COMMUNITY HEALTH NURSING PROCESS

• The community health nursing process, like the nursing process in general, is
composed of Assessment, Diagnosis, Planning, Implementation, and Evaluation.
However, for purposes of tradition, community assessment is already integrated into
the process of community diagnosis.
• COMMUNITY DIAGNOSIS:
TRADITIONAL PARTICIPATORY ACTION RESEARCH
Research for purpose of identifying and meeting Research seeks social transformation.
individual needs with existing social systems.
Community problems or needs are defined by 2.The research problems are defined bybthecommunity members themselves
experts or external researchers who are considered/viewed as “experts of their own reality.”
The research problem is studies by the researchers 3.The community group undertake the investigation or research from data
who control the research process. collection to analysis. External researchers work alongside the community
group.
Recommendations for the community are based on 4.The community formulates recommendations and an action plan based on
the researcher’s findings and analysis. research outcome.

o As a PROFILE, it is a description of the community’s state of health as determined

by physical, economic, political, and social factors.

▪ It defines the community and state community problems.

▪ PURPOSE: To be able to obtain a quick “picture” of a community which is as

accurate as possible.

▪ A COMMUNITY PROFILE SHOULD:

• Summarize information
• Present results and figures clearly
• Be useful for planning and monitoring
o As a PROCESS, it is a continuous learning experience for the nurse/program
coordinator and the staff, as well as the community people, for the following reasons:

▪ It enables the nurse/programs/coordinator/staff, as well as the community people, for

the following reasons:
• It enables the nurse/program coordinator/staff to adjust or alter the program for
optimum effectiveness.

▪ It allows the community to gradually become aware of the solution.

▪ It is an organized attempt to involve people in recognizing and resolving problems

that concern them most.
▪ It enables the community to understand at its own pace the potential advantages of
change, which may eventually lead to alterations in attitudes, values, and behaviors.
• TYPES OF COMMUNITY DIAGNOSIS:
o Comprehensive Community Diagnosis

▪ Aims to obtain general information about the community or a certain population

group.
o Problem Oriented Community Diagnosis

▪ Type of assessment that responds to a particular need.

• ELEMENTS OF A COMPREHENSIVE COMMUNITY
DIAGNOSIS:(MAGLAYA, 2009)
A. Demographic Variables
• A comprehensive community diagnosisshould show the size, composition, and
geographical distribution of the population, as indicated by the following:
1. Total population and geographical distribution including urban-rural index and
population density.
2. Age and sex composition
3. Selected and vital indicators such as growth rate, CBR, CDR, and life expectancy at
birth
4. Patterns of migration
5. Population projections
6. Population groups with special needs – indigenous people, internal refugees, and other
socially dislocated groups.
B. Socio-Economic and Cultural Variables
• Social Indicators:
1. Communication network (whether formal or informal channels) necessary for
disseminating health information or facilitating referral of clients to the health care
system.
2. Transportation system, including road networks, necessary for the accessibility of
health care.
3. Educational level that may be indicative of poverty and may reflect on the health
perception and health utilization pattern of the community.
4. Housing conditions that may suggest health hazards (congestion and exposure to
harmful elements) and safety hazards (fire)
• Economic Indicators
1. Poverty level/income
2. Unemployment and underemployment rates
3. Proportion of the total economically active population that are salaried or waged
earners.
4. Types of industry present in the community
5. Occupation common in the community
6. Land ownership
7. Recreational facilities
• Environmental Indicators:
1. Physical/geographical/topographical characteristics of the community
a. Land areas that contribute to vector problems
b. Terrain characteristics that contribute to accidents or pose as geohazard zones.
c. Land usage in industry
d. Climate/season
2. Water supply
a. Percentage of population with access to safe, adequate water supply
b. Source/s of water supply for drinking and other activities
3. Waste Disposal
a. Percent of population reached by the daily garbage collection system
b. Percent of population with safe excreta disposal system
c. Types of waste disposal and garbage disposal system
4. Air, Water, and Land Pollution
a. Industries within the community that are hazardous to health
b. Air and water pollution index
• Cultural Factors
1. Variables that may “break up” the people into groups within the community
a. Ethnicity
b. Social class
c. Language
d. Religion
e. Race
f. Political orientation
2. Cultural beliefs and practices that affects health
3. Concepts about health and illness
4. Other factors that may directly or indirectly affect the health status of the community.
C. Health and Illness Patterns
• Leading cause of morbidity
• Leading cause of mortality
• Leading causes of infant mortality
• Leading causes of maternal mortality
• Leading causes of hospital admission
D. Health Resources
• Refers to manpower, institutional and material resources provided not only by the
state/government, but also those that are contributed by the private sectors and other
non-government organizations
• Manpower Resources
1. Categories of health manpower available
2. Geographical distribution of health manpower
3. Manpower-population ration
4. Distribution of health manpower according to health facilities (hospitals, RHUs, etc)
5. Quality of health manpower
6. Existing manpower development/policies
• Material resources
1. Health budget and expenditure
2. Sources of health funding
3. Categories of health institutions available in the community
4. Hospital-bed population ratio
5. Categories of health services available
E. Political/Leadership Patterns
• This reflects the action potential of the state/government and its people to address the
health needs and problems of the community.
• It mirrors the sensitivity of the government to the people’s struggle for a better life.
1. Power structures in the community (formal or informal)
a. This includes leadership patterns, community organizations, and government
structures, etc.
2. Attitudes of the people toward authority
3. Conditions/Events?Issues that cause social conflict/upheavals or that lead to social
bonding or unification.
4. Practices/Approaches that are effective in settling issues and concerns within the
community.

• Sources of Data in the Conduct of the Community Diagnosis:

A. Primary Data
o Source would be the community people through surveys, interviews, focused group
discussions, observations, and through the actual minutes of the community meetings.
B. Secondary Data
o Sources would be organizational records of the program, health center records, and
other public records.
• What is Community Diagnosis as a PROCESS?

• It consist of collecting, organizing, synthesizing, analysing, and interpreting health

data.
• Before data are collected, objectives must be determined as these will direct the depth
or scope of community assessment and resolve whether a comprehensive or problem
based community diagnosis will accomplish the objectives.
• The community is an active partner and not a recipient of care. The nurse
works with and not for the community.
• In working with the community in a diagnostic exercise, use appropriate participatory
methods for mobilizing community participation.
• The nurse is not an external assessor of community needs, but a facilitator working
with a team of community members and leaders.

• Steps in Conducting a Community Diagnosis

1. Planning:
a. Determine the objectives

▪ Decide on the depth and scope of the data to be gathered; regardless of the type of
community diagnosis to be conducted.

▪ The nurse must determine the occurrence and distribution of selected environmental,
socio-economic, and behavioral conditions important to disease prevention and
wellness promotion.

▪ Statement of objectives should be SMART (Specific, Measurable, Attainable,

Realistic, Time-bound)
b. Define the Study Population

▪ Identify the population group, based on the objectives of the study; the study
population maybe the entire community population or be focused on a population
group, such as women in the reproductive age group or the infants.
c. Prepare the Community
▪ Meet with community leaders to enable the nurse to formulate the community
diagnosis objectives .

▪ Initial data are gathered through the key leaders are as follows:
• Spot map of the entire community
• Initial secondary data ( total number of households per area, total population per area,
list of traditional healers, list of CHWs)
d. Choose the Methodology and Instrument of Community Diagnosis

▪ Choose methodologies and instruments to be utilized in the conduct of the community

diagnosis.
o Survey questionnaires
o Observation checklist
o Interview guide
e. Setting the Targets

▪ Involves constructing a timetable of activities, taking into consideration the sample

size and the number of personnel that will work.

2. Implementation
a. Actual data Gathering

▪ During the actual data gathering, the nurse supervises the data collectors by checking
the filled-out instruments for completeness, accuracy, and reliability of the
information collected.

▪ Data gathered should cover the following:

o Community dimensions secondarily related to health

▪ Demographic data

▪ Economic characteristics

▪ Social indicators

▪ Political characteristics

▪ Cultural characteristics
▪ Environmental indicators
o Community dimensions directly related to health

▪ General health indicators – birth, death, morbidity, mortality rates

▪ Maternal and child health care – family planning, midwifery services, child care

▪ Immunization status of children

▪ Food and nutrition – daily food budget, daily food intake, knowledge on basic food
groups

▪ Illness and injury- type of sickness, medical personnel attending to the sick, where the
sick go for consultation and treatment, types and sources of medicines, dental care,
mental health, accidents, causes of death.

▪ Water and environment – water supply and storage, food storage, sanitation (excreta,
garbage, waste water disposal, pets and vermin control)

▪ Endemic diseases

▪ Health education

▪ Health resources – (government/private) health manpower, health centers, health

services

▪ Perceptions of health problems – concepts of health, perceived health problem,

solutions to health problems.
b. Collation/Organization of Data
• There are 2 types of data that may be generated:
o Numerical data – data that can be counted
o Descriptive data – description of observable characteristics of different factors
• Before collation, the accomplished questionnaires are edited. (Editing means going
through the questionnaires to ensure that all questions have been properly entered.
• To facilitate data collection, the nurse must develop categories for the classification of
responses, making sure that the categories are MUTUALLY EXCLUSIVE and
EXHAUSTIVE.
o MUTUALLY EXCLUSIVE choices do not overlap
o EXHAUSTIVE CATEGORIES anticipate all possible answers that a respondent
may give
o FIXED-RESPONSE QUESTIONS choices must be provided to serve as categories
for the respondent’s answer.
o OPEN-ENDED QUESTIONS do not provide choices or categories and the answers
may be given freely by the respondent.
• The next step will be to summarize the data.
o Manual tallying or Counting
o Computer Tallying – responses should be given codes

c. Presentation/Organization of Data:
• Data collected may be presented as:
o Statistical tables
o Graphs
o Descriptive data

Line Graph:

Pie Chart:

Bar Graph:

d. Analysis of Data:
• Aims to establish trends and patterns in terms of health needs and problems of the
community.
• It allows comparison of obtained data with standard values.
e. Identification of Community Health Nursing Problems
• Make a list of the health problems and categorize them as:
o Health Status Problems

▪ May be described in terms of increased or decreased morbidity, mortality, or fertility.

▪ E.g. 40% of the school-aged children have ascariasis.
o Health Resources Problems

▪ May be described in terms of lack of or absence of manpower, money, materials, or

institutions necessary to solve health problems.

▪ Example: 25% of the BHWs lack skills in vital signs taking.

o Health Related Problems

▪ Maybe described in terms of existence f social, economic, environmental, and

political factors that aggravate the illness -inducing situations in the community.

▪ Example. 30% of the households dump their garbage in the river.

f. Priority-Setting of Community Health Nursing Problems
• Make use of the following criteria:
o Nature of the Problem Presented

▪ The problems are classified by the nurse as health status, health resources, or health
related problems.
o Magnitude of the Problem

▪ Refers to the severity of the problem, which can be measured in terms of the
proportion of the population affected by the problem.
o Modifiability of the Problem

▪ Refers to the probability of controlling or reducing the effects posed by the problem
o Social Concern

▪ Refers to the perception of the population or the community as they are affected by
the problem.
• Steps in Prioritizing Problems
1. Score each problem according to each criteria.
2. Divide the score by the highest possible score.
3. Multiply the answer by the weight of the criteria
4. Add the final score for each criterion to get the total score for the problem. The
highest possible score is 10, while the lowest possible score is 1 /
5
12.

5. The problem with the highest total score is given high priority by the nurse.
• SCORING SYSTEM IN PRIORITIZING HEALTH PROBLEMS
CRITERIA Highest Possible Score WEIGH
T
NATURE OF THE PROBLEM
Health Status 3
Health Resources 2 1
Health-Related 1
MAGNITUDE OF THE PROBLEM
75% - 100% Affected 4
50% - 74% Affected 3 3
25% - 49% Affected 2
< 25% Affected 1
MODIFIABILITY OF THE PROBLEM
High 3
Moderate 2 4
Low 1
Not Modifiable 0
PREVENTIVE POTENTIAL
High 3
Moderate 2 1
Low 1
SOCIAL CONCERN
Urgent community concern 2
Recognized as a problem but not needing urgent attention 1 1
Not a community concern 0
TOTAL SCORE:

g. Feedback to the Community

• Community meetings are held to inform the community people of the results of the
community diagnosis.
• This is done to:
o Increase their awareness on their health status as an entire community
o Enhance community participation in action planning.
h. Action Planning
• Action programs are the activities necessitated by the results of the community
diagnosis.
• Feasibility, impact on the community, scope of coverage, and community acceptance
are the factors to consider in formulating an action program.

3. Evaluation – done to:

1. Measure the achievements of the program
2. Serve as basis for introducing corrections or revisions to the action program.
3. Provide concrete basis for the validity and appropriateness of the action plan. Since
impact evaluation entails thorough investigation of the community, a follow up to the
community diagnosis is necessary.
 Problem 1: 40% of the school aged children have ascariasis. Problem 2: 25% o f the BHWs lack skills in vital signs taking
Prioritization: Prioritization:
Nature of the problem (3÷3) x 1 = 1 Nature of the problem (2÷3) x 1 = 2/3
( Health Status)
Magnitude of the problem (2÷4) x 3 =1 / 1
Magnitude of the problem
2 (2÷4) x 3 =1 / 1
2

(25% - 49% affected) 25% - 49% affected

Modifiability of the prob. (3÷3) x 4 = 4 Modifiability of the prob. (3÷3) x 4 = 4
(High) (High)
Preventive potential (3÷3) x 1 = 1 Preventive potential (3÷3) x 1 = 1
(High) (High)
Social Concern (2÷2) x 1 = 1 Social Concern (2÷2) x 1 = 1
(Urgent community concern) (Urgent community concern)
TOTAL 8 /
1
2 TOTAL 8 /
1
6

COMMUNITY HEALTH NURSING PROCESS (Part 2)

PLANNING FOR COMMUNITY HEALTH NURSING PROGRAMS AND

SERVICES

PLANNING:
• Refersto the process of constructing a program, formula, or alternative model that will be used
as basis for a course of action or decision in order to achieve a desired end.

• Participatory
planning is a process by which a community undertakes to reach a given socio-
economic goal by continuously diagnosing its problems and charting a course of action to
 resolve those problems. Experts are needed, but only as facilitators. Moreover, no one likes to
participate in something which is not of his/her own creation.

• The concept of planning is summarized as follows:

o Planning is futuristic
o Planning is change oriented
o Planning is continuous and dynamic process
o Planning is flexible
o Planning is a systematic process

• Approaches to Planning Health Programs:

o Participatory planning for Community Health – planning should involve people’s participation.
They are an integral part of the decision making and action process.
▪ Three important approaches utilized when planning projects and programs towards attaining a

sustainable community health development:

✓ Community-based approach which empowers the people to address their health needs and
problems;
✓ Integrated approach which considers various dimensions of health and development such as
changing lifestyle, changing environment and reorienting health care systems;
✓ Comprehensive approach which strikes at the root of the problem and addresses the social
determinants of health.

o Planning for health promotion

• Things to consider in planning community health nursing programs and services:

o It involves the application of nursing process based on participatory community
development model;
o It generates and sustains the community’s sense of ownership and commitment to the
health programs and services.

• Why is there a need for planning?

The following are the reasons why planning is important in community health
practice:
o Planning provides more rational decision-making instead of gut-feel, vested interests,
or political considerations.
o Given the multiple needs of the people and the scarce community resources, planning
utilizes available resources properly.
o With the conflicting values and views within the community, planning assists in the
determination of common goals, objectives, and strategies.
o Positive change and growth is feasible with planning.

• TYPES OF PLAN:
1. Strategic plan - a long range of plan that extends from 3-5 years
2. Operational plan - short-range plan (less than 3 years) that deals with the routine activities of an
organization.
3. Program plan – courses of action for the solution or improvement of a particular health problem,
and deals with formulation of strategies.

Strategic Plan – It involves the identification of the following:

a. Vision statement – describes what the organization will be like when it has fulfilled its mission. It
clarifies the aspirations of the organization and define the direction it’s heading in.

Four important attributes of a vision statement;

➢ Idealism
➢ Uniqueness
➢ Future orientation
➢ Imagery

b. Mission statement :
➢ Defines what an organization does and includes tangible goals which the organization strives to
accomplish.
➢ It is a short summary of an organization’s core purpose, focus, and aims. This usually includes
a brief description of what the organization does and its key objective

c. Goaland Objective setting – “WHERE do we want to go?”

▪ This phase refers to the process of formulating the objectives of the health program and nursing

services in order to change the status quo.

GOALS
➢ broad and not constrained by time and resources; states the ultimate desired end point of all
activities; it is directed towards solving health status problems
Example: To reduce the incidence of tuberculosis among children in Atok, Benguet.
OBJECTIVES
➢ stated in specific and measurable terms, client-centered, and outcome-focused; concerned with
the resolution of the health problem itself. It is stated SMART
Formulation of the objectives:
➢ An important step in participatory local planning is to define precisely what specific objectives
are to be achieved, which should be stated in concrete terms, e.g. increasing i) incomes of
identified households, ii) production of certain crops and iii) literacy among locally elected
women officials.
➢ The objective may not always be quantifiable, particularly when it involves attitudinal changes.
It’s still helps to be as specific as possible so that people can see how much change has taken
place.
Long-Term Objective: Example: By the year 2025, the incidence of
tuberculosis among children in Atok, Benguet will be reduced by 15%
Short-term objective: At the end of 2020, 80% of infants in Atok,
Benguet will be immunized with BCG.

80% of households will have access to safe and adequate water supply
within six months.

d. Strategy and activity setting - “How do we get there?”

How do we attain the vision?

▪ Defines the strategies and activities that nurses (with the community) set to achieve in order to

realize their goals and objectives

Deciding the strategy

▪ This is the most difficult part of participatory local planning as it involves assessing and

mobilizing needed resources and choosing the planning methods. It is important to specify: a)
resources that are locally available and those needed from outside. (people with skills, funds,
raw material inputs, etc.); b) if resources are available when needed; and c) who should be
approached, who will approach and with whose help to secure these.
▪ Consider alternative local planning methods and approaches such as (i) whether to contract a

job to private individuals or to do it on a cooperative basis; ii) whether to focus on several small
household-based units or one big unit; and iii) whether to train local people as trainers for the
jobs or to hire trained personnel from outside.
▪ Once a course of action is chosen, it should be explained and specified in clear terms to avoid

confusion and misunderstanding among the local stakeholders.

Ensuring feasibility
▪ The working groups at this point should consider whether the objectives are realistic. It is
important to ensure that: i) assumptions and stipulations regarding the availability of resources,
managerial competence and technical expertise are realistic; ii) proposed activities are
economically viable; and iii) local market can absorb the expected outputs.
▪ It is important to identify potential project beneficiaries and check how the benefits would flow to

them.

Program Planning:

o A type of plan concerned with courses of action for the solution or improvement of a particular
health problem;
o It deals with formulation of a strategy for the achievement of a given health policy objective;
o Also referred to as “very big projects or the composite of more than one big project.”
o Types of programs:

▪ Programs for direction, coordination, and management

• Refer to programs to formulate policies, programs, and projects; to direct coordinate and control
activities; and to provide informational and administrative support (including personnel, finance
and logistics, and legal services)
▪ Programs for health system infrastructure

• Include programs for planning and development of a basic health facility network, health
manpower policies and training, health education and public information
▪ Technology program

• Programs providing functional support like infrastructure development, human resources

development, health information, accounting, and budgeting.
o Steps in Program Planning
1. Organizing a planning group
2. Formulating goals
3. Identification of strategies
4. Determining activities
5. Estimating resources
6. Assessing the effects of the program

Preparing the work plan

▪ This is a blueprint for decentralized project management drawn up by the core group/ project
implementation committee, specifying the ‘what, who, when and how’ of local project
implementation.
▪ The work plan should contain the following information in simple tabular form: (i) all activities for
implementation of the project; (ii) names(s) of the person(s) responsible for each activity; (iii)
starting and completion time for each activity; and (iv) the means to carry out the activities.
▪ It should also define the outputs expected from each activity to measure performance during

implementation or on completion of the project, for effective monitoring and evaluation.

o Determine evaluation methods, tools, & strategies
➢ self-evaluation / reflection
➢ peer evaluation
➢ case discussion
➢ use of weights and measures
➢ ARAS
➢ Diaries
➢ PRA tools
➢ records review

Easter College | Dept. of Nursing | Community Health Nursing | Prepared

by Bertha PadallaAlibcagPage 12

Example:
Health Problem: 40% of school-age children have ascariasis

Objectives Strategies / Time Resources Person

Activities frame Responsible
Materials/ supplies Manpower Money/
budget req’t
To reduce the prevalence Training of Sept. 2020 Office supplies, modules, MHO, PHN, Php 3,000 Ms. Vangie
of ascariasis among BHWs Oct. 2020 whiteboard, pencil and RHM, BHW (food and M.
school- age children to paper, evaluation exam officers supplies)
20% by the end of 2020.
Supply and Oct. 2020 Mebendazole syrup (#) MHO, PHN Ms. Lilia A.
distribution of May 2021
Mebendazole
 Health education Nov. 2020 Training posters, pen and PHN, RHM Php 2,500 Mr. Pancho
of mothers paper, sound system, white
board & marker, manila
paper

Easter College | Dept. of Nursing | Community Health Nursing | Prepared

by Bertha PadallaAlibcagPage 12

IMPLEMENTING A COMMUNITY HEALTH PROGRAM

• Plans are actually carried out, resources are mobilized to meet objectives set.
• Participation of the people is critical in this phase Nursing intervention for Community Health
Development

1. Community ownership
▪ Community ownership is the act or degree of ownership and responsibility taken by the

community towards any programs or activities running in the community.

▪ The people of the community need to feel a sense of ownership of the program or project, which

can only come with their full participation in the decisions regarding planning as well as their
assuming some responsibility for implementation.
▪ Community ownership in health means community participation in health through legal or
authorized right to focus on:
▪ Local health issues

▪ Delivering equity and equality in health

▪ Improving quality health care services and facilities

▪ Promoting community health projects

▪ Promoting community health education and training

▪ Providing employment opportunities to community people

▪ Community ownership is necessary because:

▪ Community ownership encourages responsibility and accountability among the community

people
▪ Promotes co-operation, coordination and collaboration between the stakeholders and the

community people
▪ Raise community leadership and empowerment

▪ Promotes new ideas and strategies through the bottom- up approach

▪ Community ownership responds to the needs of people of respective communities

▪ Increases community participation

▪ Benefits of Community Ownership:

▪ Economic benefits/ financial sustainability of the programs

▪ Provides physical base for provision of services

▪ Increase in public acceptability

▪ Empowerment of local community

▪ Sustainability of the programs

▪ Active community participation, engagement and mobilization at all levels of program

implementation
▪ Community awareness on various diseases prevention and control

▪ Capacity building/skill enhancement of community people

▪ Active people participation

▪ Better stewardship towards local assets

▪ Increase in pride and confidence among community people

▪ Strong government support

▪ CO also promotes leadership and democratic decision

▪ Consequences of lack of Community Ownership:
▪ Delay in completion of projects

▪ Absence of community mobilization

▪ Limited attraction of donors/government agencies for implementing programs in those areas

▪ Lack of accountability and responsibility among the community stakeholders

▪ Lack of opportunities and resources in the community

▪ Less focus by the government on community issues

▪ Lack of coordination and collaboration among community members causing huge gap between

projects and their activities

▪ Unclear vision and priorities

▪ Lack of planning and control

2. Community organizing – is the process whereby the community members:

➢ develop the capability to assess their health needs and problems;
➢ plan and implement actions to solve these problems;
➢ put up and sustain organizational structures which will support and monitor implementation of
health initiatives by the people.

3. Partnership and collaboration – the aim of partnership and collaboration is to get people to
work together to address problems or concerns that affect them. It gives the people the
opportunity to learn skills in group relationship, interpersonal relations, critical analysis, and
most important of all, decision-making process in the context of democratic leadership. At this
point, people become partners, NOT competitors.

PROGRAM MONITORING AND EVALUATION

PROGRAM MONITORING AND EVALUATION
• MONITORING: is an ongoing activity during the life of a project. It is through monitoring that a
project is able to determine what progress has been made in relation to the work plan.
Monitoring helps determine whether a project is on track and if any of its strategies or activities
need to be changed so that it can be as successful as possible.
• EVALUATION: determines how successful a project has been in meeting its objectives. It also
helps assess the impact of project activities on desired outcomes, like knowledge
or behaviourchange. Project evaluation begins with a baseline survey that is conducted before
project activity begins; project evaluation concludes when data is collected again through an
end-of-project survey and then compared to baseline data.
➢ it is not a record nor account of what was done but of what DIFFERENCE the “doing” made.
➢ used to help in the selection and design of future plans/programs/projects.
➢ it is an assessment of whether or not the planned project or plan of care actually worked for the
client.

Types of Evaluation:
• Impact Evaluation – estimates the impact of care or of a program on a client by comparing the
conditions of the affected groups after it has taken place with what they would have been.
• Cost effectiveness analysis – done to compare alternative care interventions in terms of the cost
of producing a given output.
• Both monitoring and evaluation are vital elements of care.
• Both are interrelated processes and require baseline information and documentation during
implementation.

Reminder: Participatory monitoring and evaluation is an integral part of the participatory project
design and implementation process. It works best when the entire project process, from
planning to the final evaluation, is conducted in a participatory manner.

Participatory monitoring enables project participants to generate, analyse, and use information
for their day-to-day decision making as well as for long-term planning.

In participatory evaluation, just as in participatory monitoring, the beneficiary community and

Community Based Organizations (CBOs) together decide on how to conduct the evaluation. If
a project follows a participatory approach from the beginning, it is easy to conduct a
participatory evaluation at the end. While conventional monitoring and evaluation focuses on
the measurement of results – service delivery, information dissemination, behaviour change,
etc. – participatory monitoring and evaluation focuses on the results and process. The main
characteristics of this process are inclusion, collaboration, collective action, and mutual
respect.

Participatory M&E encourages dialogue at the grassroots level and moves the community from
the position of passive beneficiaries to active participants with the opportunity to influence the
project activities based on their needs and their analysis. In addition, information is shared both
horizontally and vertically within the implementing organization. It is generated by the
community group and shared first with the larger community, and then with the donor. In
contrast to conventional monitoring where information moves vertically – from the CBO to the
donor – in participatory monitoring, information is much more widely shared, particularly at its
source, which is the community.

Conventional M&E vs. Participatory M&E

Conventional M&E Participatory M&E
Who Initiates? Donor Donor and project stakeholders
Purpose? Donor accountability Capacity building, increasing ownership over results, and multi-stakeholder
accountability
 Who External evaluator Project stakeholders assisted by a PM&E facilitator
Evaluates?
Terms of Donor with limited input from project Project stakeholders
Reference
Methods Survey, questionnaire, semi-structured Range of methods such as Participatory Learning and Action, Appreciative Inquiry,
interviewing, focus group discussions and testimonials
Outcome Final report circulated within the donor Better understanding of local realities; stakeholders involved in analysis
institution, with copies to project and decision makingregarding project information; stakeholders able to adjust
management at the CBO project strategies and activities to better meet results
Source: Coupal 2001.

The examples below illustrate the two approaches to monitoring and evaluation.
Organization A Organization B
Every month, field staff collect the number of condoms distributed in Every month, field staff collect the number of condoms distributed in
health centers and report those figures to their project manager. health centers. Community representatives, health center staff, and
Every month, the project manager adds up the distribution numbers project field staff discuss this information during their monthly review
and sends the report to the donor. The donor enters the figures into a meetings. These data are then sent to project headquarters for
computer, and generates a report for the Ministry of Foreign forwarding to the donor. When the number of condoms distributed
Assistance. Very few people actually look at the data to see what it is decreased, the local stakeholders tried to figure out why by asking
saying. Is condom distribution increasing or decreasing? Will the clients. With a simple change in strategy, they were able to once again
project reach its objective of reducing sexually transmitted infections? increase the number of condoms distributed. Monitoring information was
How can field staff, health center staff, and community members used within the organization to improve the program and to report to the
work together to make the project a success? donor

INDICATORS FOR PARTICIPATORY MONITORING AND EVALUATION

Indicators are signals: they indicate the status of, or change in, something. They work as
markers like milestones on the roadside which indicate the distance travelled, or the location at
a given point.
When implementing projects, indicators are used to check project progress and results.
Indicators are ‘measures’ that demonstrate progress and results to project staff and volunteers,
to the beneficiary community, and to the donors.

Types of Indicators:

1. Process indicator – this indicates the project’s stage of implementation – the progress in
completing planned activities
2. Change indicator - describes the level of change achieved through the activities. They are also
referred to as results indicators since they indicate the results that are achieved through the
project’s intervention

Good indicators should be useful in the establishment of “trigger points” for action. Good
indicators are sometimes referred to as CREAM indicators:
➢ Clear - precise and unambiguous
➢ Relevant - appropriate to the subject at hand
➢ Economical - available at reasonable cost
➢ Adequate - provides a sufficient basis to assess performance
➢ Monitorable - amenable to independent validation

Quantitative indicators are numeric. Examples of quantitative indicators include:

➢ Number of people trained
➢ Number of pamphlets distributed
➢ Number of trainings conducted

Qualitative indicators describe the state of something using words rather than numbers.
Examples include:
➢ BHWs are able to get vital signs correctly
➢ Mothers were able to discuss the causes and prevention of ascariasis

Objectives Indicators
Conduct a 3-day training for 10 community leaders from each of the 3 villages on discrimination against • No. of training workshops
people living with HIV/AIDS and affected families by the 3rd month. conducted ____
• Number of community leaders
trained ___
Male___ Female___
Conduct a 5-day basic health skills training for BHWs • Number of training sessions
conducted ___
• Total number of BHW
trained__
Male____ Female____
Easter College | Dept. of Nursing | Community Health Nursing | Prepared
by Bertha PadallaAlibcagPage 12

Health Problem: 40% of school-age children have ascariasis

Objectives Strategies / Time Resources Person

Activities Indicators frame Responsible
Materials/ supplies Manpower Money/
budget req’t
To reduce the Training of # of trainings Sept. 2020 Office supplies, MHO, PHN, Php 3,000 Ms. Vangie
prevalence of BHWs conducted Oct. 2020 modules, whiteboard, RHM, BHW (food and M.
ascariasis among # of BHW pencil and paper, officers supplies)
 school- age children attendees evaluation exam
to 20% by the end of Male:____
2020. Female:___
Supply and # of times Oct. 2020 Mebendazole syrup MHO, PHN Ms. Lilia A.
distribution of conducted May 2021 (#)
Mebendazole # of children
beneficiaries
Health # of health Nov.- Training posters, pen PHN, RHM Php 2,500 Mr. Pancho
education of education Dec.2020 and paper, sound
parents conducted system, white board
# of parent & marker, manila
attendees paper
Mother:___
Father:____

Easter College | Dept. of Nursing | Community Health Nursing | Prepared

by Bertha PadallaAlibcagPage 12

COMMUNITY HEALTH DEVELOPMENT

I. INTRODUCTION:

A. HEALTH AS A MULTI-FACTORIAL PHENOMENONREVIEW

B. COMMUNITY AS CLIENT

C. REVIEW ON THE APPROACHES TO COMMUNITY DEVELOPMENT

a. WELFARE APPROACH / Spiritualist / Dole out Approach

b. MODERNIZATION APPROACH / Project Development
c. TRANSFORMATION / PARTICIPATORY APPROACH / Liberative

D. HISTORICAL EVOLUTION OF THE DEFINITION OF DEVELOPMENT

a. COLONIAL PERIOD (15 Century- WWII): Development was defined as relief and
th

rehabilitation work just to patch up the damages brought about by the war.
• It was indeed a social work but it was a temporary nature of development.

b. POST WWII- Mid 1960’s: development meant “ECONOMIC GROWTH”

• Increased agricultural production
• Increased gross national product
 c. Mid 1960’s-1970’s: Development is
i. Industrialization – physical and environmental growth
ii. Redistribution of economic gains – POLITICAL DEVELOPMENT – workers had to
struggle for such because control over the economic gains was in the hands of a few
who wanted to personally own the economic gains.

d. 1980’s: Socio-cultural Development or development of the human specie

e. 1990’s to the Present: Development means

i. Total development or a planned change on all the factors that comprise a community
(SPECEP)
ii. Development is a process and an end in itself

• PROCESS - development is defined as a “planned change” on a slow step by step and

committed pursuit of problem resolution from the point of view of individual, family,
community or nation in order to move away from a life situation that is considered to
be unsatisfactory to a situation that is satisfactory.

• AS AN END TO ITSELF -Development means:

1. Continued/ sustained delivery of goods and services

2. Continuation of local action stimulated by outside programs or agencies
3. Generation of successor services and initiatives as a result of program of project-built
local capacity.
S:Sustainability.
I:Independence and interdependence
E:Empowerment
G:Growth
E:Equitable distribution of natural resources and the fruits or benefits
derived from such natural resources.

E. COMPONENTS OF DEVELOPMENT:
1. Social development
2. Political development

3. Economic development.

4. Cultural development
5. Ecological, Environmental/ Physical development

6. Community Health Development

F. CHARACTERISTICS OF COMMUNITY DEVELOPMENT (CD)

1. CD is concerned with all the people of the community, rather than any particular or
segment of the population.
2. CD is concerned with the whole of community life instead of any one specialized
aspect.
3. CD is concerned with bringing about social change in the community
4. CD is concerned with the problem solving of social issues and conflicts.
5. CD is based upon the philosophy of self-help and participation by as many member of
the community as possible
6. CD usually involves technical assistance, personnel, equipment, supplies, money or
consultation from the government or voluntary private organizations, both domestic
and foreign
7. CD is essentially interdisciplinary
8. CD is both a concern task goals and process goals
9. CD involves educational process. It is always concernedwith “teaching and learning”
from the people.
10. CD continues over a substantial period of time. It is not a CRASH program, but rather
it is a process.
11. CD program should be based on felt needs, and desires, as well as aspirations of the
people in the community.
12. CD directs participation is open to any resident who wishes to participate.

G. GOALS OF DEVELOPMENT:

1. Educate and motivate people for self -help

2. Develop responsible local leadership in health
3. Inculcate among members of rural communities sense of citizenship and among urban
dwellers of civic consciousness in relation to health.
4. Revitalize institution designed to serve as instruments of local participation.
5. Initiate a self-generative, self-sustaining and enduring process of growth in health.
6. Enable people to establish and maintain cooperative and harmonious relationship.
7. Bring about gradual and self chosen changes in the community’s health with a
minimum of stress and disruptions.

H. OBSTACLES OF DEVELOPMENT:
 1. Man himself (ex. Greediness, selfishness, dishonesty,etc)
2. Conditions that are less humane brought about by a number of causes like poverty,
ignorance, ill health
3. Unjust oppressive structures and situations which serves to dehumanize man.
Examples: social injustice and human exploitation
Non-participatory approaches utilized in trying to bring about
change.

I. ASSUMPTIONS AND PRINCIPLES OF DEVELOPMENT AND COPAR (in order to

prevent the above obstacles to happen)

ASSUMPTIONS PRINCIPLE

1. Issue that threaten people’s lives move them to action, therefore; 1. Do not ignore a highly pressing issue that is identified
by the majority.

2. Any person is afraid to go against many, strong and organized 2. Mass-based leadership is imperative
people, therefore;

3. People are open to change, have the capacity to change and are able 3. Provide opportunity to change and capability to
to bring about change, if given the chance to do so, therefore; change
4. Provide them the chance to make development happen
that should lead to a just and self-reliant community

4. Learning happens fast when one experiences something successful, 5. Provide practical true-to-life activities where people
concrete and practical, therefore; will likely succeed. (experiential learning)

5. Any person is an image of God, full of worth and dignity so he/she is 6. Let the people decide or allow for consensus building,
responsible for his own life, therefore; instead of making decisions for them

6. Development is not offered in a silver platter, therefore; 7. People who want development to happen should
strive for it.

7. People who develop the attitude or practice of self-evaluation every 8. Always conduct ARAS with the people
after an activity is able to identify areas for improvement, therefore;

J. COMMUNITY ORGANIZING PARTICIPATORYACTION RESEARCH (COPAR):

An alternative approach to Community Health Development

A. Background of Community organizing in the Philippines:

1. The health Scenario
2. Responses to the health situation
3. The alternative approach: COPAR
B. DEFINITIONS:

ORGANIZING: Is an effective strategy for building people’s capabilities

towards self determination and self reliance.

COMMUNITY ORGANIZING (CO): It is a social development approach that

aims to transform the apathetic, individualistic, and voiceless poor into a
dynamic, participatory and politically responsive community.
It also means:

GO IN SEARCH OF YOUR PEOPLE

LOVE THEM;
LEARN FROM THEM;
SERVE THEM;
BEGIN WITH WHAT THEY KNOW
BUILD ON WHAT THEY HAVE;

BUT OF THE BEST LEADERS

WHEN THEIR TASK IS ACCOMPLISHED,
THEIR WORK IS DONE,
THE PEOPLE ALL REMARK,
“WE HAVE DONE IT OURSELVES”

By: LAO TSE

PARTICIPATORY ACTION RESEARCH (PAR)

1. It
is an investigation of problems and issues concerning the life and environment of the
underprivileged by way of collaboration with them as equal partners.

2. It
is a strategy of development where in community needs, conditions and problem are
identified, solutions are planned and priorities are implemented through a partnership
with the community and with the otherconcerned agencies.

CHARACTERISTICS OF TRADITIONAL AND PARTICIPATORY ACTION

RESEARCH
 TRADITIONALPAR

1. Research for purpose of identifying1. Research seeks social transformation

And meeting individual need with
Existing social systems.

2. Community problems or needs are2. The research problems are defined by

Defined by experts or externalthe community members themselves who
Researchers to community groupare viewed as “experts of their own and
considered neutral or non biased.Reality.”

3. The research problem is studied3. The community group undertakes the

by the researchers who control theinvestigation or research from data Collection
research process. to analysis. External researchers work
alongside the community group

4. Recommendations for the community4. The community formulates

are based on the researcher’srecommendations and an action plan
findings and analysisbased on research outcome.

THREE (3) CONCEPTS / STEPS OF PAR:

1. Conscientization / Arousal
2. Participation / Organize
3. Action / Mobilization

II . COPAR-is a social development approach and a systematic, continuing process

of people transforming themselves from their “culture of silence” to a
collective voice and action.

A. IMPORTANCE OF COPAR:

1. COPAR is an important approach for community development and people

empowerment as this help the community workers to generate community
Participation in development activities.
2. COPAR prepares people to eventually take over the management of a development
program(s) in the future.

3. COPAR maximizes community participation and involvement.

B. WHY COPAR IS USED AS AN APPROACH TODEVELOPMENT:

1. COPARrecognizes that individuals and small group with varying interests compose a
community.

2. COPAR acknowledges the importance of leadership but emphasizes the participation

of the members.

3. COPAR is a genuine bottom-up strategy.

4. COPAR attempts to rectify the powerlessness and passivity of the poor.

C. GOALS OF COPAR:

1. People empowerment.
2. Social restructuring which means:
a. Equitable distribution of wealth, power in health and resources.
b. Organize the silent PDOES to speak up
c. Decision making that is now coming from the majority instead of the elite.
3. Alliance building
4. Genuine democracy
5. Improved quality of life.

D. THE ROLES OF THE COMMUNITY ORGANIZERS:

1. AS FACILITATOR:
a. Helps enhance individual and group strengths and helps maximize weakness and
conflicts.
b. Heightens group unity.
c. Assists individuals and group respond to common interests.

2. AS TRAINOR:
a. Assesses training needs of local leaders.
b. Helps plan and conduct educational programs to strengthen individual and group
capabilities.
c. Assists key leaders in training others.
d. Engages in continuous dialogues with people.
e. Helps in remolding the leaders and members in terms of skill and attitudes towards
self-determination.

3. AS ADVOCATES:
a. Helps analyze and articulate critical issues.
b. Assists others to understand and reflect upon these issues.
c. Evokes and provokes meaningful discussions and actions.

4. AS RESEARCHER:
a. Conducts social analysis
b. Engages in participatory research wherein people become co-investigator.
c. Simplifies/enriches appropriate research concepts and skills in order to make these
functional for the people interests.
d. Engages in social integration to understand social phenomena from the people’s point
of view.

5. AS PLANNER:
a. Conducts initial analysis of area resources and potentials
b. Assists local groups in planning for their common good, including appropriate
strategies and alternative actions.
c. Helps systematize groups’ actions to attain desired goals.

6. AS A CATALYST:
a. Initiates debates and actions regarding critical problems.
b. Monitors and nurtures growth of individuals and groups to facilitate long term
structural transformation for people’s welfare.

E. QUALITIES OF AN ORGANIZER:

1. Irreverence
2. Sense of Humor
3. Visionary
4. Tenacity
5. Flexibility
6. Genuine Love for People
7. Critical Thinker
F. THE DO’S AND DON’TS OF COMMUNITYORGANIZING

DO’s:

1. Be one and be familiar with the people you are working with.
2. Have an orientation or faith in the power of people to transform. Have trust in the
people’s capability to change.
3. Be conscious of balancing local and national issues. The entire CO revolves around
concrete local issues as the best starting point for training consciousness and
motivation for action. CO ought not to be limited to local issues because the roots of
the local problems are to found in larger national structures.
4. Assess action on the basis whether they are consensus oriented. CO is democratic and
participatory in all aspects.
5. Anticipate the responses of outside forces and be prepared for this. This is to prepare
both the people and the organizer on what actions to be undertaken. Always prepare
with the people to the incoming problems.
6. If there is conflict between authority and the people, go with the people. This is the
general rule that governs CO.
7. Should there be economic projects as entry point, it must be undertaken within the
context of supporting and sustaining the struggle towards people’s goals, elevating
their awareness and consciousness by inculcating values and a concrete expressions of
the alternative system we are working for.

DON’T’S:

1. Don’t romanticize
2. Don’t be an empiricist.
3. Don’t protect people from hardships.
4. Don’t be dogmatic

III. PHASES OF COPAR

A. PRE ENTRY PHASE (activities done before going to community)

• Initial phase where the CO identifies the community where he/she is going to work
with based on a pre set criteria
• Considered as the simplest phase in terms of actual outputs, activities, strategies and
time spent for it.

CRITICAL ACTIVITIES DURING THE PHASE

 1. SELECTING THE APPROPRIATE AREA OR COMMUNITY FOR
HEALTH DEVELOPMENT WORK.

1.1 Criteria for community selection:

A. DOPE COMMUNITY

B. Clustered household of at least 100

C. Health services in the site are inaccessible to meet the needs of the
community residents

D. Poor health status of the community

E. Presence of verbalized or requested need from the community

F. Absence or inadequacy of similar health services by any NGO or GO

health agency. If there is an existing agency, the approach that they use is
not similar to COPAR.

1.2. Initial consultation with the LGU’s, existing PO’s and other relevant
agencies.
Thus facilitates the CO in:
a. identifying the communities that fit the criteria
b. Initially introducing the importance and goals of community health development work.

2. PRELIMINARY SOCIAL INVESTIGATION (PSI)

The process of looking systematically for issues which organize people based on
actual situations and experiences of the community.

PURPOSES OF PSI
For the CO to get to know the community he or she is going to immerse and work
with and identify potential issues which might motivate people to action. It must be an
issue that:
A. Affect a large number of community folks
B. People affected strongly feel that it is an urgent and important concern
C. Preferably winnable or the people should be able to get what they want.

HOW TO DO PSI:
A. Study the existing documents or reports (secondary data) at the municipal, barangay
health offices and related agencies. Data would include the following:
B. Observe and engage in actual dialogues and informal interviews with key informants
of the community.

C. Collation and analysis of preliminary data in order to identify

• Current needs/problems or issues that highly affect them at the moment and may
galvanize action from them
• Important data needed in a health program but which are not found in the existing
secondary data
• Stage of health development of the community and its health programs and activities
being implemented and the approach being utilized.
• Constraints and problems encountered by other agencies while working in the area.

D. Write-upanalysis and formulation of an initial plan which will later serve as a guide
for the CO when he/she facilitates the community in formulating their own
development action plan.

3. Final networking and consultation with LGU’s

Purposes of Courtesy Call:

a. Pay respect to the leaders of the community as a form of initially establishing rapport.

b. To strengthen initial contacts established during community selection and PSI.

c. To introduce the agency being represented in terms of

• Personnel
• Philosophy, principles of community health development work, objectives and program
components.

d. To evaluate results of analysis or observations to the current needs, problems or

Issues affecting the community, undergoing health programs/activities and
strategies utilized.

e. To know the other municipal and barangay officials, especially the heads of
Offices and other health/non health related agencies based inthe same
community.

f. To level off expectations with the municipal officials in terms of support, roles etc.
g. Initial
discussions planning of some immediate activities upon entry of the program
with the key persons.

4. Ocular survey, informal dialogues with community residents and key

informants within selected community and further contact building.
Importance of Ocular Survey:
a. To identify
• political boundaries,
• points of entry to and exit from the community,
• location of different households, landmarks,
• residence of contact persons
• possible staff house
• barangay hall meeting places, etc.

b. To meet contact persons in the community

c. Conduct initial dialogues with the community residents available and obtain ideas,
feelings and reactions about possible entry of a health agency and about their
experiences with previous agencies.

d. To further identify key contacts who were not identified earlier.

5. Orientation of Agency Community Health Workers

Content of Orientation:

B ENTRY PHASE
• This signals the actual entry and immersion of the CO in the selected community
• Also termed as the social preparation and critical awareness building phase and it is
considered as the most crucial phase because it includes major activities on
sensitizations of the people on the critical events on their lives.

CRITICAL ACTIVITIES

A. COURTESY CALLS AND SENSITIZATION of Formal and Informal Leaders at

the selected Barangay to:
1. Recognize the important role of the local authorities, especially in relation to
mobilizing the community members of health activities later on.
2. To establish rapport or a trusting relationship with them
3. Discuss initial plans such as:
• community visits,
• immersion, settling down,
• utilization of participatory approach to community health development work.

B. COMMUNITY/SOCIAL INTEGRATION- it is a basic continuing activity by

which the CO becomes one with the poor through immersing self in the
community in order to;

A. Get to know their

• Culture
• Economy
• Leaders
• History
• Lifestyle of the community more deeply

B. Be accepted as a community resident

C. Respected the people and recognize the positive aspects of their culture
that give them the strength to struggle.

D. Understand how the people analyze their own situation, and

E. Modify their own values and lifestyle in keeping with that of the community

Guidelines in Community Integration:

1. The health worker’s appearance, speech, behavior and lifestyle should be keeping with
those of the community residents, without disregard of his/her being a model

2. Avoid raising the expectation of the community residents by adopting a low key
profile and approach
3. Live with the poor sectors of the community for at least three months

4. Visit
as many people as possible in the community through house to house visits
answering house calls to avoid creating jealousies and factions
5. Participate in direct production and social activities of the people as well as household
chores

6. Seek
out and converse with people where they usually congregate such as in the stores,
wells, washing streams, church or house yards

7. Avoid too much drinking and NO drinking

8. Avoid flirting with male and female community folks

9. Share people’s housing, food, entertainment and meetings

C. LEADER SPOTTING and CORE GROP FORMATION

• Laying down the foundation of a strong people’s organization by bringing together
several of the most advanced indigenous leaders to exchange knowledge and insights
towards a deeper understanding on the dynamics of society.

• CORE GROUP – a group of people initially identified as leaders

(key persons and opinion leaders) with the following
characteristics:

a. Share high level of interest and needs and are open/willing to share
needs and interests with others on a collective basis.

b. Manifest attitudes/values of integrity and credibility in words and in

Actions.

c. Open to know more and gain skills

d. Committed to share time and resources

e. Express willingness to act on something, solve problems and needs collectively

f. Share similar vision, goals and values with that of the people

FUNCTIONS OF A CORE GROUP

1. Serve as the initial contact group of the community development

 worker/CO

2. performs the initial action/ mobilization of the community

3. Later on be selected as officers of the People’s organization (P.O.) or

Become chairs of the different working committee

4. Helps the CO gather data for a community, spot additional potential

leaders and prospective members for the community wide organizational
representatives of the various sectors.

5. Helps in laying out plans and tasks for the formation and maintenance
community wide organization

SOCIOGRAM – a systematic process of identifying indigenous leaders in the

community who can facilitate change process.

• Sociogram helps the people to:

a. Identify key persons, opinion leaders and deviants/isolates in the community

• KEY PERSON – star in the sociogram. The person who is most approach by many
people. An obvious leader, a person/ people from whom the CO has to win support
and train the local CO or the alter ego.

• OPINION LEADER – person who is approached by the KP and is therefore the

person behind the key person’s ideas and opinions, In other words, the adviser of KP.

• DEVIANT/ISOLATE – a person who is not or never approached by any view

community members.

b. Getthe identified indigenous leaders to express their support to the COPAR approach,
its phases and activities.

D. TENTATIVE PROGRAM PLANNING

An activity in which the CO:
• Choose one major issue or concerns identified during the PSI and works on it with the
community leaders, while waiting for the result of DSI
 • Closely coordinates with existing local community health workers in relation to health
service delivery especially attending to common ailments as a “come on” activity to
community organizing.

*In areas where there are no volunteers, home visit will be done by the CO
himself/herself.

*In areas where there are trained community health volunteers, the CO
plans with them regarding shared home visit, where the community
volunteer health worker act as the frontline and the CO helps to enhance
skills of the volunteer worker.

E. GROUNDWORKING
•A basic tactic used in community organizing work where the CO goes around and
motivate peoples and identified leaders on a one to one basis to do something about an
issue at hand or to raise a particular issue during a barangay meeting.
• To mind set community leaders and residents about a particular issue.
F. COMMUNITY MEETING/CONSULTATION
The first of a series of community meetings that will be held during this
phase with the following objectives:

A. To get the people’s collective ideas and feelings about the entry of the agency to their
community in terms of acceptability or unacceptability.

B. To formally introduce to the community the agency’s purpose/objectives, philosophy,

principles, objectives,and program components and the COPAR approach that will be
utilized.

C. To present the initial results of investigation, particularly the PSI result

D. To evoke from the community residents about their vision of a happy family and
developed community in the light of their analyzed situation.

G. COMMUNITY STUDY (DEEPENING SOCIAL INVESTIGATION MAKING

USE OF PAR)
A systematic process of collection , collation and analysis of primary and
secondary data not reflected in the PSI in order to:

1. Furtherdraw a clearer picture about the community

2. Have a basis for planning and organizing activities
3. Determine the correct approach and method of organizing.

COMMUNITY DIAGNOSIS (CDx)

Output of the community study or deepening social investigation which is
defined as both profile and a process.

• As a profile, a CDx is a description of the community’s state of health as determined

by its SPECEP factors

• As a process, the CDx is a continuous learning experience for both the agency and the
community.

- 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.

- As a continuous activity in all the phases of COPAR, social investigation goes on even
if there is already an existing CDx

GUIDELINES/POINTERS IN CONDUCTING SOCIAL

INVESTIGATION

1. This activity can be well facilitated if the CO has well integrated with and has acquired
the trust of the people.

2. For this to be considered as a truly participatory study, community leaders can be

trained to assist the CO worker in the study.

3. The use of survey questionnaire is discouraged as much as possible due to the

following possible reasons:

o Dishonesty of data that will be given especially if the worker has not yet fully
integrated with the people.
o Difficulty of the community folks and leaders inreading and answering usually very
long questionnaires.
o Previous experience of community folks with traditional researchers that leave them a
feeling of being subjects of study instead of being active participants of the study
o Data can be more effectively gathered through information methods like casual
conversation and the use of participatory appraisal tools
 4. Validation of community data should be done regularly.

C. ORGANIZATIONAL BUILDING PHASE

• After the formation and training of a core group, the other members of the community
are encouraged to join and form a formal structure and the inclusion of more formal
procedures of Planning, Implementation, monitoring and Evaluating community wide
activities.
• Community organization facilitates community participation health and health related
development activities.

CRITICAL ACTIVITIES:

1. COMMUNITY MEETINGS OR ASSEMBLIES in preparation for organizational

building
• These are series of community gatherings where all community members or household
representatives are enjoined to attend to the following purposes;
- Collectively discuss, agree, plan, or act on something that they have already decided or
thought about individually.
- To give the community folks their collective power and confidence to act on something.
- To draw up guidelines for the organization like:
*To formulate their vision
*To identify possible obstacles that block them from achieving such
vision
*To formulate their mission, goals and objectives.
*To collectively decide on the activity they are going to do after the
formulation of their goals and objectives.
*To evoke from them the characteristics and qualifications of a leader of
a specific committee.
*To select from among the chairs and members of the different
committee
*To formulate names for each of the committees of the group that they
have formed based on their identified tasks
*To discuss roles of the leaders and be approved by the community
residents
*The roles, functions and tasks of PO members and officers should be
clearly defined before PO is organized.

2. Training and education of PO leaders

 3. Setting up the PO – the formation of a community wide organization requires
preparation in two equally important aspects:

a. Legal requirement-organization of constitution and by-laws, registration papers,

guidelines for election of officers, financial statements, etc.
b. Technical requirement-formation of committees

4. Team building activities

CHARACTERISTICS OF PEOPLE’S ORGANIZATION:

1. It is a group of individual
2. It has an internal structure
3. new leaders continually emerge
4. Raises its own funds by using their own resources

D. COMMUNITY ACTION PHASE

ACTIVITIES
1. Organization and training of the different committees
2. Project implementation, monitoring and evaluation based on CDAP
3. Action-Reflection-Action-Session
• A regular cycle of evaluation which largely focuses on self reflection about one’s
contribution to the success and failure of an activity and what one can do to enhance
or improve future similar activity/actions.

Objectives:
a. For an individual or group to identify and celebrate their own strengths related to an
activity just completed
b. For them to critically analyze the cause of mistakes and failures in that particular
activity, so that consequent suggestion can be done, thus, they will be more capable of
effectively transforming the next activity and their daily errors in life.
c. To relieve the pains experienced due to errors or mistakes due to behaviors of others in
the community.
d. To reconcile hurt feelings among the members of the group.

E. SUSTENANCE AND STRENGTHENING/

CONSOLIDATION/INSTITUTIONALIZATION
• This refers to the continuous effort of the CO to undertake consolidation of the
organization of members with the following task:
1. Ensuring regular conduct of organizational meeting
2. Facilitateenhancement of financial management system
3. Deliberate plan to develop the leaders to be self reliant
4. Development of 2 liners as future leaders
nd

5. Assistance to the organization in establishing networks with other sectors (local,

national, international, GA, NGA

The word INSTITUTIONALIZATION also stresses two

ideas: process and institution. When we talk of institution, it suggest that a permanent
structure has been established wherein a process has taken place to achieve its present
state.

In the process of institutionalizing community based organization, there are several

steps that should be undertaken:

1. Networking/Linkage Building
a. It involves establishing of working relationship with different agencies other
organization/sectors
b. Community based organization can form network or federation to enhance their
organization capabilities and widen their support base.
c. It is in phase that when the organization has attained unity and ability for collective
decision-making, consolidation and expansion activities can be pursued.

2. Consolidation/Expansion
Consolidation means more advanced skills training, higher form of mobilization,
integrated and long term program/projects, additional committees and tasks.

Expansion means an increased membership, wider area/work coverage,

establishing linkages with other groups.

3. Phase out/Pull out of the organizing program

**The relationship between the CO and the people is temporary. If the goal of
empowering the community is achieved, then roles of the outside organizer end and
shift to a supportive role.