COPAR | NCM 119 | TOPIC 14

ELEARN
COMMUNITY ENGAGEMENT • Development of local leadership and educational
v “The process of working collaboratively with and through objectives
groups of people affiliated by geographic proximity, special v Social planning
interest, or similar situations to address issues affecting the • A rational, deliberately planned, technical process of
well-being of those people.” -CDC,1997 working collaboratively problem-solving with regards to substantive social
v Community engagement seeks to engage community to problems
achieve sustainable outcomes, equitable decision-making v Social action
processes, and deepen relationships and trust between • Social justice
government organizations and communities. • Democracy

COMMUNITY DEVELOPMENT • Redistribution of power, resources and decision making

v “A process where community members are supported by PRINCIPLES OF COMMUNITY ORGANIZING
agencies to identify and take collective action on issues which v Go to the people, live among the people.

are important to them.” -UN- v Learn, plan, and work with the people

v “Advocates principles of self -help and voluntary participation, v Start with and build on what the people know.
with technical assistance from the government of voluntary v Teach by showing, learn by doing.
organizations.” -Jimenez, 2008 - v Not a piecemeal but an integrated approach.
v A grassroot process by which communities:
supported/ v Not relief but release
Assisted
• Become more responsible COMMUNITY ORGANIZING PROCESS
• Organize and plan together v CA – Community Analysis

• Develop heathy lifestyle options v DI – Design and Initiation

• Empower themselves v I – Implementation

• Reduce poverty and suffering v PMC – Program maintenance and consolidation

• Create employment and economic opportunities v DR – Dissemination and reassessment

• Achieve social, economic, cultural and environmental THE COMMUNITY ORGANIZER (FACE)
v Enabler
goals
v Advocate
v 4 characteristics
• A process for implementing change iiso v Facilitator
v Change agent
• A program for specified activities
• An outcome COMMUNITY ORGANIZING
• An ideology of action PARTICIPATORY ACTION RESEARCH
v Strategy by the Health Resource Development Program (HRDP)
COMMUNITY ORGANIZING III for the implementation of Primary Health Care Delivery in
v Form of community engagement that seeks to rally people to
depressed and underserved communities
work together and act on issues owned, identified, and solved
v Tool for community development and people empowerment
thru and by the people’s own efforts
v Contract for COPAR: 5 years renewable
v Father of community organizing: Saul Alinsky
v Continuous sustained process of educating people in the
v 2 phases:
community (critical awareness of their condition)
• Educating the people
v Mobilizing with the people (mobilize community resources to
• Mobilizing all stake holders to address the problem
solve a problem
ESSENCE OF COMMUNITY ORGANIZING
v Working with the people (To work on people’s immediate needs
PROCESS
v Focus self-reliance v Priority: identification of the problem first by the community
v AIM: community development v Develop confidence
v CONCEPT: teamwork v Identify needs
v ELEMENT: participation of people v Cooperative and collaborative
v STRATEGIES: teaching, training and transfer of technology v In educating people

MODELS/TYPOLOGY OF COMMUNITY • Continuous

ORGANIZING • Process
v Locality development
• Sustained
• Use of democratic procedures
v Self-reliance
• Voluntary cooperation
v Active participation
• Self-help
v Mobilize people
v Empowerment

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COPAR NCM 119
v Purpose: v At the NGO Level:
• Community development approach that allows the • Formulation of institutional goals, objectives and targets
community (participatory) to analyze the situation for the program
(research) plan a solution, and implement projects • Revision of curriculum
(action) utilizing the process of community organizing • Coordinate participation of other departments within
• CA – DI – I – PMC - DR the institution

AIMS OF COPAR v At the community Level:

Apathetic à Dynamic • Community consultations / dialogues
Individualistic à Participative • Setting of issues related to site selection
Voiceless poor community à Politically community • Site selection
Welfare • Development of criteria for site selection
Participatory/transformation • Preliminary social investigation (PSI)
Politically • Networking with LGU’s, NGO’s and other departments
4 IMPORTANCE OF COPAR v Community profiling
v Tool for community development
• Contact person (well known, accepted) à who
v Offer alternate solutions to health problems that may not
identifies other persons who can be depended
require medical intervention
• Demographic characteristics
v Prepare people to take over management of program in the
• Basic cultural practices and lifestyles
future
• Community health services and facilities
v Community resources are mobilized for community resources
v Criteria for site selection
4 PRINCIPLES OF COPAR • Depressed
v Do people have the capacity to change?
Listening Challenge • Exploited
v Do people posses the ability to bring change? Celebration Relation -

• Residents:100-200 families
v Based interest on poorest sectors Reflection Ship Buildingon
• Poor
v Lead to development of self reliant community Action
• Economically depressed
METHODS USE IN COPAR
• Safe (No serious peace and order problem)
v Action-reflection-action-sessions
• How high morbidity and mortality cases
v Consciousness raising
• Evaluate if entered by other organization with same
v Participatory and mass based
program
v Group centered
• Do not have any BHS or nearby hospital
PHASES OF COPAR PROCESS
v Host family criteria

PHASES OF COPAR PROCESS • Strategically located in the barangay.

• Do not belong to the rich segment.
HEALTH PROMOTON MODEL MAGLAYA
• Respected by both formal and informal leaders of the

Preparatory phase Pre entry community.

- Area of selection • Neighbors not hesitant to enter.
- Profiling of community
- Entry • No disruptions of usual doings.
v Recommended activities (3Ps and F)
Organization and Entry
• Profiling and site selection P
capability phase
P
• Pay courtesy call to the LGU
Education and training Community study/diagnosis P
• Preliminary social investigation
phase (Research phase) F
• Foster family
Collaborative phase Community organization and
capability building phase
ENTRY PHASE
v Also called the SOCIAL PREPARATION PHASE
Phase out phase Action phase v Signal the actual entry of the CO into the community
Sustenance and
strengthening phase v Includes sensitization and motivating them
Phase out phase v Recommended activities
• Immersion/ integration/ sensitization with the
PREENTRY PHASE (1-2 MONTHS) community
v Initial phase where the community organizer (CO) looks for a • Information Campaign on health programs
community to serve/help • Deep social investigation
v The simplest phase in terms of actual output, activities • Potential leader spotting
• Cor group (CG) formation

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COPAR NCM 119
• Self awareness and Leadership Training (SALT)/ action v Re source mobilization
T

planning v Setting up of linkages/ network/ referral systems

v Criteria for potential leader SUSTENANCE AND STRENGTHENING PHASE (7-8 MO)
• Low profile v Formulation and ratification of constitution and by laws
• Education at least basic primary education v Identification and development of “secondary leaders”
• Approachable/ respected by both formal and informal v Setting up of a financing scheme
sectors v Continuing education and training of BHW
• Develops a good communication skill v Development of long term Community health development
• Serve willfully Plans
v Core group formation v Formalizing linkages, networks and referral systems
• Leader spotting through sociogram v Registration to S.E.C. (Security and Exchange Commission)
• Key Persons – approached by most people PHASE OUT PHASE
• Opinion Leader –approached by key persons v Turn over of works
• Isolates – Never or hardly consulted v Transfer of Community Organizing roles and responsibilities

COMMUNITY STUDY/ DIAGNOSIS PHASES and documents to the organizations

(RESEARCH PHASE) v Follow up
v Selection of the research team
CRITICAL STEPS IN BUILDING PEOPLES
v Training on data collection
ORGANIZATION
v Planning for the actual gathering of data
INTEGRATION
v Data gathering CO becoming one with the people to:
v Training on data validation v Immerse himself in the community
v Community validation v Understand deeply the culture, economy, leaders, history,
v Presentation of the community study / diagnosis and rhythms and lifestyle of the community
recommendations v Methods of integration include:
v Prioritization of community needs / problems for action v Participation in the activities of the people
v Method of data collection v House-to-house visits
• Survey – most practical (using questionnaires) v Conversation with people where they usually gather (stores,
• Interview – face to face (using interview guide) water wells, washing streams, or church yards)
• Record review (checklist) v Helping out in chores
• Census – most IDEAL (provides BIGGEST BULK OF SOCIAL INVESTIGATION
DATA) v Also known as COMMUNITY STUDY

• Observation – ocular surveys v Systematic process of collection, collating, and analyzing data

v Type of census to draw a clear picture of the community

• De facto – ACTUAL place ( individuals are recorder to v Pointers for the conduct of social investigation:

the geological area where they were present at a v Use of survey questionnaires are discouraged

specific time) ❑ v Community leaders can be trained to assist CO in doing SI

• De juRe – residency (individuals are recorded by their v Can be more effectively and efficiently collected through

place of residence informal methods

• “Usual residence” – the place where a person lives v Secondary data should be thoroughly examined

and sleeps most of the time v SI is facilitated if CO is properly integrated and has acquired
the people’s trust
COMMUNITY ORGANIZATION AND CAPABILITY
BUILDING PHASE v Confirmation and validation of data is done regularly
v Community meetings to draw up guidelines for the organization TENTATIVE PROGRAM PLANNING
v Election of officers v CO to choose one issue to work on in order to begin organizing
v Development of management system the people
v Delineation of the roles, functions and task of officers GROUNDWORK
v Training of Leaders v Going around and motivating the people on a one-on-one basis

v Team building Exercises THE MEETING

v People collectively ratifying what they have already decided
v A –R -A-S (Action- Reflection-Action- Session)
individually
COMMUNITY ACTION PHASE
v Gives people the collective power and confidence
v Organization and training of (BHW’s)
v Problems and issues are discussed
v PIME of health services (Project Implementation Monitoring
and Evaluation

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COPAR NCM 119
ROLE PLAY
v Act out the meeting that will take place between the leaders of
the community and the government representatives

MOBILIZATION OR ACTION
v Actual experience of the people in confronting the powerful and
the actual exercise of people power

EVALUATION
v People reviewing steps 1-7 to determine the success of their
objectives

REFLECTION
v Dealing with deeper, on-going concerns to look at the positive
values CO is trying to build in the organization
v Reflect on the stark reality of life compared to the ideal

ORGANIZATION
v The result of many successive and similar actions of the people
v Final structure is set up with elected officers and supporting
members

ROLE/ACTIVITY IN COMMUNITY
HEALTH CARE DEVELOPMENT
RECORDER/DOCUMENTER/REPORTER
v Community worker keeps a written account of services
rendered, observations, conditions, needs, problems, and
attitudes of the clientele in community development activities,
accomplishments made, etc..
v Takes responsibility to disseminate pertinent information to
appropriate authorities, agencies, and to the client/community.
v Develops the people’s capabilities to maintain their own
recording and reporting system

RECORDS
v Refers to forms on which information pertaining the client is
noted

REPORTS
v Refers to periodic summaries of the services/activities of
an organization/unit
v The analysis of certain phases of its work
PURPOSES OF RECORDS AND REPORTS
1. Measure service/program directed to the clients
2. Provide basis for future planning
3. Interpret the work to the public and other
agencies, community
4. Aid in studying the condition of the community
5. Contribute to client care

PRINCIPLES OF EFFECTIVE AND USEFUL REPORTS

v all items should be carefully selected in order to give significant
information
v Reports are of the most interest value when they are arranged
so that comparison may be made between successive periods
of time
v Reports are of value only when the items included carry
common meaning to all who make use of them
v Reports are more read/received when presented in an
interacting manner

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3. ORGANIZATION-BUILDING PHASE 5. Phase Out Phase

• It entails the formation of more formal structures and the inclusion of • The phase when healthcare workers leave the community to stand alone
more formal procedures of planning, implementing, and evaluating • This phase should be stated during the entry phase so that the people
community-wide activities. will be ready for this phase.
• It is at this phase where the organized leaders or groups are being • The organizations built should be ready to sustain the test of the
given trainings (formal, informal, OJT) to develop their KSA in community itself because the real evaluation will be done by the
managing their own concerns/programs residents itself.

RECOMMENDED ACTIVITIES: CRITICAL STEPS (ACTIVITES) IN BUILDING PEOPLE’S ORGANIZATION

>Meeting with the officials 1. Integration
>Identifying the problems. - CO becoming one with the people in order to:
>Spreading awareness and soliciting solution or suggestion. - immerse himself in the poor community
>Analysis of presented solution. -understand deeply the culture, economy, leaders, history, rhythms,
>Planning of the activities. and lifestyle in the community
>Organizing the people to build their own organization.
>Registration of the organization (legal purposes). Methods of Integration Includes:
>Implementations of projects/programs. ✓ participation in direct production activities of the people
>Evaluation. ✓ conduct of house-to-house visits
✓ participation in activities like birthdays, fiestas, wakes, etc.
4. SUSTENANCE AND STRENGHTENING PHASE ✓ conversing with people where they usually gather such as in stores,
• This occurs, when the community organization has already been water wells, washing streams, or in churchyards
established and the community members are already actively ✓ helping out in household chores like cooking, washing the dishes,
participating in the community-wide undertakings. and etc.
• At this point, the different committees set-up in the organization
building phase are already expected to be functioning by way of 2. Social Investigation
planning, implementing, and evaluating their own programs, with the - it is a systematic process of collecting, collating, analyzing data
overall guidance from the community wide organization. to draw a clear picture of the community
- also known as the community study
RECOMMENDED ACTIVITIES: Pointers for the Conduct of Social Investigation:
>Meeting with the organizational leaders. ✓ use of survey questionnaires is discouraged.
>Evaluating the programs. ✓ community leaders can be trained to initially assist the community
>Re-implementation of the programs (for unmet goals). worker/organizer in doing social investigation
>Educating and training. ✓ data can be more effectively and efficiently collected through
>Networking and linking. informal methods (house-to-house visits, participating
>Conduct of mobilization of health and development concerns. conversations in jeepneys and others)
>Implementation of livelihood projects. ✓ secondary data should be thoroughly examined because much of
>Developing secondary leaders the information might already be available
✓ social investigation is facilitated if the community organizer/worker
is properly integrated and has acquired the trust of the people
✓ confirmation and validation of community data should be done
regularly

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3. Tentative Program Planning • ROLES AND ACTIVITIES IN COMMUNITY HEALTH CARE

- community organizer choose one issue to work on in order to begin DEVELOPMENT
to organize the people
4. Groundwork • As a Recorder / Documentor / Reporter
-going around and motivating the people on a one on one basis to do ✓ Community worker keeps a written account of services rendered,
something on the issue that has been chosen observations, conditions, needs, problems, and attitudes of the
5. The Meeting clientele in community development activities, accomplishments
-people collectively ratifying what they have already decided individually made, etc.
-the meeting gives the people the collective power and confidence ✓ Community worker takes responsibility to disseminate pertinent
-problems and issues are discussed information to appropriate authorities, agencies, and most especially
6. Role Play to the client/community.
- means to act out the meeting that will take place between the leaders ✓ At the same time, the community worker develops the people’s
of the people and the government representatives capabilities to keep/maintain their own recording and reporting
-It is a way of training the people to anticipate what will happen and system
prepare themselves for such eventually
7. Mobilization Records- refer to forms on which information pertaining the client is noted.
-Actual experience of the people in confronting the powerful and the Reports- refers to periodic summaries of the services/activities of an
actual exercise of people power organization/unit or the analysis of certain phases of work
8. Evaluation
-The people reviewing the steps 1-7 so as to determine whether they
Purposes of Reports and Records:
were successful or not in their objectives
• measure service/program directed to the clients
9. Reflection
• provide basis for future planning
-Dealing with deeper, on-going concerns to look at the positive values
• interpret the work to the public and other agencies, community
CO is trying to build in their organization
• aid in studying the conditions of the community
-It gives the people time to reflect on the stark reality of life compared
• contribute to client care
to the ideal
Effective and Useful Reports Depends on Certain Basic Principles Such As:
10. Organization
-The people’s organization is the result of many successive and similar • all items should be carefully selected in order to give significant
actions of the people information
-A final organizational structure is set up with elected officers and • reports are of the most interest value when they are arranged so that
supporting members. comparison may be made between successive periods of time
• reports are of value only when the items included carry common
The above steps in building organizations are done in all/any of the phases of meaning to all who make use of them
the COPAR process. Their application and the specific strategies and purpose • reports are more read/received when presented in an interacting
may vary slightly depending on the phase of the process it is applied. manner

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Developing Work Groups for Community Health Development 2. The stage of Conflict- the authority stage.
-One of the expectations of a nurse as a change agent in the This stage is characterized by the group’s concern over dominance,
community is to work effectively with groups. control and power.
-Certain socio-cultural tendencies and values can affect group life. Conflict experience is either between members or between members
Example: authoritative or autocratic behavior can block opportunities for and the leader.
participative-democratic decision-making. 3. The Stage of Cohesiveness
Following the previous period of conflict, the group gradually develops
◼ 5 Major Stages of Group Development into a cohesive (closer) unit.
1. The Stage of Orientation This stage has an increase of morale and mutual trust as members
- There are two tasks confronting group members during this stage feels group belongingness.
1. They must determine a way of achieving their primary tasks for the The members are willing to share more about themselves to others in
purpose of joining the group. the group.
2. They must find a place for themselves in the group, one that will give The chief concern of the group is with intimacy and closeness.
him/her comfort and pleasure from the group members as well. Often the group suppresses all expression of negative feelings in order
to maintain a harmonious atmosphere.
In achieving these two tasks, the group member’s behavioral patterns are 4. The Work Group Stage
basically attempts at warding off anxiety. During this stage, the uniqueness of the members and the leaders are
The main concern of the members: seen and expected.
1. is whether they are “in” or “out” of the group. Members accept one another’s differences without associating
2. search for a role for themselves, wondering if they will be liked and “good” and “bad” with the differences.
respected or ignored and rejected. Conflicts exists but these are on substantive issues rather than
3. members are careful with their choice of words because they are emotional ones.
not sure how they will be taken by others in the group. The state of the mature work group may last for the remainder of the
4. discuss topics of apparently little substantive interest to any of the group’s life.
participants; however, these topics serve as a vehicles to explore how During the stage of advanced work group or true teamwork, the
they are perceived by co-members. tension is between “work” or progress, and regression at an earlier
stage.
With these exploratory attempts, a member eventually discovers who responds 5. The Termination Stage
favorably to him, who sees things the way he does, whom to fear, and to After being together and working on specified “tasks”, members of
respect. Gradually he begins to formulate a picture of the role he will play in the groups experience a sense of ending.
group. This termination stage either be temporary or permanent
5. Another common experience is the search for similarities. This According to Dunphy (1965), the tasks of the group at this stage may
experience offers great support to members. include:
6. Giving and seeking advice is another characteristics of the early 1. Finishing the agenda
group. 2. Establishing key decisions
So, the early group can be described as a groping, testing, reluctant group. Also 3. Completing the group product
a dependent one. 4. Tying up loose ends
5. Writing off unfinished business
The members expect the leader to provide the group with structure and ◼ The key emotions are joy and sadness
answers, look for approval and acceptance - The group celebrates for the work and achievements done. However,
there is emotional coping with the loss of valued personal relationships.

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5 Interventions to Facilitate Group Growth 3. Process, Negotiate and Resolve Conflicts to Member’s satisfaction
o The nursing interventions, tasks and techniques emphasize the 1. Help members understand the nature of conflicts
importance of working on feelings, needs and communication. 2. Help members go through the coping process of conflict resolution using the
1. Provide the Necessary Orientation, Structure and Direction problem-solving approach
– During the stage of orientation and dependence, the level of anxiety can be 3. Help members generate new ways of looking at the situation or problem
decreased by helping provide the necessary orientation, structure and 4. Help members analyze the here-and-now experience. And are as follows:
direction to the group.
– Introduction for new member to the old members as well as to the Understanding the nature of conflict
facilitator must be address. - group members learn to develop a positive attitude toward conflict when they
realize that it has the following characteristics:
2. Help meet member’s interpersonal needs 1. It is a natural part of any relationship and of any group
-Should communicate the message that each one is important in the 2. Conflict is desirable and extremely valuable for several reasons, according to
achievement of group goals. Johnson and Johnson:
- Members should be provided with the necessary emotional support by ✓ It encourages inquiry, promotes objectivity and sharpens analysis
acknowledging their discomfort during the time of heightened level of since it provides for a greater diversity of opinions, interests, values,
anxiety, and by eliminating or minimizing the sources of the anxiety. and ideas among group members.
-Avoid making demands until group anxiety has abated. ✓ Stimulates interest and curiosity, increases motivation and energy of
- Members “open up” when they feel secure, know they won’t be ignored, group members.
ridiculed, criticized or embarrassed by other group members. ✓ It can reduce the natural tension and frustration of working together
✓ Members derive personal benefits from the experience of conflict.
✓ Conflicts bring information to members about where they are, what is
◼ According to (Johnson and Johnson 1975), the leader’s tasks and techniques important to each of them, how the group work can be made effective
are as follows: and how their relationship can be improved.
1. Listening attentively to what each is saying ✓ Help group members avoid being bothered by the past, which they
2. Not judging the contributions of members or commenting on every cannot change.
contribution made. 3. Any conflict can be handled constructively by the group when the following
3. Doing away with preaching, teaching or moralizing aspects are considered:
4. Avoiding forcing members into participation before they are ready. ◼ Members should develop specific group norms or rules to create an
atmosphere conducive to healthy management of conflicts.
◼ The Leader encourage productive participation by:
1. Observing for signs of a member’s efforts to be heard and giving her an Example: conflict should be over issues and not between persons
opportunity to contribute.
2. Being sensitive in identifying those too eager to talk as they can take up ◼ Conflicts are manage effectively by encouraging group cooperation and
all the group’s time. by using the problem-solving approach.
3. Encouraging and supporting all members who participate
4. Summarizing and clarifying the contributions.
5. Not monopolizing the discussion or commenting too frequently
6. Show enthusiasm for the discussion and a sincere interest in the group
members.

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B. Conflict Resolution Through the Problem-Solving Approach 4. Be Aware of the Effects of Own Behavior on the Group: Use self for
◼ According to Johnson and Johnson 1975, the basic steps of problem- Group Growth
solving approach are: The nurse as the facilitator or coordinator of group discussion exerts an
1. Clarify the basic issue – the opposing viewpoints must be clear to every influence on the behavior and experience of group members. She must;
member of the group. o be the model of the group as regards behavior that is expected or
2. Diagnose the dimension and causes of conflict accepted.
- The objective here is to define the nature and magnitude of the forces o be on time for meetings, keeping appointments and promises.
that bring about the conflict and forces that minimize the conflict. o utilize every available opportunity to maximize group growth by
3. Explore ways to settle the conflict making sure that she does not rail road the group’s decision
- there are 3 steps; o be open and free self from the tendencies to be proud and
a. Eliminate or reduce the forces that bring about the conflict and/or authoritative
strengthen/increase the forces that minimize the conflict. o allow the group’s decision to dominate group life
b. Integrate positions or ideas that are similar such as the dimension or o act as the group’s completer and ensure that the missing aspects are
magnitude of the conflict is reduced. made available for the group.
c. Help the members analyze if the opposing views can be taken by the group as
its decision. 5. Derive Opportunities to Apply Learning on Another Situation
4. Decide upon and implement an agreement satisfactory of the group ◼ Group experiences-provide varied learning opportunities for members
- the opposing viewpoints can be listed, together with the positive and -This particular intervention is also helpful when the facilitator helps
negative aspects of each, in as far as the group’s goals and tasks are the group undergo successfully the stage of termination.
concerned.
5. Evaluate the success of the action taken
- in order for the group to learn to be dynamic in pursuing its goals and -end-
provisions for replanning are adequately considered.

C. Generating New Ways of Looking at the Situation or Problem

◼ The facilitator need to develop conditions that allow concerns, issues and
problems to be reformulated.
◼ During discussion, the atmosphere must be such that members are given
the freedom and support to have self-confidence needed to entertain and
express novel ideas without being afraid of harsh or disapprove.

D. Helping Members Analyze the Here-and-Now Experience

◼ During experiences of conflicts, tension and anxiety can affect group
process to a degree that individual members feel the need to do something
about the situation they are in.
◼ Essentially, this intervention helps members recognize, examine and
understand the “how” and “why” of interactions.

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