The objective aim of this article is to understand the low level of community mobilization for health by questioning the legitimacy of the Community-Level Health Committee s (CLHC s ) and their leaders. In other words, it will focus on the process of judging the CLHCs and their leaders by the local population, identifying and analyzing all the elements that serve as references for the construction of their legitimacy. Data were collected from 9 CLHCs ’ member s and 60 heads of households recruited in three villages, through individual interviews. All interviews were recorded, transcribed and entered into Word files. Data processing was done using NVIVO10 software. The results of the study indicate that the CLHCs, which are supposed to facilitate community mobilization, do not work like they are supposed to do. As an effect of this situation, the populations do not trust the CLHCs and its first officials. Through analysis, we note that the criteria used for their implementation did not take into account the real needs and expectations of the communities. This community structure does not have the expected support. Both their composition and their mode of operation did not meet the social norms and aspirations of the populations. The CLHCs were not perceived as community structures that help to improve the conditions of access to health care, but rather as a mechanism put in place by health agents with the complicity of certain members of the population so as to use the resources of the health facilities for their own interests. Hence the lack of trust in them.
Bhattacharyya, K., Winch, P., LeBan, K., & Tien, M. (2001). Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention, and Sustainability. Basic Support for Institutionalizing Child Survival Project (BASICS II).
Boulle, T. (2013). A Review of the Functioning of Health Committees in Nelson Mandela Bay Health District—With Particular Emphasis on Identifying Key Challenges. http://www.salearningnetwork.uct.ac.za/sites/default/files/ image_tool/images/386/publications/other_reports/20131027_identifying_key_challenges_ of_health_committees_in_nelson_mandela_bay_2.pdf
Dubnick, M. J. (2002). Seeking Salvation for Accountability. In 2002 Annual Meeting of the American Political Science Association (pp. 7-9). The American Political Science Association.
Falisse, J.-B., & Ntakarutimana, L. (2020). When Information Is Not Power: Community-Elected Health Facility Committees and Health Facility Performance Indicators. Social Science & Medicine, 265, Article ID: 113331. https://doi.org/10.1016/j.socscimed.2020.113331
Ford, R., & Johnson, C. (1998). The Perception of Power: Dependence and Legitimacy in Conflict. Social Psychology Quarterly, 61, 16-32. https://doi.org/10.2307/2787055
French Jr., J. R. P., & Raven, B. (1959). The Bases of Social Power. In D. Cartwright (Ed.), Studies in Social Power (pp. 150-167). University of Michigan.
George, A., Scott, K., Garimella, S., Mondal, S., Ved, R., & Sheikh, K. (2015). Anchoring Contextual Analysis in Health Policy and Systems Research: A Narrative Review of Contextual Factors Influencing Health Committees in Low and Middle Income Countries. Social Science & Medicine, 133, 159-167. https://doi.org/10.1016/j.socscimed.2015.03.049
Goodman, C., Opwora, A., Kabare, M., & Molyneux, S. (2011). Health Facility Committees and Facility Management-Exploring the Nature and Depth of Their Roles in Coast Province, Kenya. BMC Health Services Research, 11, Article No. 229. https://doi.org/10.1186/1472-6963-11-229
Hurd, I. (1999). Legitimacy and Authority in International Politics. International Organization, 53, 379-408. https://doi.org/10.1162/002081899550913
Ilboudo, S. D. O., Sombié, I., Soubeiga, A. K., & Draebel, T. (2016). Facteurs influencant le refus de consulter au centre de santé dans la région rurale Ouest du Burkina Faso 1. Santé Publique, 28, 391-397. https://doi.org/10.3917/spub.163.0391
Kapologwe, N. A., Kalolo, A., Kibusi, S. M., Chaula, Z., Nswilla, A., Teuscher, T., Aung, K., & Borghi, J. (2019). Understanding the Implementation of Direct Health Facility Financing and Its Effect on Health System Performance in Tanzania: A Non-Controlled before and after Mixed Method Study Protocol. Health Research Policy and Systems, 17, Article No. 11. https://doi.org/10.1186/s12961-018-0400-3
Kesale, A. M., Mahonge, C., & Muhanga, M. (2022). The Quest for Accountability of Health Facility Governing Committees Implementing Direct Health Facility Financing in Tanzania: A Supply-Side Experience. PLOS ONE, 17, e0267708. https://doi.org/10.1371/journal.pone.0267708
Kilewo, E. G., & Frumence, G. (2015). Factors That Hinder Community Participation in Developing and Implementing Comprehensive Council Health Plans in Manyoni District, Tanzania. Global Health Action, 8, Article 26461. https://doi.org/10.3402/gha.v8.26461
Kunjuraman, V. (2022). Local Community Participation Challenges in Community- Based Ecotourism Development in Sabah, Malaysian Borneo. Community Development Journal, 57, 487-508. https://doi.org/10.1093/cdj/bsaa065
Lainez, Y., Wittcoff, A., Mohamud, A., Amendola, P., Perry, H., & D’Harcourt, E. (2012). Community Case Management Data in Six Sub-Saharan African Countries. The American Journal of Tropical Medicine and Hygiene, 87, 144-150. https://doi.org/10.4269/ajtmh.2012.12-0106
Lopes, D. M. Q., Beck, C. L. C., Prestes, F. C., Weiller, T. H., Colome, J. S., & da Silva, G. M. (2012). Agentes Comunitários de Saúde e as vivências de prazer sofrimento no trabalho: estudo qualitativo. Revista da Escola de Enfermagem da USP, 46, 633-640. https://doi.org/10.1590/S0080-62342012000300015
Matheson, C. (1987). Weber and the Classification of Forms of Legitimacy. British Journal of Sociology, 38, 199-215. https://doi.org/10.2307/590532
McCoy, D. C., Hall, J. A., & Ridge, M. (2012). A Systematic Review of the Literature for Evidence on Health Facility Committees in Low- and Middle-Income Countries. Health Policy and Planning, 27, 449-466. https://doi.org/10.1093/heapol/czr077
Ministry of Health Uganda (2010). Village Health Team (VHT) Strategy and Operational Guidelines. Ministry of Health Uganda.
Molyneux, S., Atela, M., Angwenyi, V., & Goodman, C. (2012). Community Accountability at Peripheral Health Facilities: A Review of the Empirical Literature and Development of a Conceptual Framework. Health Policy and Planning, 27, 541-554. https://doi.org/10.1093/heapol/czr083
Pérez, L. M., & Martinez, J. (2008). Community Health Workers: Social Justice and Policy Advocates for Community Health and Well-Being. American Journal of Public Health, 98, 11-14. https://doi.org/10.2105/AJPH.2006.100842
Sombié, I., Ilboudo, D. O., Soubeiga, A. K., & Samuelsen, H. (2017). Comprendre l’influence des facteurs contextuels sur la participation communautaire à la santé: Une étude de cas dans le district sanitaire de Tenkodogo, au Burkina Faso. Global Health Promotion, 24, 87-95. https://doi.org/10.1177/1757975915591685
Song, W., Shea, L., Nonnemacher, S. L., Brusilovskiy, E., Townley, G., & Salzer, M. S. (2022). Community Participation Comparison between Adults on the Autism Spectrum and Adults in the General Population. Journal of Autism and Developmental Disorders, 52, 1610-1621. https://doi.org/10.1007/s10803-021-05059-9
Spencer, M. E. (1970). Weber on Legitimate Norms and Authority. The British Journal of Sociology, 21, 123-134. https://doi.org/10.2307/588403
Stone, L. (1992). Cultural Influences in Community Participation in Health. Social Science & Medicine, 35, 409-417. https://doi.org/10.1016/0277-9536(92)90333-L
Suchman, M. C. (1995). Managing Legitimacy: Strategic and Institutional Approaches. Academy of Management Review, 20, 571-610. https://doi.org/10.2307/258788
Tyler, T. R. (2006). Why People Obey the Law. Princeton University Press. https://doi.org/10.1515/9781400828609
Van Ginneken, N., Lewin, S., & Berridge, V. (2010). The Emergence of Community Health Worker Programmes in the Late Apartheid Era in South Africa: An Historical Analysis. Social Science & Medicine, 71, 1110-1118. https://doi.org/10.1016/j.socscimed.2010.06.009
Walker, H. A., & Zelditch Jr., M. (1993). Power, Legitimacy, and the Stability of Authority: A Theoretical Research Program. In J. Berger, & M. Zelditch (Eds.), Theoretical Research Programs: Studies in the Growth of Theory (pp. 364-381). Stanford University Press.
Waweru, E., Opwora, A., Toda, M., Fegan, G., Edwards, T., Goodman, C., & Molyneux, S. (2013). Are Health Facility Management Committees in Kenya Ready to Implement Financial Management Tasks: Findings from a Nationally Representative Survey. BMC Health Services Research, 13, Article No. 404. https://doi.org/10.1186/1472-6963-13-404
Weber, M. (1978). Economy and Society: An Outline of Interpretive Sociology (Vol. 2). University of California Press.
Zelditch Jr., M. (2001). Theories of Legitimacy. In J. T. Jost, & B. Major (Eds.), The Psychology of Legitimacy: Emerging Perspectives on Ideology, Justice, and Intergroup Relations (p. 33). Cambridge University Press.