The learning community as a management approach.

Honduras is the site of HEALTHCOMs longest running technical assistance program. 4 resident advisers and short-term technical consultants have worked with the Ministry of Health through the Mass Media and Health Practices Project since 1980. As recently as 1985 staff members of the Health Education Division of the Ministry of Health would have rapidly polarized over operational and policy issues. Communication plans for child survival interventions in diarrheal disease control immunization and acute respiratory infections however have been developed through a learning community approach based upon cooperative group interaction and experimental learning. Consensus building begins in the earliest phases. Recognition and cultivation of this learning community have been one key to success over the years. The authors look at management issues such as the difficulty of transferring technologies to a specific group of people and to a bureaucracy of ever-changing members and shifting priorities. The following sections are presented: PROCOMSI I and II; when technical assistance ends; success vs. institutionalization; after success in Honduras; gaining commitment from friends and possible foes; regaining commitment of project staff; including physicians and nurses in the learning community; theory behind a learning community approach; and implications for institutionalization.