A community based approach in developing health policies: implications for Asia-Pacific nations

Only a few state in the US have followed up on the Nation's 1990 health objectives and almost all used professional experts and planners to do so. Hawaii has taken the extra step and involved the community in studying and preparing its health objectives. Hawaii used the US Public Health Service's framework which included preventive health services, health protection, and health promotion. Some of the priority areas under preventive health services included family planning, pregnancy and infant health, and sexually transmitted diseases. In 1985, the State organized 15 groups each studying a different health priority area with 8-20 members each from the community and various organizations. Members consisted of public health professionals (31%), health professionals from private voluntary organizations (15%), practicing physicians (13%), voluntary health associations members (11%), university faculty (8%) and the remaining members represented the military, health care institutions, business, labor, State Department of Education, and special interest groups. The study groups met monthly and arrived at 92 high, 82 medium, and 27 low priority areas. At each of 3 public forums, 5 different study groups presented their findings. Prior to the Governor's Conference on Health Promotion and Disease Prevention, each participant received a preconference report consisting of detailed summaries of each study group's findings. After the conference, the study groups met again to incorporate conference feedback into their final working papers. In December 1988, the Department of Health hosted a conference to evaluate progress and developments relating to achieving the state's health objectives. Broad based community involvement and intersectorial cooperation and political commitment in health planning are essential to meeting health objectives, policies, and actions.