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I. Pre-entry Phase
CRITICAL ACTIVITIES:
1. Selection or validation
2. Personal visit (Preliminary Social Investigation)
>A secondary data gathering through review of records. Common sources are
Barangay Health Center, Barangay Hall, and Family Records.
>Rationale:
1. Redundancy: to avoid repetitive questions
2. Irritation: to avoid rejection from the community
3. To identify common issues
> Consolidation and identification of priorities are other ways to accomplish PSI
3. Formal Communication
>The group communicates to the barangay about their purpose.
4. Courtesy Call to the municipal leader or a personal visit to the leaders like mayor or
municipal health workers
> Rationale:
1. Show respect to the leaders
2 Leaders of the community know what are or is the need of their area.
3. T o get their initial support on the health activities are going to do by the group
5. Agencies orientation
>Content:
1. Policies, Philosophy of Community Health Nursing, principles, goals and
objectives.
2. Initial data that has been gathered by college of nursing on the area.
3. Initial activities.
4. COPAR approach, strategies, principles and processes involved
Description:
> Actual entry and immersion of community health workers in the community
> Also known as the Social Preparation Phase
> Considered as the most crucial phase because
* It determines acceptance of the community
*Sensitization of people on critical events in their lives , e.g. dreams and
aspiration
CRITICAL ACTIVITIES
1. Courtesy call at the barangay level - conducting a personal visit to the leaders
Purposes:
a. To (sensitize) make them aware of your presence in their community
b. To make them feel that you have recognized their important roles in this
health partnership.
c. To establish rapport or initiate a trusting relationship with them.
d. To discuss initial but immediate plans, such as;
*settling down in the staff house
*terms or conditions related to the staff house immersion
*Immersion
*Ocular survey
>Reasons :
1. To determine the house of the contact persons, or leaders of the
community.
2. to be familiar on the landmarks
3. To be aware on the physical and political boundaries of the area
4. To determine the entry and exit points of the area.
*kind of approach to be use - concept of partnership - " Umay kami mak-
ili...", insted of saying ,"umay kami tumulong "
Purposes of integration :
a. To get to know the people's culture, economy, leaders, history, rhythm,
and lifestyles as bases for own adjustments --better acceptance to the
community.
b. To understand and respect the people and recognize the positive aspect
of their culture that give them the strength to struggle.
c. To understand how the people analyze their own situation
d. To have basis for modifying own values and lifestyle in keeping with
that of the community.
Guidelines in integration:
a. Appearance, speech, behavior and lifestyles be in keeping with
the community residents, without disregard to being a role model
in health beliefs and practices.
Appearance--not appearing like a tourist
Speech--not talking slang
Behavior--not being too close with the opposite sex
Lifestyle--simple food yet nutritious
b. Be humble and adopt a low key profile or approach. Go down
to their level. Encourage you to call you simply. Refrain from
being messianic in approach. Do not promise anything you are
not very sure of giving.
3. Leader spotting and initial core group formation/ identifying existing leaders or
groups
a. Laying the foundation of a strong people's organization by identifying
original or indegenous members of a community with leadership
qualities and bringing them together to exchange knowledge and
insights about their community
b. Core goup- a group of people who are initially identified as leaders
(key persons and opinion leaders) with the following characteristics:
Key person:
* the star in the sociogram because she or he is the most
commonly approached by many people regarding
their own problems
* an obvious leader, persons with whom the health worker has to
win support and train as the local community organizer and
health worker. Alter ego of the health worker.
Opinion Leader:
* the person who is approached by the key person and is
therefore, the one behind the key person's ideas.
Adviser of the key person.
Deviants or isolates
* persons in the community who are not or are never approached
by any or few community members when faced with problems.
a. critically study and come up with one stand point about a particular
issue at hand
Other terms used for DSI: community study or participatory action research
Purpose of DSI:
a. Provides a clearer picture about the community
b. Basis for planning and organizing activities
c. Helps in determining the appropriate approach and method of
organizing
Community diagnosis - output of community study that is described as
both a profile and a process:
* for the agency, it learns to alter its initially drafted plans and
programs in order to adapt to the results of the community
analysis.
* for the community, it allows them the opportunity to gradually
understand their own situation and the potential advantages that
change can bring about.
a. More successful if the health worker has well integrated with the
community members.
b. Community leaders should be trained to assist the health workers in
doing DSI so that it will be truly participatory
c. The use of the survey questionnaire is discouraged as much as possible
due to the following disadvantages:
*Dishonesty of data if the health worker has not yet fully integrated
with the community
*Difficulty of community folks and leaders in reading and answering a
long questionnaire.
*Previous negative experiences of community with traditional
researchers that leave them a feeling of being subjects of study,
instead of being active participants of the study.
d. Data can be more accurately and honestly gathered through informal
methods like casual conversations during
* house-to-house visits
*while riding a jeepney with them
*in stores
*in washing streams
*while attending community gatherings
*while working with them in production and household activities
Note: it is this forth guideline that makes DSI long and tedious and
requires the community health development worker to live or immerse
in the community
Rationale for using informal methods of data gathering: To obtain
reliable data.
COMMUNITY CONSULTATION
Definition: this is the first of the series of meetings where the household
representatives and the agency will meet together in order to formally know each
other and to share their own vision, mission and objectives in relation to health
development.
Description:
1. This is the phase which entails the formation of more formal structures and inclusion
of more formal procedures of planning, implementing and evaluating community wide
activities.
2. It is in this phase where the organizational leaders, groups or communities are given
formal and informal trainings to further develop their attitudes, knowledge, and skills that
they need in managing their own activities or programs.
3. This is also considered as the MOST CRUCIAL phase of COPAR because:
a. The focus of COPAR is building and strengthening human behavior
b. The challenges and struggles of the agency health development worker occur during
this stage
CRITIAL ACTIVITIES:
Definition of terms:
a. Formalize - to give shape, form or structure with a clearly articulated vision, mission,
goals, objectives, functions or tasks and personnel
b. Genuine people's organization
(1) A living organism in a social ecosystem not just a structure. A living organism in a
social ecosystem means that it is a group of conscienticized individuals who
decided on their own, to unite efforts so that they can collectively generate more
resources and collectively act on their own common problems and concerns.
(2) An organization that the people, themselves, decided to form for their own interest
and not for the interest of external individuals or groups.
(3) This organization becomes the source of power for the community
Elements of a genuine people's organization:
a. Vision - imagination, dream, an ideal or an end result of a standard quality of life, an
abstract. It is usually broadly stated and in a noun phrase. Example: self reliance,
Empowerment, "health for all", etc.
b. Mission - principal; task or assignment, path chosen to be able to reach the vision.
Characteristics of a mission statement:
(1) Starts with "To..."
(2) Must flow from the vision statement
(3) Accomplishment of the mission leads to the realization of the vision
(4) Should be attainable
c. Goal - general, broad aim or direction, the end toward which all effort is directed at
d. Objectives
(1) Clarifies in detail what one wants to carry out
(2) It specifies for whom the project is being done, by whom. Within what period of
time, where and what a group wants to accomplish
(3) In short, this is a detailed clarification of what one wants to accomplish
e. Development plan - written outline of the goals, objectives, planned activities,
resources, monitoring scheme and evaluation plan of the community
f. Structure - refers to the skeletal arrangement and composition of the people's
organization, including the different committees, the people who man these
committees, and the relationship and lines of responsibility and authority of its leaders
and members
g. Mechanics / strategies - methods or tactics
h. Policies - set of principles or rules determining what or how things are done by a
person or a group.
i. Personnel - includes the leadership or management and program staff.
j. Membership - constitute the number of actively participating members which ideally
should come from every household comprising the community.
k. Resources - supply or support for the organization
(1) Land - includes beneath and above
(2) Labor - all human beings who extract and process raw materials into finished
products, to transport and sell goods or products or provide services
(3) Capital - materials, money, logistic or support services which the people use to
extract and process the raw materials
(4) Entrepreneur or manager
(5) Exchange value
In short, resources would refer to the 6 Ms - manpower, machinery, methods, minute
(time), money, materials.
l. Participation - considered to be the MOST IMPORTANT ELEMENT of the
organization because without this, the organization cannot be considered as a living
organism
b. Adolescent
Characteristics:
(1) Structure - well-defined with formal elected officers having defined task and
responsibilities
(2) Leaders - Either elected indigenous or relational
(3) Relationship of leaders and members - Functional or is based on position or
authority, with creation of certain cliques or factions.
(4) Goal - To effect specific changes in the community, not only on a particular
issue
(5) Programs - Well-defined, with clear sources of funds, with paid staff, and has a
legal personality
c. Adult / maturity - Viable, functional
Characteristics:
(1) Structure - Formal with networks and alliances
(2) Leadership - mass based with leaders who are able to form operational alliances
and networks and have developed certain culture or value systems such as "we
attitude", open and humble, objective, etc.
(3) Relationship - Close intra and inter- organizational
(4) Goal - Social and value transformation that starts from a smaller community to a
wider or bigger society.
(5) Programs - Directed at strengthening the organization, self-reliant task groups in
the community are available to provide health services, resources are now
generated within the community.
b. Formalization of the vision, mission, goals (VMG) and objectives formulated during
the community consultation
How can this be done?
(1) The community leaders and every household representative meet to review their
articulated values transformed into the vision of a happy family and a develop
community
(2) They will now refine the vision and mission, with the assistance of the community
health development worker
(3) They will agree to present this vision and mission for approval to the general
membership
c. Formulation of the structure, policies or constitution and by-laws of the organization
Some types of organizational structure:
(1) Centralized otherwise termed as totalitarian - power comes from the leader , staff,
and key informants
Example: BOD
Pres.
BOD
(3) Decentralized. This structure requires the general membership as the main decision
makers. It has different committees below the general assembly who are responsible
in front lining community activities according to concern. But the over-all decision
maker is the general membership or assembly.
GA
(4) Autonomous. In this type of structure, different small committees or groups in the
community network and link with each other.
Note : In community health development where genuine collective voice and action is
needed, the best structure to be developed is the autonomous. It this is not yet possible,
the next best alternative is the decentralized type. ( again, it is very important for the
community health development worker to facilitate the people to decide to adopt this
structure, instead of dictating them to adopt this structure).
How can we help the organization formulate its own policies or constitution or by-laws?
(1) Evoked from the different committees formed the following:
a. how will they name of organization?
b. do they like to establish a specific office for such?
c. How will they man the office, if ever they will have to establish one?
d. How will they sustain the organization?
e. What will be the requirements in terms of :
*Membership * Leadership tenure of office and etc.
(2) Assist them to formulate or present this into a write up.
d. Assist the leaders to prepare and conduct a community wide meeting for the
ratification or approval of the formalized vision, mission, organizational structure and
by-laws or policies.
e. Registration of the people's organization to Securities and Exchange Commission
(SEC).
6. Mobilization or action
Definition: this refers to the actual implementation of the plan or "putting the plan into
action" by the different committee chairs and members
7. Action-reflection-action session (ARAS) This is now the second ARAS that will be
conducted but the first ARAS to be facilitated by the community leader. The
community health development worker will act as a process observer and a co-
facilitator, when needed.
Definition:
>stage where the people's organization has been fully established and that the community
members are already actively participating in community-wide undertakings.(V/A:
Amstein's ladder of people's participation)
> the different committees in the organizational structure are already and are expected to
do their functions of assessing, planning, implementing and evaluating (A-P-I-M-E)
> the community is more united or one in terms of vision, mission, goals and programs.
INDICATORS OF A CONSOLIDATED, SELF-GOVERNING PEOPLE'S
ORGANIZATION:
1. Internal indication:
a. Realization of the goal of social transformation is evident in the changes of the value
system / lifestyle:
(1.) More focus on preventive habits rather than curatives
(2. )ARAS is already institutionalized →more open, objective way of addressing
conflicts and issues
2. External indicators
a. Linkages
(1) The Po maintains and strengthens linkages with others
(2) The agency only serves to be the consultant of the people's organization. As a
consultant, it functions to provide assistance only as necessary.
b. It has established networks ( composed of several linkages) c. Able to source from
outside for programs of projects that require additional resources not within the
community's ability to produce.
a. parabola model
b. SWOT analysis
c. Fish bone analysis
d. historical mapping
4. Sustaining mechanisms
a. developing second liners
b. Identification of a good project, preparation and submission of a project proposal to
appropriate funding agencies
Examples:
*Botika sa Barangay or Botika Binhi
*Nursing Promotive and Preventive Health Clinic
* non-formal education projects
*private laboratory clinic
Definition: Stage whereby the community development workers or change agent leaves
the self-sustaining people's organization and looks for other areas to work with.
CRITICAL ACTIVITIES: