Autonomy of the Volunteer Sector in the Evaluation of Public Health Programs: An Exploration From the Perspective of an HIV/AIDS Coalition

Abstract

As recommended in the Ottawa Charter, Canadian government agencies are counting on the involvement of grassroots organizations to implement federal public health programs at the local level. At issue is the forced acceptance by community organizations of the predefined role of suppliers of services. Because of the top-down issues of health promotion practice, the problem is crucial for public health nursing. The author uses reflexive analysis, grounded in the internal colonization framework, to explore the case of a Canadian public health program and its relations with a provincial coalition of volunteer organizations working on AIDS issues. Implementing the Ottawa Charter highlights the challenges of the meanings and actions inherent in the notion of partnership between public agencies and community organizations of volunteers. Participation suggests more democratic and egalitarian social organizations, with hierarchical structures in a broader image of a modern society.