Citizen Participation in Food Aid Planning and Implementation: A Successful Strategy in Ghana Noel A. Brathwarte and Warren A. Hodge Introduction For almost a decade, the World Health Organisation (WHO) has been encouraging its members, national governments, institutions, health professions, as well as international agencies, to take measures to ensure that citizens have the opportunity to participate individually and collectively in die planning and implementation of health and other development programmes.' Even though it appears that this idea has virtually won universal acceptance, actual support for its inclusion as a main strategy in management decision-making has remained varied and fragmented. This situation has been partially explained by the lack of a universal blueprint. In addition, the WHO supports the view that the style and mechanism of involving citizens ought to be a dynamic expression of and be consistent with each country's specific social, cultural and economic conditions or patterns, as well as their political and administrative systems. 2 . 3 In keeping with these considerations, managers and planners of health and health-related programmes in third world countries are expected to devise ways and means of effectively and successfully involving citizens in decisions which affect their well-being. This participation should, however, go beyond peripheral levels to the point where local participants are considered as partners or collaborators working together to achieve specific objectives. This paper conceives of community participation as a strategy that can be utilised to influence and ultimately change the way management makes decisions about health or health-related programmes, especially when these programmes influence the outcomes of other social programmes. Part I will briefly describe the food shortage problem in Ghana, and its accompanying health effects, as well as the proposed solution. Part II will outline the strategy used to involve local communities in planning and implementing the programmes-as-solution; and the third section will discuss both the implementation of the project and factors that some comunity leaders and policy makers believe influenced successful outcomes. The principal aim of the paper is to describe how a two-tier system of citizen involvement, namely committees and action teams, was successfully used in Ghana, and to suggest that planners and managers of health or health-related projects in the developing world should continue to involve local communities in decision-making and implementation processes. The Problem Between 1981 and 1983, the two main national health problems in Ghana, 1. World Health Organisation, Formulating Strategies for Health for All by the Year 2000, WHO, Geneva, 1979. 2. World Health Organisation, Managerial Process for National Health Development, WHO, Geneva, 1981. 3. Pan American Health Organization, Managerial Analysis of Health Systems, PAHO Scientific Publication No. 449, Washington, D.C., 1983. at OUP site access on March 4, 2014 http://cdj.oxfordjournals.org/ Downloaded from