A wide-ranging analysis of community involvement in health development (CIH) as a concept, a strategy, and an ongoing experiment in the search for ways to improve health care for the majority of the world's population. Noting that discussions of health-sector reform have given CIH greater prominence, the book aims to provide a resource of ideas and practical methods for all health professionals interested in applying a participatory approach to development work. The book has seven chapters. The first traces the historical evolution of the concept of CIH and discusses its place within the broader areas of development theory and practice. The next three chapters provide detailed case studies of recent experiences with CIH in Bolivia, Nepal, and Senegal. Chapter five, on health development structures, draws on data from nine countries included in a study, which explored the potential of civil society organizations to promote and facilitate CIH. Results of the study confirm the considerable potential of health development structures to bring together both different sectors and different levels of government. Chapter six discusses the need to develop an appropriate methodology of participatory development. Lessons from the case studies are used to identify a set of operational principles for community action for health. The final chapter draws a number of important conclusions concerning ways in which the concept of CIH can move closer to practical reality. Many past failures are attributed to the unrealistic expectation that participatory efforts would make it possible to achieve more with less money.