Foreword

Communities are the backbone of global health, for without them our work would have neither context nor meaningful effect. The idea of ‘community’ has many faces people gathered together by harsh necessity in refugee camps; members of a particular profession joined by a common mission; children of similar age facing the same set of challenges; individuals who share the same faith. But the affiliations they form, by choice or circumstance, be as loose as people living in close proximity or those enlisting in formal networks, create a structure by which we can deliver services to the world’s poorest citizens more efficiently and effectively. More than 2500 members of the global health field practitioners, advocates, policy makers, students and funders across the international health spectrum gathered in Washington, DC in May 2008 for the Global Health Council’s 35th Annual International Conference. The majority of the 400 papers and presentations shed new light on the work being done to deliver health-care services in communities around the world, and Global Public Health highlights in this issue a selection that shows the breadth and substantial scope of the conference. Several themes emerged clearly during these five days: women are the catalysts for change in their communities, for without their help as volunteers, as champions, as leaders, as providers and as nurturers the provision of health services becomes nearly unfeasible; yet, women’s health continues to be under-prioritised and underfunded. Engagement with local stakeholders is essential in ensuring the success and sustainability of any programme. Providing access and resources to the poorest of the poor in the most remote hamlets of the world continues to be a challenge, but new tools and approaches are emerging to guide the path. These are not new quandaries, but how the global health community itself tackles these issues creatively, efficiently and together continues to evolve. Many papers in this issue of Global Public Health highlight a set of rigorous, welldefined and meaningful programmes, developed and executed at the interface between the community and a range of health efforts. For example, a major challenge has always been the chasm between policy and practice. As such, bridging the gap between policy makers and providers through effective advocacy and common understanding can mean the difference between lip service and actual implementation. One such paper in this journal, by Caffrey et al., discusses such an engagement of parliamentarians to improve women’s health in Kenya and Namibia. Another paper, by Agbonyitor, shows a community model of tackling HIV/AIDS in Nigeria, where home-based care by volunteers from a faith-based organisation is offered to people living with HIV/AIDS. And Mazia et al. cite in their treatise the frequent disconnect at the community level between prevention of mother-to-child transmission and maternal and neonatal health services, but shows how in a tiny hamlet of Swaziland two sets of activities have been done in a coherent coordinated fashion to good effect.