Community Positive Health (CPH) is Stema’s unique framework for promoting health in low-resource settings. The CPH 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. CPH helps communities and decision makers:
We’ve developed a measurement framework for Community Positive Health (CPH) that identifies the resources and risk factors shaping health outcomes. This framework, created with local partners, uses participatory, qualitative, and data-driven methods to align interventions with community priorities.
By integrating different domains of health, the framework highlights gaps and potential solutions for maximum impact on well-being.
The building blocks of CPH were identified through participatory approaches with communities and consist of both tangible and intangible resources. Tangible resources include: Education, Transport, Shelter, Health Systems, Energy, Food and Water, Environment, Economic Capital, and Communication. Intangible resources include: Participation, Agency, Governance, Equity, Culture, and Peace, Safety, and Security.
Over the coming 18 months, we will
Throughout this process we will evaluate the framework and continuously improve and refine the model.
We are currently developing a digital, globally scalable quantitative index. This tool will build on our existing framework and provide communities and decision-makers with actionable insights.
Goals of the CPH Index
The CPH Index will be built using community-level data, with flexible models that provide insights at sub-national, national, and regional levels.
To ensure the index is effective and impactful we will:
By refining the CPH Measurement Framework and CPH Index, we aim to empower communities with tools and insights that lead to lasting health improvements and smarter resource allocation.
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.