"Loyal in nursing profession." - Fidelity in nursing.

Difference between Public Health Nurses vs Community Health Nurses

PHN: provide healthcare to people and communities who are unable to seek assistance.
CHN: involves advocacy and policy development to eliminate healthcare disparities.

Clientele in CHN
● Individual
● Family
● Community
● Groups

COPAR
Community
Organizing
Participatory
Action
Research

Introduction
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 a
dynamic, participatory and politically responsive community.

Definition
● COPAR stands for 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.
● 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).
● 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).
● 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
● Community working to solve its own problem.
● Direction is established internally and externally.
● Development and implementation of a specific project less important than the
development of the capacity of the community to establish the project.
● Consciousness raising involves perceiving health and medical care within the total
structure of society.

Importance
● COPAR is an important tool for community development and people empowerment as
this helps the community workers to generate community participation in development
activities.
● COPAR prepares people/clients to eventually take over the management of a
development. programs in the future.
● COPAR maximizes community participation and involvement; community resources are
mobilized for community services.

Principles
● 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.
● COPAR should be based on the interest of the poorest sector of the community.
● COPAR should lead to a self-reliant community and society.

Critical Steps
● Integration
● Social Investigation
● Tentative program planning
● Groundwork
● Meeting
● Role Play
● Mobilization or action
● Evaluation
● Reflection
● Organization

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

● Train faculty and students in COPAR.

● Formulate plans for institutionalizing COPAR.
● Revise/enrich curriculum and immersion program.
● Coordinate participants of other departments.

Site Selection

● 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

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.

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.

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

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. 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

● Recognize the role of local authorities by paying them visits to inform their presence and
activities.
● Her appearance, speech, behavior and lifestyle should be in keeping with those of the
community residents without disregard of their being role model.
● Avoid raising the consciousness of the community residents; adopt a low-key profile.

Activities in the Entry Phase

● Integration. Establishing rapport with the people in continuing effort to imbibe

community life.
● living with the community
● seek out to converse with people where they usually congregate lend a hand in
household chores
● avoid gambling and drinking
● Deepening social investigation/community study
● verification and enrichment of data collected from initial survey
● conduct baseline survey by students, results relayed through community assembly

Core Group Formation

● Leader spotting through sociogram.

● Key Persons. Approached by most people
● Opinion Leader. Approached by key persons
● 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

● Community Health Organization (CHO)

● preparation of legal requirements
● guidelines in the organization of the CHO by the core group
● election of officers
● Research Team Committee
● Planning Committee
● Health Committee Organization
● Others
● 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 committees 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

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

● Identification of secondary leaders.
● Linkaging and networking.
● Conduct of mobilization on health and development concerns.
● Implementation of livelihood projects.