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The World Health Organisation, WHO in short, defines « community » as being a group of individuals living together in specific conditions of organisation and social cohesion. Its members are linked, at variables degrees, by political, economic, social and cultural characteristics as well as by common interests and aspirations, including health matters. Communities are of extremely varied sizes and profiles ranging from isolated rural exploitation groups to villages, towns and more structured urban districts.

Within the framework of the Multi Country Network Project, the community is understood as the end product of all our actions. Through these, we can identify the key actors of the entire system, namely:

i)   The community of service providers;
ii)  The community of community health workers;
iii) The associations-based community for financing and verification.

This is a direct structure between the service provider and the patient. The latter, therefore, requires quality services, and the staff will be motivated to provide them.

Mutual Health Insurance Schemes and health insurance systems may play a role as regards equity in health care distribution, particularly for the vulnerable group.

The community’s commitment is linked to several levels with the PBF system. The commitment goes beyond traditional commitment in the service providers’ management committees:

i) Community organisations are subcontracted to check whether patients were really visited and whether the latter are satisfied about the services.
ii) Community’s representatives are part of the committees controlling PBF implementation and/or of budget- holding committees), and may, therefore, exert their influence as regards the choice of indicators and that of indicator-based bonuses.   

The State, represented by decentralised entities, should regulate according to the agreements and pre-established standards to guarantee the success and sustainability of the system.