its outcomes can be both positive and negative.A positive outcome generally relies on the capacity and willingness of communities,and the individuals in them,to become politically and socially empowered/self-reliant,so that they can prioritize and act upon health issues based on local need.negative outcome occur where professionally paternalistic and disempowering health policy decisions force health-related outcome that are irrelevant to sustained community development and are not based on or resourced according to the social reality of that community.Further-more,there is potential for communities to become introspective and insular as they seek to protect their hard-earned gains,to the exclusion of neighbouring communities and the population as a whole