Community Health

Nursing 1
Community Organizing
Participatory Action Research
__________

HOMER C. BALMES, RN MCD CSAS

CHN Instructor
Community
Health Nursing
Program
“An integration beyond limits”
 How do we do it?

St. Luke’s way

“PAKIKIPAMUHAY/ PAKIKIBAHAGI
in teaching, learning and practicing
Community Health Nursing and
Community Development”
KEY STRATEGY/ APPROACH
FRAMEWORK OF ENGAGEMENT
 The Framework
For the Development Framework of the program, the
concept of community development (CD) was
adopted to the community health nursing practice
utilizing the principles of Community Organizing
Participatory Action Research (COPAR).
 COPAR
Community Organizing Participatory Action Research
A social development approach that aims to
transform the apathetic, individualistic and
voiceless poor into dynamic, participatory
and politically responsive community.
IS HEALTH A PRIORITY
AMONG
HOUSEHOLDS?
COMMUNITIES?
 HOUSEHOLD BUDGET!
1. - PAGKAIN
2. - KURYENTE at TUBIG
3. - BAON Sa ESKWELA/ PANG-MATRIKULA
4. - UPA sa BAHAY
5. - BAYAD sa UTANG (Bombay)
6. - PANG-BISYO (Load, Sugal, Alak)
7. - ------------------------------------
NATIONAL BUDGET!
 TERTIARY LEVEL

SECONDARY LEVEL

PRIMARY LEVEL
AREA 1
AREA 2
AREA 3
 CHN PROGRAM
is our humble attempt to fight for
SOCIAL JUSTICE!
SOCIAL JUSTICE IS ONLY POSSIBLE IF THERE IS
SOCIAL CHANGE
R.S.I.
The QWERTY keyboard
The Dvorak keyboard
The original QWERTY keyboard suffers from many
problems that Dvorak himself identified:
• Many common letter combinations require awkward
finger motions.
• Many common letter combinations require a finger to
jump over the home row.
• Many common letter combinations are typed with one
hand. (e.g. was, were)
• Most typing is done with the left hand, which for most
people is not the dominant hand.
• About 16% of typing is done on the lower row, 52% on the
top row and only 32% on the home row.
Are we
ready?
Three Major Approaches to Development
1. Welfare/Dole out Approach
2. Modernization/ Development Approach
3. Participatory/ Liberationist Approach
 Dole out Approach
• aka Welfare Approach
• Response: remove visible manifestations of poverty
• Assumption: poverty is inevitable, a result of laziness of the poor and
cruel fate
• Side Effect: Breeds dependency
• Positive Aspect: Best during cases where immediate help is needed (i.e.
calamity)
Dole-out Approach
“Give a poor
man a fish and
he gets to live
for a day.”
 Modernization Approach
• aka Industrialization or Developmental Approach
• Response: Adopt western mode of development, utilize
technology and liberalize!!! Development will result
from injection of more funds, more foreign investment,
more trade and commerce, more impact projects and
EO economy
 Modernization Approach
• Assumption: Poverty as a result of traditionalism
• Implication: Anyone who is non-western will be poor.
• Side effect: Resources tend to be controlled by the few.
• Positive Aspect: Infrastructure and trade promote employment and
economic growth
Modernization Approach

Teach a poor man

how to fish and he
gets to live for a
week.
 Liberationist Philosophy
• aka Participatory or Sustainable Development Approach
• Response: Empower the poor to break away from poverty. Let the poor
share in this vision of progress
• Assumption: Poverty is a result of unjust social structures. It is
historically based and is propagated by the worldwide system of
inequality between nations.
 Liberationist Philosophy
• Implication: Man is the main actor of change.
The poor must cast off its sheep mentality.
• Promotes:
– unity and creation of People’s organizations
– COM strategy
• Conscientization
• Organization
• Mobilization
 Liberationist Philosophy
• Modes
– Parliamentary
– Extra-parliamentary
– Armed Struggle
• Side comment: Needs a visionary leader who can
overcome conflict and promote consensus
building
Liberationist Approach
Teach a poor man why he is poor,
teach that poor man how to catch
fish and teach that poor man how
to nurture his fishing ground and
he gets to live for
a lifetime.
 COPAR
• C.O. = Community Organizing
• P.A.R.= Participatory Action Research
 COPAR
• C.O. = Community Organizing
OFTEN ASSOCIATED WITH….

• PAKIKIBAKA
OFTEN ASSOCIATED WITH….

• MAKAKALIWA
OFTEN ASSOCIATED WITH….

• PROPAGANDA
• COPAR upholds liberating principles
 COPAR
• P.A.R.= Participatory Action Research
• P.A.R.= Participatory Action Research
• P.A.R.= Participatory Action Research
• P.A.R.= Participatory Action Research
 COPAR
A collective, participatory, transformative, liberative, sustained
and systematic process of building people’s organizations by
mobilizing and enhancing the capabilities and resources of the
people for the resolution of their issues and concerns towards
effecting change in their existing oppressive and exploitative
conditions (1994 National Rural Conference).
 COPAR
A process by which a community identifies its
needs and objectives, develops confidence to
take action in respect to them and in doing so,
extends and develops cooperative and
collaborative attitudes and practices in the
community (Ross 1967).
 COPAR Process
The sequence of steps whereby members of a community come
together to critically assess to evaluate community conditions
and work together to improve those conditions.
COMMUNITY ORGANIZING PROCESS
by Ka LITO MANALILI
START from where the people ARE,
and BUILD from what they HAVE…
Philippine Ecosystems
Ang BAGAY na ginawa nang TAMA……
KALAHATI na AGAD ang NAGAWA…
 CO-PAR PROCESS
Pre Entry – Entry – Organization Building – Strengthening
 Objectives of Community Organizing
1. To make people aware of social realities toward the
development of local initiative, optimal use of human,
technical, and material resources, and strengthening of
people’s capacities.

2. To form structures that hold the people’s basic interests as

oppressed and deprived sectors of the community and as
people bound by the interest to serve the people.

3. To initiate the responsible actions intended to address

holistically the various community health and social problems.
 Importance of CO-PAR
1. COPAR is an important tool for community development and
people empowerment as this helps the community workers to
generate community participation in development activities.

2. COPAR prepares people/clients to eventually take over the

management of a development programs in the future.

3. COPAR maximizes community participation and involvement;

community resources are mobilized for community services.
 Emphases of CO in Primary Health Care
1. The community works to solve their own problems.
2. The direction is internal rather than external.
3. The development of the capacity to establish a project is
more important than the project.
4. There is consciousness-raising to perceive health
and medical care within the total structure
of society.
 Principles of COPAR:
1. Community Organizing is People-centered
2. Community Organizing is Participative
3. Community Organizing is Democratic
4. Community Organizing is Developmental
5. Community Organizing is Process-Oriented
 CO-PAR PROCESS
Pre Entry – Entry – Organization Building – Strengthening
1. Pre – Entry Phase
• It is the initial phase of the organizing process where the
community/organizer looks for communities to serve/help.
• It is considered the simplest phase in terms of actual outputs,
activities and strategies and time spent for it.
1. Preparatory Phase (Pre – Entry)
Activities:
1. Designing a plan for community development including all its
activities and strategies for care development.
2. Designing criteria for the selection of site (Area Selection)
3. Actually selecting the site for community care
1. Preparatory Phase (Pre – Entry)
Preparation of the Institution
– Train faculty and students in COPAR.
– Formulate plans for institutionalizing COPAR.
– Revise/enrich curriculum and immersion program.
– Coordinate participants of other departments.
– Site Selection
1. Preparatory Phase (Pre – Entry)
Initial networking with local government.
– Conduct preliminary special investigation.
– Make long/short list of potential communities.
– Do ocular survey of listed communities.
– Criteria for Initial Site Selection
– Must have a population of 100-200 families.
– Economically depressed. No strong resistance from the community.
– No serious peace and order problem.
– No similar group or organization holding the same program.
1. Preparatory Phase (Pre – Entry)
Identifying Potential Municipalities
– Make long/short list of potential municipalities

Identifying Potential Community

– Do the same process as in selecting municipality.
– Consult key informants and residents.
– Coordinate with local government and NGOs for future
activities.
1. Preparatory Phase (Pre – Entry)
Choosing Final Community
– Conduct informal interviews with community residents and key
informants.
– Determine the need of the program in the community.
– Take note of political development.
– Develop community profiles for secondary data.
– Develop survey tools.
– Pay courtesy call to community leaders.
– Choose foster families based on guidelines
1. Preparatory Phase (Pre – Entry)
Identifying Host Family
– House is strategically located in the community.
– Should not belong to the rich segment.
– Respected by both formal and informal leaders.
– Neighbors are not hesitant to enter the house.
– No member of the host family should be moving out in the
community.
2. Entry Phase
• Sometimes called the social preparation phase as to the
activities done here includes the sensitization of the people on
the critical events in their life, innovating them to share their
dreams and ideas on how to manage their concerns and
eventually mobilizing them to take collective action on these.
2. Entry Phase
• This phase signals the actual entry of the community
worker/organizer into the community. Must be guided by the
following:
1. Recognizes the role of local authorities by paying them visits to
inform them of their presence and activities.
COURTESY VISITS
2. Entry Phase
• This phase signals the actual entry of the community
worker/organizer into the community. Must be guided by the
following:
2. The appearance, speech, behavior and lifestyle should be in
keeping with those of the community residents without disregard of
their being role models.
2. Entry Phase
• This phase signals the actual entry of the community
worker/organizer into the community. Must be guided by the
following:
3. Avoid raising the expectations of the community residents; adopt a
low-key profile. (AVOID THE MESSIAHNIC/ SUPERHERO COMPLEX)
 Steps in COPAR
1. Integration - being or becoming with the people
– living with the community
– seek out to converse with people where they usually congregate
– lend a hand in household chores
– avoid gambling and drinking
 Steps in COPAR
1. Integration - being or becoming with the people
Integrations style:
– Now you see me, now you don’t
– Boarder Style
– Elitist Style
– People-centered Integration
• Pagbabahay-bahay
• Huntahan
• Participation in Production Process
• Participation in social activities
 Steps in COPAR
2. Social Investigation - Deepening social investigation/
community study - Social Analysis - systematic process of
collecting and collating data to draw a clear picture of the
community
– verification and enrichment of data collected from initial survey
(Family Profiling Tool)
– conduct baseline survey by students, results relayed through
community assembly – for community validation
 Steps in COPAR
3. Tentative Program Planning (Community Level)
– choosing one issue to work on in order to begin organizing
the people (Health)

Family Nursing Care Plan (Family Level)

– development and planning of care at the family level
through FNCP – home visits
 Steps in COPAR
4. Groundworking
– going around and motivating the people on one-on-one
basis to do something on the issue that has been chosen
3. Organizational Phase
• Entails the formation of more formal structures and
the inclusion of more formal procedures of
planning, implementation, and evaluating
community-wide activities. It is at this phase where
the organized leaders or groups are being given
trainings (formal, informal, OJT) to develop their
skills and in managing their own concerns/programs.
3. Organizational Phase
Activities includes:
• Spotting and Developing Potential Leaders
• Core Group formation
• Setting up community Organization
 Steps in COPAR
5. The Meeting (Social Preparation) – Community Assembly
– people collectively ratifying what they have already decided
individually
– gives the people the collective power and confidence
4. Sustenance and Strengthening Phase

 Occurs when the community organization has already been

established and the community members are already actively
participating in community-wide undertakings.
4. Sustenance and Strengthening Phase

 At this point, the different community's setup in the

organization building phase are already expected to be
functioning by way of planning, implementing and evaluating
their own programs with the overall guidance from the
community-wide organization.
 Steps in COPAR
6. Role Play
– act out the meeting that takes place between the leader of the
people and the government representatives

7. Mobilization
– actual experience of the people in confronting the powerful and the
actual exercise of people power
4. Sustenance and Strengthening Phase
Strategies used may include:
1. Education and training
2. Networking and linkaging
3. Conduct of mobilization on health and
development concerns
4. Implementing of livelihood projects
5. Developing secondary leaders
4. Sustenance and Strengthening Phase
Strategies used may include:
1. Education and training
1. Conducting Community Diagnosis
2. Training Community Health Workers
3. Health Services and Mobilization
4. Leadership-formation activities
 Steps in COPAR
8. Evaluation
– the people review their steps or activities so as to determine
whether they were successful or not in their objectives
9. Reflection
– dealing with deeper on-going concerns to look at positive values
– gives the people time to reflect on the stark reality of life
compared to the ideal
 Steps in COPAR
10. Organization
– result of many successive and similar action of the people
– final organizational structure is set up with newly elected
officers and supporting members
CONTROL

COMMUNITY Control OVER THE PROGRAM

SLCN Control OVER THE PROGRAM

YEARS
Thank You!