the literature to assess programmes aiming for community empowerment. I will propose a new instrument to assess community capacity building programmes that in my view closes a gap in assessing such programmes.
The second and third purposes of the thesis, covered in part II (chapters 5-8), are to investigate two questions: One is to what degree appreciative principles are present in CAH in Kyrgyzstan (I will define what I mean with appreciative principles), and the second one is to document the lessons learnt and the effects of introducing Appreciative Inquiry (AI) into CAH in Kyrgyzstan. Regarding the first investigation, I had always an interest in the importance of non-dominant, respectful behaviour of staff working with people in community development programmes and put a special emphasis on it while developing CAH. Chapter 7 presents the findings as to how far this emphasis has led to a presence of appreciative principles throughout the system of CAH. Regarding the introduction of AI into CAH, it has built on this earlier emphasis on appreciative principles but opened new dimensions and possibilities. Chapter 8 documents them and the effects they had on CAH.