Evidence for the importance of community involvement: implications for initiatives to prevent mother-to-child transmission of HIV.

This paper underscores the importance of involving the community in the prevention of mother-to-child transmission (MTCT) of HIV and highlights the need to understand community attitudes and garner community support so that successful outcomes are achieved. It draws from experiences of and approaches to community involvement that have been carried out in the development and health fields over the last 40 years. Particular emphasis is placed on identifying what has been learned from related experiences that can be useful in the design implementation monitoring and evaluation of interventions to prevent MTCT. Overall the review underscores the need for active involvement of community members when new interventions affecting their well- being are being considered. It is critical for interventions that are complex addresses sensitive issues and demands changes in community norms and values to make communities partners--a source of expertise in developing and sustaining such interventions. Moreover particular attention needs to be paid to marginalize less vocal and less powerful members of the community to ensure that their needs are addressed.