Community Development in Occupational Therapy Education: Learning From Global Experiences

Introduction

Participation and community integration are, according to Kothari (2004), a prerequisite for a person’s well-being. Therefore, occupational therapists consider community centered practices such as community development an essential practice domain for enhancing well-being. This chapter aims to show how occupational therapists use practice and research in different places (Belgium, Brazil, Germany, South Africa) to educate students on sustainable community-based practice from a critical citizenship perspective.

Background

The World Health Organization (WHO) published the Declaration of Alma Ata “to protect and promote the health of all the people of the world” (WHO, 2002, p.1). Eight years later, in 1986, WHO advertised the Ottawa Charter of Health Promotion. Within this charter, health promotion is seen as “the process of enabling people to increase control over, and to improve, their health” (Charter, 1986, p.4). Health for all by the year 2000 emphasized that health is influenced by social, economic, and environmental interrelated factors (Mahler, 1981). Dahlgren and Whitehead (1991) visualized this challenging process with a ‘rainbow’ model of the main determinants of health. This model was adapted by Barton and Grant (2006) with a bigger emphasis on the environment. A distinction is made between physically constructed, natural environment, and global ecosystems (Graham & White, 2016). All layers have an influence on a person’s health, which is visualized at the center of the health map in Figure 1.

Figure 1.

Health Map developed by Barton & Grant (2006) based on Dahlgren & Whitehead (1991).

Source: © 2006 Barton and Grant. Used with permission.

From an occupational therapy perspective, the environment influences people’s participation in meaningful occupations (Law, 1991; Hammel, 2014) and enables people to participate in occupations of their choice and need to enhance their health, well-being, and quality of life. Occupational therapists need to include all factors which contribute to occupational engagement (Townsend and Polatajko 2007). Moreover, Wilcock (2006) stresses the importance of the meaningful engagement in occupations and explains that people engage in occupations with individual and shared goals, e.g. shared or collective occupations (Ramugondo & Kronenberg, 2015). Occupational therapy is a profession that contributes to inclusion and equity, and to disruption of the processes of exclusion and inequality. A critical perspective may foster participation and social cohesion within society where participation entails “everyday social and cultural life and is interconnected with concepts of human and occupational rights” (Fransen et al., 2015, p. 262). Having knowledge of the available choices for community members may enable occupational therapists to develop appropriate programs while actively involving the people who will benefit from community-based programs. If participation barriers could be identified and removed, community members could better contribute to community development by focusing on specific sustainable development goals.