TY - JOUR T1 - Community Ownership in Primary Health Care—Managing the Intangible JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 327 LP - 331 DO - 10.9745/GHSP-D-20-00427 VL - 8 IS - 3 AU - Eric Sarriot AU - Ali Nashat Shaar Y1 - 2020/09/30 UR - http://www.ghspjournal.org/content/8/3/327.abstract N2 - Key MessagesThe concept of community ownership in primary health care has a long history but remains challenged in terms of definition, measurement, and differences of perspective from practitioners on a gradient between utilitarianism and empowerment. It continues to be somewhat intangible.Although a universal definition across time and contexts may be illusory, contextual appreciation of its dynamic evolution under programmatic influences—for different stakeholders with diverse agendas—is accessible to evaluation and learning.No one can “manage” someone else’s ownership, but programs can reject hubris and tokenism by intentionally questioning their unavoidable impact on community ownership and whether they foster it through meaningful dialogue and “sense-making” with local stakeholders.See related article by Fontanet et al.In this issue of GHSP, Fontanet et al.1 invite us to return to a concept that has existed since early discussions of community medicine2 and primary health care3: community ownership in health. Many of us who work in global health have felt and seen the excitement and sense of possibility when communities took charge, made a project “their own,” innovated to find contextual solutions, and generated energy and hope in addition to buy-in for a lifesaving or health-promoting intervention. In 1992, one of this article’s authors witnessed how heavy rains had damaged a clinic serving the poor population of Jiftlik in the Jordan valley. Without institutional funds to rehabilitate the structure, the village residents felt a sense of ownership and accountability and restored the clinic themselves, and this clinic is still providing services in 2020. The literature is rich with case studies like this.4–6As critical as community ownership is—and even foundational for many—it also appears to remain somewhat intangible, possibly impractical for some, and certainly complex for all. We consider some of the reasons for this quandary.The first stumbling … ER -