The need to specifically look into the ways of strengthening the community systems cannot be emphasized more at any other time than perhaps in the present scenario of the extant(though some still say imminent)pandemic of Influenza A ('swine flu/Mexican flu).
In the past we have always worked on health systems strenghening(HSS) in isolation under the mistaken presumption that it alone would be adequate to ensure access to equitable healthcare ,in an emergency or otherwise, to all those who need them.
Even under the rights perspective it was just the right to health-care which was considered to be focussed in our plannings and interventions.
It is ,however,strongly felt by me that it is imperative to ensure fully community based and community led interventions backed with directed efforts for a sustained community systems strengthening(CSS) .All the pursuits must be in accordance with the reguirements of establishment,protection,promotion and full assertion of the right to health.
All the socio-economic detrerminants of health have to be clearly delineated with a strong community perspective on the basis of evidence generated and /or validated by the community.Behaviour change for practices like hand washing,a 'cough etiquette' cannot be just adopted in all parts of the globe by a mere dissemination of 'IEC materials'.
Just released WHO Guidance package for pandemic influenza preparedness and response clearly mentions the need for "whole-of-society" approach based on a comprehensive response from the community at large and not the traditional 'health sector' in isolation.
The WHO Guidance,Interim CDC Guidance and the national/technical guidelines and literature must be consolidated to meet the local requirements to strengthen a community based response supported by an effective and adequately monitored(say by social audit) quality service delivery.
Together we can definitely tide over this or any other crisis in future also with that approach.
Do provide your valuable feedback and critical commments to faciltate finetuning of the perspective,line of thinking and approaches.
Thanks and best wishes,
Dr Rajesh Gopal,Gujarat,India.