Guiding Participation and Inclusion

We welcome yesterday’s launch of NHS England’s Guidance for Participation and Inclusion which begins to lay a foundation for transformational change.

The central challenge for participation and inclusion more generally is how can we promote citizen-led innovation that stays local, but over time proliferates?

On Tuesday in late September in Chicago, John McKnight and I had lunch with Marion Tompson, the founder of La Leche League International. Both John and I consider this one of the finest and most enduring examples of citizen-led health-producing change there is. It also affords us a wonderful answer to the question of how to promote citizen-led innovation that stays local, but over time proliferates. It is an exemplar of what we can do to support people to share their healthfulness with each other.

When I asked Marion how they managed to grow from five women meeting — as a breastfeeding support group in a Chicago neighborhood in the 1950s — to a worldwide movement, she simply said, “We kept everything ‘mother sized,’ and did not fall into the trap of trying to go to scale. Local is everything.” Programs scale, movements spread.

It was this small group of women who, chapter by chapter, focused on the value of breastfeeding, who promoted world-wide the principles and values of breastfeeding. She emphasized, “We did not take on the ‘formula industry’; we just doggedly focused on what we were passionate about.” In other words on what is strong, not what is wrong.

They focused on what is strong, not what is wrong.

But, by doing so they did push back on the all-consuming message of that industry that argued formula was far superior to breast milk.

The question such initiatives pose for us in terms of participation is how can we help people discover that which is invisible yet abundant within and around them?

The La Leche initiative and others like it remind us that health resources are largely in our communities. Our challenge is to identify, connect and mobilize them. Participation and inclusion that only focuses on getting more people using more government-run programs misses this point. And that is what is most significant about England’s new NHS guidelines. Firstly, they begin to point to the resourcefulness that’s already in our neighborhoods — albeit hidden in plain view behind labels — as the key starting point.

Secondly, by citing ABCD they open the way to a conversation that goes beyond a focus on individuals to a discussion about the “collective” nature of health.

So, this guidance signals a widespread acceptance across the healthcare systems of the importance of meaningful “participation” both of individuals and communities, and it usefully begins to share ideas, approaches and examples of how this could be achieved. We congratulate NHS England on its recognition of the need to develop more connected powerful communities and of the potential of the ABCD approach and therefore a belief that the answers lie in communities! We are looking forward to working with NHS England and others to further develop a greater understanding of the principles and value of the ABCD approach.

In a final analysis, as John McKnight would say: “You can’t know what a community needs, until you first know what a community has.”


Photo of (L-R) John McKnight, Marion Tomson and Cormac Russell courtesy Nurture Development. Blog post re-posted with permission from Nurture Development. Home page image: R. Mitra.


About the Lead Author

Cormac Russell
Cormac Russell
Cormac Russell is Managing Director of Nurture Development, Director of ABCD Europe and a faculty member of the Asset Based Community Development (ABCD) Institute at Northwestern University, Chicago. He has trained communities, agencies, NGOs and governments in ABCD and other strengths-based approaches in Kenya, Rwanda, Southern Sudan, South Africa, the UK, Ireland, Sweden, the Netherlands, Canada and Australia. In January 2011 Cormac was appointed to the Expert Reference Group on Community Organising and Communities First, by Nick Hurd MP, Minister for Civil Society in the UK which he served on for the term of the Group. Examples of recent work include: Leading all national sporting organizations in Canada, in conjunction with the Canadian Council for Ethics in Sport, to adopt a shared vision as to how sport can become an asset for community building. This is effecting significant changes in the structures of major sporting organizations but also at a local community level in terms of community empowerment and citizen driven development. Advising I&Dea in the UK on the development of an asset based approach to health and on addressing health inequalities in low income communities as well as how an assets approach can improve community health and well-being. Partnering with Youth Work Ireland on a national program involving hundreds of youth practitioners and thousands of young citizens to develop a strong culture of youth led initiatives. Working in partnership with the University of Limerick and Atlantic Philanthropies in Ireland to infuse an ABCD approach across the entire city of Limerick. Part of this process involved organizing an entire neighborhood to address issues of loneliness, fear and intimidation and to support citizen driven development. The long-term vision is of a city that puts citizens and communities in the driving seat, through processes of neighborhood organizing and bottom up planning and where services are organized in the way in which community is organized. 

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