NCM 113- LECTURE

COMMUNITY HEALTH NURSING

Midterms

COMMUNITY DEVELOPMENT Principles of Community Development

• The United Nations defines community development Self-determination

as a “process where community members come ➢ people and communities have the right to make
together to take collective action and generate their own choices and decisions.
solutions to common problems.”
Empowerment
• A holistic approach grounded in principles of ➢ people should be able to control and use their
empowerment, human rights, inclusion, social justice,
own assets and means to influence.
self-determination and collective action (Kenny,
2007)
Collective action
➢ coming together in groups or organizations
• CD programs are led by community members at every
stage – from deciding on issues to selecting and strengthens peoples’ voices.
implementing actions, and evaluation.
Working and learning together
➢ collaboration and sharing experiences is vital to
Purpose of Community Development good community activity.

✓ To bring people to motivate themselves through

programs geared towards their overall Characteristics of Community Development
development as a unit of society.
✓ Focus on geographic communities; local
✓ Encouraging togetherness and teamwork is definition is important - Includes a broad range
another purpose of community development and of people.
this brings about a sense of strength.
✓ Also, can focus on population groups.
✓ It aims to bring social reforms through
discouraging ancient social or cultural practices ✓ Promotes empowerment, cooperation and
that are outdated and possibly harmful. consensus.

✓ We also cannot underestimate the purpose of ✓ Leadership shared with citizens and those with
community development that is creating appointed power.
awareness on various social concerns such as
health, poverty, security, hunger among others. ✓ Relationship oriented

✓ It also aims to promote good governance as it

ensures the community leaders are on their toes. Philosophy of Community Development
It makes them aware that they are being watched
when it comes to issues related to their people • Seeks to strengthen the capacity of community
and how they make decisions that affect them. members to act collectively to improve their
physical, social, economic, and political
environment.
• Builds sustainable places through participation
and empowerment.

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Midterms

Core Values of Community Development Elements of Community Development

1. Collaboration and inclusion Community Development as a Process

o A large part of community development ➢ Community Development is a process form one
revolves around two major values: group condition to another. It is an evolutionary state
inclusion and collaboration. Healthy teamwork of change from lower point to the upper. It is the
is crucial in order for a community process of total development of man in a
development project to succeed. community is the motivation of people towards
change in their behavior and mental growth.
2. Meaningful participation and change Thus it can be easily said that C.D is a process
o Speaking of teamwork, it’s essential to of emphasizing social as well as psychological
understand that your participation is needed for change in human social life.
a greater purpose. Your contributions have
significant meaning and value as you move Community Development as a Method
your community towards change. ➢ Community development as a method of
practical work in the community people is
3. Respect involved in it to bring change and development
o Respect for your community and others is so in the community. It is a method of
important in this process. Without it, the improvement and progress in which the social
change that’s needed will not be possible. organizer play an important role. Social worker
Focusing on solidarity and being respectful of goes to the communities met with people and
others is a large part of the process. aware them about the socio economic
backwardness and its causes in the locality. So,
4. Strengths-based assets C.D as a method uses by the social organizers to
o A goal of community development is to bring people together and work collectively for
strengthen the overall strength of the the improvement and progress of community.
community and its residents.
Community Development as a Program
5. Integrity ➢ It is a set of procedures and having its rules and
o No good work can be accomplished without regulation in the form of programs. There
integrity. We need honest, dutiful people who programs are involved in the better
value their community and actively seek out improvement of the community people in
positive change for everyone. various sectors. Different programs are working
to achieve a variety of specific change and
6. Hope development in community. The community
o There’s no more important quality for program tries to meet the basic needs and
community development than hope. Change requirements of the people. Basically,
starts with individuals, then it grows as we community development program activities are
work together with hope for a better, more as under:
fruitful future.
***Physical improvements, such as roads,
housing, sanitation, drainage, system and farming
etc.
*** Functional activities are health, education,
protection, recreation etc.

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COMMUNITY HEALTH NURSING
Midterms

**** Social activities including group discussion Technology:

cooperation, work together, self-reliance etc. - a catalyst for social change
- gives power and a voice to people within the
Community Development as a Movement larger ecosystem.
➢ It is the gradually change in behavior, belief,
mental horizon and motivation towards change
in human life. As a movement, it is the Approaches to Community Development
persuasion of masses to become self reliance
and work for the betterment of community. This
movement is imposable without the help, WELFARE APPROACH
cooperation and coordination and also active ❖ the immediate and/or spontaneous to ameliorate
participation of the people in community the manifestation of poverty especially on the
programs. When the people identify the need of personal level.
program as their own, then the process of
development starts with full zeal and progress. ❖ assumes that poverty is God-given; destined,
In this way the process of community hence the poor should accept their condition
development takes place as a movement from since they will receive their just reward in
lower stages to the peak point. heaven.

❖ believes that poverty is caused by bad luck,

natural disasters and certain circumstances
Pillars of Community Development which are beyond the control of the people.

Objectives/goals:
MODERNIZATION APPROACH
- deepen the decentralization process
❖ assumes that development consists of
- set the National and Local Community
abandoning the traditional methods of doing
Development agendas and support the
things and must adopt the technology of
communities to understand them.
industrial countries.
People:
❖ believes that poverty is due to lack of education,
- t’s the people of the community who
lack of resources such as capital and technology.
generates solutions to common problems that
improve the economic, social, environmental
and cultural wellbeing of the community.
- The control of community people over the PARTICIPATORY RESEARCH
amount, quality and benefits of development ❖ this is the process of empowering/ transforming
activities helps make the process sustainable. the poor and the oppressed sectors of society so
that they can pursue a more just and humane
Strategy: society.
- useful, in guiding daily actions and
prioritizing and reviewing established goals, ❖ believes that poverty is caused by prevalence of
and for measuring progress. exploitation, oppression, domination and other
- aim to provide a focus on specific needs unjust structure.
which have an impact across the whole
community. -identifies long and short-term
goals the community wants to achieve.

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COMMUNITY HEALTH NURSING
Midterms

COPAR- Community Organizing projects geared toward the social human

Participatory Action Research development of rural and urban communities.

The Heath Resource Development Program • to make health services available and accessible
to depressed and underserved communities in
➢ A model for establishing and implementing the Philippines
effective, sustainable and participatory PHC
programs in DDU (deprived, depressed,
underserved) communities. • Community organizing as the main strategy to
be employed in preparing the communities to
➢ It entails development and mobilization of develop their community health care systems
students and faculty of paramedical institutions, and the establishment of community health
and enrichment of health oriented curriculum organization to manage the community health
and reorienting the health education of future programs.
health workers to be more responsive and
relevant to the current community health needs. • Organizing work in the communities were done
in 3 phases.

Strategies of HRDP
• Participatory Action Research as fascinating
strategy for maximum community involvement
1. Strengthening the integration of PHC, COPAR, through collective identification and analysis of
Adult teaching learning concepts, strategies and community health problems and collective
methodologies in the health science curricula. health action

2. Systematization of the student’s exposure

program.
• Available funds to finance community initiated
projects.
3. Development of CHO which can sustain health
development program HRDP I
o Trained the faculty, medical/nursing students
4. Community – capability building through to provide health care services to the far flung
leadership and skills trainings. barrios because of lack of man power for health
services at the same time that similar activities
5. Provision of health services by the faculty, fulfilled the curricular requirements of the
students and the trained Barangay Health students for public health.
Workers
o The PCPD provides seed money for the income
generating projects.
History of HRDP
o Short-term service
• was developed and sponsored by the Philippine HRDP II
Center for Population and Development (PCPD) o The 2nd cycle uses the same strategy but the
program could not be sustained by the
• PCPD is a non-stock, non – profit institution, schools or hospitals and the
which serve as a resource center assisting incomegenerating projects eventually
institutions and agencies through programs and become the hindrance to the goal of
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achieving the health program because the dynamic, participatory and politically
people tend to be more interested in the responsive community.
income generated by the projects.
DEFINITION:
o Both HRPD I and HRDP II have brought
about some changes in the community life of • A social development approach that aims to
the people. transform the apathetic, individualistic and
voiceless poor into dynamic, participatory and
o Established basic health infrastructure; basic politically responsive community.
health services were increased; there were
trained workers and organized health groups
• A collective, participatory, transformative,
to take care of the need of the community
liberative, sustained and systematic process of
building people’s organizations by mobilizing
and enhancing the capabilities and resources of
HRDP III the people for the resolution of their issues and
o PCPD refined the program and resulted to what concerns towards effecting change in their
is now called HRDP III, which has these unique existing oppressive and exploitative conditions
features: (1994 National Rural Conference).
✓ Comprehensive training of the staff and faculty
• A process by which a community identifies its
of the participating agency in which the
needs and objectives, develops confidence to
community work was initiated.
take action in respect to them and in doing so,
extends and develops cooperative and
✓ Periodic training program and regular assistance
collaborative attitudes and practices in the
to the participating agency were provided to
community (Ross 1967)
strengthen the health outreach program to
become community oriented
• A continuous and sustained process of educating
✓ PHC as the approach with which all nursing / the people to understand and develop their
medical students, their CI’s and indigenous critical awareness of their existing condition,
health workers are trained for community health working with the people collectively and
work and around which all other project inputs efficiently on their immediate and long-term
will revolve. problems, and mobilizing the people to develop
their capability and readiness to respond and take
action on their immediate needs towards solving
their long-term problems (CO: A manual of
experience, PCPD).
COPAR- Community Organizing
Participatory Action Research
Process
COPAR or Community Organizing Participatory ❖ the sequence of steps whereby members of a
Action Research community come together to critically assess
to evaluate community conditions and work
together to improve those conditions.
➢ is a vital part of public health nursing.
COPAR aims to transform the apathetic,
individualistic and voiceless poor into

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 NCM 113- LECTURE
COMMUNITY HEALTH NURSING
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Process and Methods used in COPAR Importance

❖ COPAR is an important tool for community
1. A progressive cycle of action- reflection-action development and people empowerment as
➢ which begins with small, local, and concrete this helps the community workers to generate
issues identified by the people and the community participation in development
evaluation and reflection of actions taken by activities.
them.

2. Consciousness Raising
❖ COPAR prepares people/clients to eventually
take over the management of a
➢ through experiential learning dvelopment.programs in the future.
➢ is central to the COPAR process because it
places emphasis on learning that emerges
from concrete action and which enriches ❖ COPAR maximizes community participation
succeeding action. and involvement; community resources are
mobilized for community services.
3. Participatory and Mass –based
➢ It is primarily DIRECTED TOWARDS and
BASED in favor of the POOR, the powerless Principles
and the oppressed.
❖ People especially the most oppressed,
4. Group centered and not leader oriented exploited and deprived sectors are open to
➢ Leaders are identified, emerge and are tested change, have the capacity to change and are
through action rather than appointed or selected able to bring about change.
by some external force or entity.
❖ COPAR should be based on the interest of the
poorest sector of the community.

Structure ❖ COPAR should lead to a self-reliant

❖ Refers to a particular group of community community and society.
members that work together for a common
health and health related goals.
PHASES OF COPAR
Emphasis
✓ Community working to solve its own 1. Pre- entry Phase
problem.
✓ Direction is established internally and - Is the initial phase of the organizing process
externally. where the community organizer looks for
✓ Development and implementation of a communities to serve and help. Activities
specific project less important than the includes:
development of the capacity of the
community to establish the project. Preparation of the Institution
✓ Consciousness raising involves perceiving ✓ Train faculty and students in COPAR.
health and medical care within the total ✓ Formulate plans for institutionalizing
structure of society. COPAR.

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✓ Revise/enrich curriculum and immersion ✓ No member of the host family should be

program. moving out in the community
✓ Coordinate participants of other departments.
2. Entry Phase
- sometimes called the social preparation
Site Selection phase. Is crucial in determining which
✓ Initial networking with local government. strategies for organizing would suit the
✓ Conduct preliminary special investigation. chosen community. Success of the activities
depend on how much the community
✓ Make long/short list of potential communities organizers has integrated with the
✓ Do ocular survey of listed communities. community

Criteria for Initial Site Selection Guidelines for Entry

✓ Recognize the role of local authorities by
✓ Must have a population of 100-200 families.
paying them visits to inform their presence
✓ Economically depressed.No strong resistance and activities.
from the community. ✓ Her appearance, speech, behavior and
✓ No serious peace and order problem. lifestyle should be in keeping with those of
✓ No similar group or organization holding the the community residents without disregard of
same program. their being role model
✓ Avoid raising the consciousness of the
Identifying Potential Community community residents; adopt a low-key
✓ Do the same process as in selecting profile.
municipality.
✓ Consult key informants and residents. Activities in the Entry Phase
✓ Coordinate with local government and NGOs Integration. Establishing rapport with the people
for future activities in continuing effort to imbibe community life
living with the community
Choosing Final Community seek out to converse with people where they
✓ Conduct informal interviews with usually congregate
community residents and key informants. lend a hand in household chores
✓ Determine the need of the program in the avoid gambling and drinking
community Deepening social investigation/community
✓ Take note of political development. study
✓ Develop community profiles for secondary verification and enrichment of data collected
data. from initial survey
✓ Develop survey tools. conduct baseline survey by students, results
✓ Pay courtesy call to community leaders relayed through community assembly
✓ Choose foster families based on guidelines Core Group Formation
Leader spotting through sociogram
Identifying Host Family Key Persons. Approached by most people
✓ House is strategically located in the Opinion Leader. Approached by key persons
community. Isolates. Never or hardly consulted
✓ Should not belong to the rich segment.
✓ Respected by both formal and informal
leaders.
✓ Neighbors are not hesitant to enter the house.

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committees setup in the organization-

3. Core Group Phase building phase are already expected to be
functioning by way of planning,
- Once the community health nurse identifies implementing and evaluating their own
the potential leaders, they are formed into a programs, with the overall guidance from the
core group. community-wide organization

- The core group will be given the role of Key Activities

community organizer. Training of CHO for monitoring and
implementing of community health program.
*** Integration with the core group members Identification of secondary leaders.
- Deepening social investigation Linkaging and networking.
- Training and education Conduct of mobilization on health and
- Mobilizing the core group development concerns.
Implementation of livelihood projects.

4. Organization- building Phase

6. Phase- Out
- Entails the formation of more formal - The phase when the health care workers leave
structure and the inclusion of more formal the community to stand alone.
procedure of planning, implementing, and
evaluating community-wise activities. It is at - This phase should be stated during the entry
this phase where the organized leaders or phrase so that people will be ready for this
groups are being given training (formal, phase.
informal, OJT) to develop their style in
managing their own concerns/ programs. - The organizations built should be ready to
sustain the test of the community itself
Key Activities because the real evaluation will be done by
Community Health Organization (CHO) the residents of the community itself.
preparation of legal requirements
guidelines in the organization of the CHO by
the core group Critical Steps in Building People
election of officers Organization (Activities in Building
Research Team Committee People’s Organization)
Planning Committee
Health Committee Organization
Others Methods of Integration includes:
Formation of by-laws by the CHO - Participation in direct production activities of
the people
- Conduct of house visits
5. Sustenance and strengthening phase - Participation in activities like birthdays,
fiestas, wakes, etc
- Occurs when the community organization - Conversing with people where they usually
has already been established and the gather such as stores, water, walls, washing
community members are already actively streams, or churchyards
participating in community-wide - Helping out in the household chores like
undertakings. At this point, the different cooking, washing the dishes, etc

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SOCIAL INVESTIGATION ➢ The entry phase or sometimes called the social

preparation phase.
➢ A systematic process of collecting, collating,
analyzing data to draw a clear picture of the MEETING
community.
➢ Core group formation
➢ Also known as community study ➢ People collectively ratifying what they have
already decided individually
➢ The meeting gives the people the collective
Pointers for the conduct of Social Investigation power and confidence
➢ Problems and issues are discussed
o Use of survey or questionnaires is discouraged

o Community leaders can be trained to initially ROLE PLAYING

assist the community worker/organizer in SI

o Data can be more effectively and efficiently ➢ To act out the meeting that will take place
collected through informal methodshouse visits, between the leaders of the people and the
participating in conversations in jeepneys and government representatives.
others.
➢ It is a way of training the people to anticipate
o SI is facilitated if the community worker is what will happen and prepare themselves for
properly integrated and has acquired the trust of such eventually.
the people.

o Confirmation and validation of community data MOBILIZATION OF ACTIONS

should be done regularly.
➢ Actual experience of the people in confronting
o Secondary data should be thoroughly examined the powerful and the actual exercise power
because much of the information might already
be available.
EVALUATION

➢ Determines whether the goal is met or not

TENTATIVE PROGRAM PLANNING
➢ The people reviewing the steps 1- 7, so to
➢ Community organizer to choose one issue to determine whether they were successful or not
work on in order to begin organizing the in their objectives.
people.
REFLECTION
GROUNDWORK
➢ Dealing with deeper, on-going concerns to look
at the positive values Community workers are
➢ Going around and motivating the people on trying to build in the organization.
something or an issues ➢ It gives the people time to reflect on the stark
➢ A time to spot and develop potential leader reality of life compared to the ideal

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ORGANIZATION

➢ The result of many successive and similar

actions of the people

➢ Occurs when the community organization has

been established and the community members
are already participating in a community wide
undertaking

The Community Health Worker as a

Documenter/Reporter

❖ The community health worker keeps a written

account of services rendered, observations,
condition, needs, problems and attitude of the
client in community activities,
accomplishments made etc.

❖ Community workers takes responsibility to

disseminate pertinent information to
appropriate authorities, agencies, and most
especially to the client.

❖ At the same time, the community worker

develops the people’s capabilities to keep/
maintain their recording and reporting system

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