Community-based program design

Community practice in social work is linked with the historical roots of the profession's beginning in the United States. More specifically, the history of community-based social work has evolved from the Charity Organization Society (COS) and the settlement house movements. However, during the earlier half of the 20th century, much of this work targeted the mentally ill and focused on institutionalization. Not until the 1960s did the shift from institutions to communities, known as deinstitutionalization,[2] increase the emphasis on community-based program design. Community-based organizations and community-based programs burgeoned because of this. The poor conditions of mental health institutions and an increasing amount of research that illustrated the benefits of maintaining the relationships of the individuals served within the community surfaced to further the growth of community-based programs.

Although social work has been historically defined by these institutionalized and deinstitutionalized periods, informal community design programs have always existed. In fact, informal community-based programs predate human service applications of this approach.[1] In 1990, Bernice Harper illustrated this point in the book Social Work Practice with Black Families: A Culturally Specific Perspective in regards to African American communities, by writing that:

Blacks have always cared for the sick at home, yet it was never labeled 'home care.' Blacks have been dying at home and receiving care in the process, yet it was never called 'hospice care.' Blacks have relieved each other from the caring and curing processes, yet it was never seen as 'respite care.' Blacks have cared for each other in their homes, in their neighborhoods, and throughout their communities, yet it was never referred to as 'volunteerism.'[3]

The community-based program design is a method utilized in the field of applied anthropology. In the mid to late 20th century, anthropologists focusing on research program design discovered that excluding the desire, input, and commitment of local communities and people (for which problems were being attempted to be solved) would be unsuccessful and unsustainable without some type of community-based methodology.[13] Additionally, there are examples, from the past 20 years, of social scientists like anthropologists utilizing collaborative strategies with the communities that they research and study to introduce ideas that can enact change at the individual level and even on a global scale.[13] Applied anthropologists use the community-based model to help indigenous groups recognize and construct their individualized "theories of need and change" and even help these groups accumulate the various forms of capital required to address those needs, including financial resources, and political support.[13] When conducting community-based research, it is imperative that an anthropologist establish a definition of the community they will be working with by identifying the community members and stakeholders of such said community and provide justification or clear reasoning for the defined community group.[14]

An example of the anthropological model can be found within the field of medical anthropology and the work conducted by medical anthropologist Paul Farmer. In 1998, Farmer and his colleagues developed a community-based model of care in order to provide free and comprehensive HIV treatment in impoverished areas of Haiti. The winning key strategy that Farmer and his contemporaries developed out of the community-based model was the use of community health workers, who would check on patients at their own homes to make sure patients were taking their medications correctly and regularly.[15] Due to Paul Farmer's success of the medical community-based program design in Haiti, Farmer and his colleagues were invited to duplicate their efforts in Lima, Peru in order to combat drug-resistant tuberculosis; and, subsequently, the Clinton Foundation leaned on Farmer's organization Partners in Health to support medical efforts in the government of Rwanda. Partners in Health was able to rebuild the government's local infrastructure by building new hospitals and health centers and introduced low-cost medicines and therapies through the use of community health workers.[15]

• Charitable organization
• Community-based participatory research
• Community organization
• Nonprofit organization