PRIMARY HEALTH CARE II

LEARNING CONTENTS

MODULE 1: HEALTHY COMMUNITY

1. Definition of Community, Characteristics and Classification

2. Components of Community
3. Concepts of Healthy Community
4. Elements of Healthy Community
5. Factors that affect Community Health
6. Effects of Healthy Community

MODULE II: HEALTH STATISTICS AND EPIDEMEOLOGY

1. Health Statistics
2. Health Indicators
3. Epidemiology

MODULE III: COMMUNITY HEALTH CARE DEVELOPMENT

1. Approaches to Community Development

2. HRDP-COPAR Model as a Strategy for Community Development
3. Phases of COPAR
4. Critical Activities
5. Roles and Activities in Community Health Care Development

MODULE IV: CARE ENHANCEMENT QUALITIES OF HEALTH CARE WORKERS IN

COMMUNITY SETTING

1. The Community Health Care Worker

2. Qualities of a Health Worker
3. Functions of a Health Worker
4. The Community Health Worker as Health Educator
5. Conflict Management

MODULE V: APPLICATION OF COPAR in COMMUNITY HEALTH CARE PROCESS

1. The Community Health Care Process

LEARNING MODULE WORKSHEET

Time Module Teaching-Learning Assessment Time

Activity
Frame No. Strategies Frame

Week 1 1 Google Class 3 hours

Orientation Evocative
Discussion online
Advance Reading (Module1)
 Comprehensive
Task 1 completion

Week 2 I E-classroom Use of Rubrics to 3 hours

A-C Presentation of their outputs Grade students
online

Week 3 1 Module Review Learning Task/s 3 hours

completion
D-F E-classroom
Online quiz

Week 4 2 Module Review Checking of 3 hours

A-B Edmodo/ google class/Zoom Comprehensive
Meeting Tasks

Week 5 2 Module Review Checking of 3 hours

B-C Edmodo/ google class/Zoom Comprehensive
Meeting Tasks

Week 6-8 3 Module Review Presentation of Pre- 9 hours

assigned topics
A-B Edmodo/ google class/Zoom
Meeting

Week 9 3 Module Review Presentation of Pre- 3 hours

assigned topics
C Edmodo/ google class/Zoom
Meeting

Week 10 Midterm Examination

Week 11- 3 Module Review Presentation of Pre- 9 hours

13 assigned topics
C-D Edmodo/ google class/Zoom
Meeting

Week 14 4 Module Review Problem Based 3hours

Learning
Edmodo/ google class/Zoom
Meeting

Week 15- 5 Google Class Problem Based 9 hours

17 Learning
 Week 18 Final Examination

MODULE 1: HEALTHY COMMUNITY

Comprehensive Task I

1. Write YES opposite the item listed if it is visible/noticeable in the community that you
are in and write NO if it is not.
Attributes YES/NO
1. People

2. Place

3. Interaction

4. Common Characteristics, interest

and goals

2. With the following attributes, develop concept/s of your own community utilizing all
the items that you marked YES.
3. How do you classify your own community? If you reside in other place other than in
Zamboanga City, you should have two answers here, that of your own hometown
and the place you are now in, in this city.
1. Urban
2. Rural
3. Rurban
4. What made you classify it as it is?
5. Do you consider your own community as an ideal Community?
6. Do you consider it as a Healthy Community?
Rubrics:
Definition of Key Terms

Poor ( 1 point) Fair ( 3 points) Good ( 5 points)

Vocabulary Word The vocabulary The word is spelled The word is spelled
 word is not listed incorrectly correctly
Definition Wrong definition is Definition is The correct
written incomplete definition is correct
and complete

1. Definition, Characteristics and Classification of Community

Community - A community is a social unit (a group of living things) with

commonality such as norms, religion, values, customs, or identity. Communities may share
a sense of place situated in a given geographical area (e.g. a country, village, town, or
neighbourhood) or in virtual space through communication platforms. (Wikipedia)

Community - collection of people who interact with one another and whose common
interests or characteristic forms the basis for a sense of unity and belonging. (Allender et al
2009)

Maurer and Smith (2009) 4 Defining Attributes of Community

1. People
2. Place
3. Interaction
4. Common Characteristics, interest or goals

Characteristics of Community

1.Environment - it includes physical, socio-cultural, educational and employment milieu.

2.Population Behaviour or lifestyle- self responsibility, self-care competency
3. Human Biology- genetic characteristics of population
4. System of Health Care- promotion, prevention , cure and rehabilitation
Classification: Latest
 1. Geopolitical – formed by both natural and man-made boundaries…examples are:
1. Barangays
2. Municipalities
3. Cities
4. Provinces
5. Regions
6. Nations

2. Phenomenological – refers to relational, interactive, functional groups in which place

or setting is more abstract communities and people share a group perspective or
identify based on culture, values, history interest and goals. Examples are: schools,
churches, colleges, mosques universities and various groups for organizations.

Classification: Old
1. Urban- high density, a socially heterogeneous population with complex structure,
occupation is non-agricultural.
1. Rural- usually small and the occupation of the people is usually farming, fishing and
food gathering. It is peopled by simple folk characterized by primary group relation,
well knit and having a high degree of group feeling.
2. Rurban- a mixture of rural and urban, usually located near the center of the city but
maybe characterized by primary groupings with development on side and country
atmosphere at the other.

1. Components of a Community

Core- represents the people that make up the community. Included in the community CORE
are the demographics of the population as well as the values, beliefs and history of the
people.

Eight Subsystem
1. Housing- type of housing facilities, availability, laws and regulation governing the people.
2. Education- laws, regulations, facilities, activities affecting education, ratio of health
educators to learners, distribution of facilities, availability of informal education facilities
3. Fire and Safety- fire protection facilities and fire prevention activities
4. Politics and government- political structures present in the community, decision making
process, pattern of leadership
5. Health- health facilities and activities, distribution and utilization, ration of providers
6. Communication-systems, types of communication existing, forms of communications
7. Economics- occupation, types of economic activities, income
8. Recreation- recreational activities/facilities

C. A healthy community

1. Prompts its members to have a high degree of awareness that “ we are community”
2. Uses its natural resources while taking steps to conserve them for future generations
3. Openly recognizes the existence of sub-groups and welcomes their participation in
community affairs
4. Is prepared to meet crises
5. Is a problem-solving community…able to identify, analyze and organize to meet their
own needs
6. Has open channels of communication
7. Seeks to make each of its system resources available to all members of the
community
8. Has legitimate and effective ways to settle disputes.
9. Encourages maximum citizen participation in decision making
10. Promotes high level wellness among all its members.
D. Elements of Healthy Community
1. People are partners in health care.
2. People work together to attain goals.
3. Physical environment promotes health, safety, order and cleanliness
4. Safe water and nutritious food.
5. Families provide members with basic needs.
6. Available, affordable health care.

1. Factors Affecting Health

A. Political- involves one’s leadership, managing and involving other people in decision
making.
1. Safety- the condition of being free from harm and injury
2. Oppression- unjust or cruel exercise of authority and power
3. Political will- determination to pursue something which is in the interest of the
majority
4. Empowerment- the ability of the person to do something.
B. Cultural – relating to the representation of non-physical traits, such as values, beliefs,
attitudes and customs shared by group of people and passed from one generation to the
next.
1. Practices- customary action usually done to maintain or promote health
2. Beliefs- a state or habit of mind wherein a group of people place a trust into
something or a person.
C. Heredity- the genetic transmission of traits from parents to offspring; genetically
determined
D. Environment- the sum total of all the conditions and elements that make up the
surroundings and influence the development of the individual.
E. Socio-Economic- refers to the production activities, distribution and consumption of goods
of an individual.

2. Effects of a Healthy Community (https://owaves.com/benefits-of-living-in-a-

healthy-community/)
1. Better Physical Health
Living in a healthy community allows you to have better access to medical care, any
potential wellness amenities, and healthy foods, depending on the supermarkets and
farmers markets that are around the neighborhood.
2. Better Mental Health
Allows you to plan your daily routine, which in turn makes you feel more in control of your
days and weeks.
3. Stronger Community Support
4. Cleaner Environment
5. More Holistic Educational Opportunities
MODULE II: HEALTH STATISTICS AND EPIDIMEOLOGY
 1. Health Statistics
Definitions
1. Statistics - refers to both quantitative data, and the classification of such data in
accordance with probability theory and the application to them of methods such as
hypothesis testing

2. Health Statistics - Health statistics include both empirical data and estimates related
to health, such as mortality, morbidity, risk factors, health service coverage, and
health systems.

*https://www.who.int/topics/statistics/en/

Purposes of Health Statistics

By identifying statistical trends and trails, health care providers can monitor local
conditions and compare them to state, national, and international trends. Health
statistics provide empirical data to assist in the allocation of public and private
funds and help to determine how research efforts should be focused.

*https://www.ncbi.nlm.nih.gov/

Sources of Health Statistics

A number of sources exist that can potentially be used to generate statistics on the
health workforce. They include national population censuses, labour force and
employment surveys, health facility assessments and routine administrative
information systems.

2. Health Indicators and its (Health indices, H. Statistics, H. Indicators are same)
Implications

FERTILITY RATES
1. Crude Birth Rate (CBR) = Number of registered live births in a year x 1,000 -
solve by counting the no. Of registered live birth of every yr. ÷ midyr. Population ×
1,000
Midyear Population
(Total of population)

Implications:
1. Measures how fast people are added to the population through
births
2. Used often because of the availability of data
3. It is affected by:
Fertility/marriage practices
Sex and age composition of the population ( age of reproductive is
15 to 44 in the phil.)
Birth registration practice (30 days )
4. Crude since it is related to the total population including men,
children and elderly who are not capable of giving birth

2.General Fertility Rate (GFR) = Number of registered livebirths in a year X

1,000
Midyear Population of women 15-44 y.o
Diff. Of GFR and CBR is only women of 15 to 44 y.o

Implications:
1. More specific than the CBR since births are related to the segment
of the population that are capable of giving birth.
2. Reproductive age group for women in the Philippines is 15-44
years of age
3. In some countries, reproductive age group is 15-49 years of age

MORTALITY RATES
1. Crude Death Rates (CDR) - Number of deaths in a year x 1,000
Midyear Population Same Year
We’re computing the lives in this CDR

Implications:
1. The term crude is use because death is affected by different
factors
 2. Factors which can affect are:
Age and sex composition of the population
Adverse environmental and occupational conditions in the area
Peace and order situation
3. Widely used because of availability of data

2. Specific Mortality Rate(SMR)= Number of deaths in a specified group in a year X

1,000
Midyear Population of the same specified group, same
year (ex: no. Of deaths of senior citizens ÷ no. Of senior that
are alive in that year)

Implications:
1. Shows rate of deaths in groups with specific characteristics
according to:
1. Age
2. Sex
3. Occupation
4. Education
5. Exposure to risk factors
6. Combination of the above
2. More valid than CDR when comparing mortality experiences
between groups
3. In age specific mortality, there is high mortality rate among infants
and elderly
4. Deaths among women in the reproductive age in developing
countries are due to complications of pregnancy, childbirth and
puerperium (post partum period is from the start of birth to 45
days)
3. Cause-of-Death Rate(C-DR) = Number of deaths from specified cause x
1,000
Midyear population, same year

Implications:
1. The term crude is used since the denominator includes the whole
population
 2. Could be made specific by relating the deaths from a specific
cause and group to the mid-year population of that specific group
3. Factors that affect this rate include:
Completeness of registration of deaths
Composition of the population
Disease ascertainment level in the community
4. Infant Mortality Rate (IMR) = Number of deaths under 1 year of age in a calendar year x 1,000
Number of registered live births, same year

Implications:
1. Sensitive index of level of health in a community
2. High IMR means low levels of health standards due to:
Poor maternal and health care
Nutritional problems
Poor environmental sanitation
Poor or deficient health service delivery
3. This may be artificially lowered by improving the health
registration of births
4. Infant Mortality rate maybe further subdivided into:
Neonatal Mortality Rate = Number of deaths among those under 28 days old x 1,000
Number of registered live births, same year

5. Maternal Mortality Rate (MMR)=

Number of deaths due to PREGNANCY, DELIVERY and PUERPERIUM x 1,000

Number of live births same year

Implications:
1. Measures the risk of death from causes associated with pregnancy
and childbirth
2. Affected by:
Maternal health practices
Diagnostic ascertainment of maternal condition or cause of death
Completeness of registration of birth
 3. The ideal denominator is the number of pregnancies because all
pregnancies will lead to live births.

MORBIDITY RATES
1. Incidence Rate (IR) =
Number of new cases of disease developing from a period of time x
1,000
Population in the area during the same period of time
Implications:
1. Measures the development of a disease in a group exposed to the
risk of such in a given time
2. Tells of the speed of development of disease and is best in
determining the etiologic factors of a disease
3. Rate can be made specific for age and sex
4. IR is the measure of choice to describe:
1. Acute Condition – when incidence is usually higher than the
prevalence
2. Outbreaks – in the study of causations or etiologic factors of
identified disease.
2. Prevalence Rate =
Number of cases present at a given time x 1,000
Estimated Population at that time
Implications:
1. Measures the number of people who are actually suffering of
disease
2. Gives the existing cases at a point in time

Comprehensive Task II

1. There will be at least 5 problem solving problems that will be uploaded in Edmodo for
answering related to this topic.
1. EPIDEMIOLOGY
Epidemiology -is the study (scientific, systematic, and data-driven) of the
distribution (frequency, pattern) and determinants (causes, risk
factors) of health-related states and events (not just diseases) in
specified populations (neighborhood, school, city, state, country,
global).(www.cdc.gov)

1. Is the study of occurrences and distribution of diseases as well as

the study and determinants of health states and events in
specified populations and the application of this study to control
the health problem.
2. The backbone in prevention of diseases.

Two Main Areas:

1. Search for determinants of disease and observed distribution
2. Explanation of patterns in Disease distribution

Concerned with:
Disease prevention
Disease occurrence
Disease distribution

USES OF EPIDEMIOLOGY
1. Study the history of the health population and the rise and fall of disease and
changes in their character
2. Diagnose the health population of the community and condition of people to
measure the distribution and dimension of illnesses in terms of incidence,
 prevalence, disability and mortality and to identify groups needing special
attention.
3. Estimate the risk of disease, accident, defects and the chances of avoiding them.
4. Identify syndromes
5. Complete the clinical picture of chronic disease and describe their natural history
6. Search for causes of health and diseases.

DEFINITION OF RELATED TERMS

v Pathogen is something (such as a type of bacteria or a virus) that caused

disease.

v Pathogenic organism is an organism capable of causing disease. Non-

pathogenic organism is an organism not capable of causing disease.

v Vector is an insect, animal, etc., that carries germs that cause disease. A
vector is a vehicle that serves as an agent of transmission.

v Infection is the implantation & successful replication of an organism in the

tissue of the host, resulting in signs & symptoms as well as immunologic response.

v Carrier is an individual who harbors the organism & is capable of transmitting

it to a susceptible host but does not show the manifestation of the disease.

v Communicable disease is an illness caused by an infectious agent or its toxic

products that are transmitted directly or indirectly to a well person through an agent,
vector or inanimate object.

v Contact is any person or animal that is in closer association, animal or freshly

soiled materials.
v Contagious disease is one that is easily transmitted from one person to
another through direct or indirect means.

v Disinfection is the destruction of pathogenic microorganisms outside the body

through direct physical or chemical means.
a. Concurrent disinfection is a method than immediately after the infected
individual discharges infectious material/secretions, i.e. it is done while the patient is
still the source of infection.
b. Terminal disinfection is applied when the patient is no longer the source of
infection (either because the patient died or has been discharged). Everything the
patient had used, including the room he/she occupied is disinfected.

v Habitat is a place where an organism lives or where an organism is usually

found.

v Host is a person, animal or plant on which a parasite depends for its survival.

v Susceptible person is a person who has low resistance can easily get
infection.

v Infectious disease is transmitted not only through ordinary contact but also
requires direct inoculation of the organism through a break on the skin or mucous
membrane. Hence all contagious diseases are infectious.

v Isolation is the separation from other persons of an individual suffering from a

communicable disease.

v Quarantine is the limitation of the freedom of movement of persons or animals

which have been exposed to a communicable disease/s for a period of time
equivalent to the longest incubation period of that disease.

v Reservoir is an animal or plant in which an infectious agent lives and

reproduces in such a manner that it can be transmitted to man.
v Surveillance is the act of watching.
v Sporadic diseases are diseases that occur occasionally or irregularly with no
specific pattern. Ex. Tetanus, gas gangrene

v Epidemic diseases are diseases that occur in a greater number than what is
expected in a specific area over a specific time.

v Pandemic diseases are epidemic that affects several countries or continents.

Current examples are HIV/AIDS SARS, & Influenza, AH, N

v Endemic diseases are present in a population or community at times. They

usually involve few people during specific periods.

Occurrence of Disease
1. Imbalance between the force of infection and force of resistance
2. Multi-Causal Theory (Epidemiologic Triangle)

CHAIN OF INFECTION

A. Causative Agent is any microbe capable of producing disease. Also called an

etiologic agent.

1. Bacteria are simple one-celled-microbes with double cell membranes that

protect them from harm. They reproduce rapidly and are considered as the most
common cause of fatal infectious diseases. Classified according to:
1.1 Shape (cocci, bacilli, spirillae)
1.2 Need for oxygen (aerobic, anaerobic)
1.3 Response staining gram (Gram(+) or(-), or acid-fast)
1.4 Motility (motile-non-motile)
1.5 Tendency to capsulate (encapsulated, capsulated)
1.6 Capacity to form spores (spore-forming, non-spore forming)
2. Spirochete is a bacterium with flexible, slender, undulating spiral rod that
process cell wall. There are three forms that cause disease:
2.1 Treponema
2.2 Leptospira
2.3 Borilia

3. Viruses are the smallest known microbes. They cannot replicate

independently of the host’s cells; rather they invade & stimulate the host’s cells to
participate in the formation of additional viruses.

4. Rickettsiae are small Gram (-), bacteria-like microbes that can induce life-
threatening infections, they require host’s cell for replication. Usually transmitted to a
bite of arthropod carriers like lice, fleas, ticks as well as their waste products. They
are:
4.1 Rocky Mounted Spotted Fever
4.2 Typhus Fever
4.3 Q Fever

5. Chlamydiae are smaller than Rickettsiae but larger than viruses. These are
common cause of infection of the urethra, bladder, fallopian tubes, & prostate gland.
The most common Chlamydial infection is transmitted through sexual contact.

6. Fungi are found almost everywhere on earth. They live in organic matter, sol,
water, animals & plants. They thrive either inside or outside the body & may be
harmful or beneficial. Funji are beneficial in the manufacturing of cheese, yogurt,
beer, wine & certain drugs.

7. Protozoa are much larger than bacteria. They are the simplest single-celled
organisms of the animal kingdom. Parasitic protozoa absorb nutrients from the body
of the host.

8. Parasites live on or inside other organisms (called “hosts”) at the expense of

those organisms. They don’t usually kill their host but take only the nutrients they
need.
B. Reservoir of Infection refers to environment or objects on which an organism
survives or multiplies.

1. Human reservoir
1.1 Frank cases or the very ill
1.2 Sub-clinical ambulatory
1.3 Carriers
a. Incubatory carrier is a person who is incubating the illness.
b. Convalescent carrier is a person who is at the recovery stage of illness but
continues to shed the pathogenic organism.
c. Intermittent carrier is a person who occasionally sheds the pathogenic
organism.
d. Chronic or sustained carrier is a person who always has the infectious
organism in his or her system.
2. Animals
3. Non-living things

C. Portal of Exit is the path or way through which the organism leaves the
reservoir. Usually, this is where the organism grows.
Common portal of exit:
a. Respiratory system
b. Genitourinary tract (GUT)
c. Gastrointestinal tract (GIT)
d. Skin & mucous membranes
e. Placenta (in transplacental transmission)
D. Mode of Transmission is the means by which the infectious agent passes
through from the portal of exit of the reservoir to the susceptible host.

1. Contact transmission is the most common mode of transmission.

Three types:
a. Direct contact refers to the person-to-person transfer of organism.
b. Indirect contact occurs when the susceptible person comes in contact with the
contaminated object.
c. Droplet spread is transmission through contact with respiratory secretions
when the infected person coughs, sneezes or talks. Microbes carried in droplets can
travel up to three feet (one meter).
2. Air-borne transmission occurs when fine microbial particles or dust particles
containing microbes remain suspended in the air for a prolonged period. The
infectious disease is spread by air current & in inhaled by a susceptible person.
3. Vehicle transmission is the transmission of infectious disease through articles
or substances that harbor the organism until it is ingested by or inoculated into the
host.
4. Vector-borne transmission occurs when intermediate carriers such as fleas,
flies & mosquitoes transfer the microbes to another living organisms.
E. Portal of Entry is the venue through which the organism gains entrance into
the susceptible host. The infective microbes use the same avenues when they exit
from the reservoir.
F. Susceptible Host – the human body has many defenses against the entry and
multiplication of organisms. When the defenses are good, no infection takes place.
However in a weakened host, microbes launch an infectious disease.

EPIDEMIOLOGICAL APPROACH
a. True positive - a sign or symptom manifested is correctly identified
b. False positive – a sign or symptom manifested in not identified correctly
c. True negative - a sign or symptom not manifested is correctly identified
d. False negative - a sign or symptom manifested is not correctly identified

Comprehensive Task III -Outbreak investigation

1. Watch on the link given below how outbreak investigation is done and make a
reflection on the steps employed on how to conduct it.
*https://www.youtube.com/watch

Rubric:
Simple Recall
 Rate/Score

Criteria 4 3 2 1

Concepts 5 or more 4 -3 concepts 2 concepts 1 concept

Named Concepts recalled recalled only recalled only
recalled

Accuracy All concepts Most Some Most

explained and statements concepts concepts
verified explained and cited out of cited out of
verified opinions opinions

Focus Concepts Concepts Concepts Main idea of

summarized summarized summarized concepts not
consisting of consisting of consisting of discussed
main ideas main ideas main ideas
and main and some and only
details minor details minor details

MODULE III: COMMUNITY HEALTH CARE DEVELOPMENT

1. Definition
Community
Health
Development – is defined as a change, a process of unfolding from an un-
manifested condition to more advance or manifested condition.
1. In this process the qualities reveals possibilities, capabilities
emerge and potentials are realized.
2. Its goal is to have a better life ( Teodoro, 1978)
Community Development –is a process to create a condition of economic and
social
progress for the whole community with its active participation and
fullest
possible reliance on the community initiatives.
 This is achieved through:
1. Democratic procedure
2. Voluntary cooperation
3. Self help
4. Development of indigenous leadership
5. Education

How can we say that the community is developed?

1. The people are working together
2. Have the vision
3. Know how
4. Capabilities and experience to confront and solve problems of under
development
5. Committed to the services of the people to become SELF-RELIANT.

1. APPROACHES TO COMMUNITY DEVELOPMENT

1. WELFARE DEVELOPMENT
1. The immediate or spontaneous response to ameliorate of the
manifestation of poverty, especially on the personal level
2. Assumed that poverty is God-given, destined hence the poor should
accept their condition since they will receive their just reward in heaven
3. Believed that poverty is caused by bad luck, natural disaster and certain
circumstances which are beyond the control of people
2. MODERNIZATION APPROACH
1. Known as the project development approach
2. Introduces whatever resources are lacking in the community
3. Believes that poverty is due to lack of education, lack of resources such
as capital and technology
3. TRANSFORMATORY / PARTICIPATORY APPROACH
1. The process of empowering/ transforming the poor and the oppressed
sectors of the society so that they can pursue a more just and humane
society
 2. Assumes that poverty is not God-given, rather it is rooted in the historical
past and is maintained by the oppressive structures in society
3. Poverty is caused by exploitation, oppression and unjust structures

2. HRDP COPAR MODEL

COPAR or Community Organizing Participatory Action Research is a vital part of public

health nursing. COPAR aims to transform the apathetic, individualistic and voiceless poor
into dynamic, participatory and politically responsive community.

Definition

1. COPAR stands for Community Organizing Participatory Action Research

2. A social development approach that aims to transform the apathetic, individualistic

and voiceless poor into dynamic, participatory and politically responsive community.

3. 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).

4. 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).

5. A continuous and sustained process of educating the people to understand and

develop their critical awareness of their existing condition, working with the people
collectively and efficiently on their immediate and long-term problems, and
mobilizing the people to develop their capability and readiness to respond and take
action on their immediate needs towards solving their long-term problems (CO: A
manual of experience, PCPD).
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.
Structure

Refers to a particular group of community members that work together for a common health
and health related goals.

Emphasis

1. Community working to solve its own problem.

2. Direction is established internally and externally.

3. Development and implementation of a specific project less important than the

development of the capacity of the community to establish the project.

4. Consciousness raising involves perceiving health and medical care within the total
structure of society.

Importance

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

dvelopment.programs in the future.

3. COPAR maximizes community participation and involvement; community resources

are mobilized for community services.

Principles

1. People especially the most oppressed, exploited and deprived sectors are open to
change, have the capacity to change and are able to bring about change.

2. COPAR should be based on the interest of the poorest sector of the community.

3. COPAR should lead to a self-reliant community and society.

Critical Steps
 1. Integration

2. Social Investigation

3. Tentative program planning

4. Groundwork

5. Meeting

6. Role Play

7. Mobilization or action

8. Evaluation

9. Reflection

10. Organization

C.Phases of COPAR

COPAR has four phases namely: Pre-Entry Phase, Entry Phase, Organization-building
phase, and sustenance and strengthening phase.

1. Pre-Entry Phase

Is the initial phase of the organizing process where the community organizer looks for
communities to serve and help. Activities include:

Preparation of the Institution

1. Train faculty and students in COPAR.

2. Formulate plans for institutionalizing COPAR.

3. Revise/enrich curriculum and immersion program.

4. Coordinate participants of other departments.

Site Selection

1. Initial networking with local government.

 2. Conduct preliminary special investigation.

3. Make long/short list of potential communities.

4. Do ocular survey of listed communities.

Criteria for Initial Site Selection

1. Must have a population of 100-200 families.

2. Economically depressed.No strong resistance from the community.

3. No serious peace and order problem.

4. No similar group or organization holding the same program.

Identifying Potential Municipalities

1. Make long/short list of potential municipalities

Identifying Potential Community

1. Do the same process as in selecting municipality.

2. Consult key informants and residents.

3. Coordinate with local government and NGOs for future activities.

Choosing Final Community

1. Conduct informal interviews with community residents and key informants.

2. Determine the need of the program in the community.

3. Take note of political development.

4. Develop community profiles for secondary data.

5. Develop survey tools.

6. Pay courtesy call to community leaders.

 7. Choose foster families based on guidelines

Identifying Host Family

1. House is strategically located in the community.

2. Should not belong to the rich segment.

3. Respected by both formal and informal leaders.

4. Neighbours are not hesitant to enter the house.

5. No member of the host family should be moving out in the community.

2. Entry Phase

Is sometimes called the social preparation phase. Is crucial in determining which strategies
for organizing would suit the chosen community. Success of the activities depend on how
much the community organizers has integrated with the community.

Guidelines for Entry

1. Recognize the role of local authorities by paying them visits to inform their presence
and activities.

2. Her appearance, speech, behavior and lifestyle should be in keeping with those of
the community residents without disregard of their being role model.

3. Avoid raising the consciousness of the community residents; adopt a low-key profile.

Activities in the Entry Phase

 1. Integration. Establishing rapport with the people in continuing effort to imbibe
community life.

1. living with the community

2. seek out to converse with people where they usually congregate

3. lend a hand in household chores

4. avoid gambling and drinking

2. Deepening social investigation/community study

1. verification and enrichment of data collected from initial survey

2. conduct baseline survey by students, results relayed through community

assembly

Core Group Formation

1. Leader spotting through sociogram.

1. Key Persons. Approached by most people

2. Opinion Leader. Approached by key persons

3. Isolates. Never or hardly consulted

3. Organization-building Phase

Entails the formation of more formal structure and the inclusion of more formal procedure of
planning, implementing, and evaluating community-wise activities. It is at this phase where
the organized leaders or groups are being given training (formal, informal, OJT) to develop
their style in managing their own concerns/programs.

Key Activities

1. Community Health Organization (CHO)

1. preparation of legal requirements

2. guidelines in the organization of the CHO by the core group

 3. election of officers
2. Research Team Committee

3. Planning Committee

4. Health Committee Organization

5. Others

6. Formation of by-laws by the CHO

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. At this point, the
different committee 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.

Key Activities

1. Training of CHO for monitoring and implementing of community health program.

2. Identification of secondary leaders.

3. Linkaging and networking.

4. Conduct of mobilization on health and development concerns.

5. Implementation of livelihood projects.

D.Roles and Activities in Community Health Care Development

References:

1. COMMUNITY ORGANIZING
2. COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH (COPAR)
3. PUBLIC HEALTH NURSING (PHN)
Matt Vera, BSN, R.N.

Comprehensive Task IV
1. Define all the Critical Steps of COPAR using the HRDP- COPAR Model
vocabulary.
 2. As per the criteria set for Site Selection, what particular zone or purok in your
barangay may be the best area selected for Community Development and
Organizing utilizing the COPAR approach and explain why?
3. Name at least 3 opinion leaders and 3 key leaders in your barangay or in the
particular zone or purok you selected.
4. Since you have conducted an ocular survey in this purok you selected, list at
least 3-5 health problems or health related problems of this community which
you can initially identify.

5 main Objectives of EPIDEMIOLOGY

In the mid-1980s, five major tasks of epidemiology in public health practice were
identified: 1.Public health surveillance
2.Field investigation
3. Analytic studies,
4. Evaluation
5. Linkages.