NCM 104

COMMUNITY HEALTH NURSING 1

COPAR
__________
ST LUKE’S COLLEGE OF NURSING
What comes into mind when you
encounter
Community Development?
What is a COMMUNITY?
 COMMUNITY
• People who live within a geographically defined
area and possess social and psychological ties
with each other and with the place they live in.

• A group of people who live close to one another

and are united by common interests and mutual
aid.

• A combination of social units and systems which

perform major social functions…and the
organization of social activities.
 What is DEVELOPMENT
and when can we say that we are
developing?
ECONOMIC GROWTH AND
FREEDOM
 DEVELOPMENT
• Implies structural changes and improvement
within community systems encompassing both
economic change and the functioning of
institutions and organizations.

• It is a process that creates growth, progress,

positive change or the addition of physical,
economic, environmental, social and
demographic components.
 Carolino
(2014)
 Community Development (CD)
• Community development is a holistic approach grounded in
principles of empowerment, human rights, inclusion, social justice,
self-determination and collective action (Kenny, 2007).

• Community development considers community members to be

experts in their lives and communities, and values community
knowledge and wisdom.

• Community development programs are led by community members

at every stage - from deciding on issues to selecting and
implementing actions, and evaluation.

• Community development has an explicit focus on the redistribution

of power to address the causes of inequality and disadvantage.
Effective community development Community development is a
should be: grassroots process by which
communities:

• a long-term endeavor • become more responsible

• well-planned • organize and plan together

• inclusive and equitable • develop healthy lifestyle options

• holistic and integrated into the bigger • empower themselves

picture
• reduce poverty and suffering
• initiated and supported by community
members • create employment and economic
opportunities
• of benefit to the community
• achieve social, economic, cultural and
• grounded in experience that leads to environmental goals
best practices
 STRATEGIES IN COMMUNITY
DEVELOPMENT
• Community Education and Communication

• Community Planning and Administration

• Community Governance

• Community-based Project Management

• Community-based Disaster Risk Reduction and Management

• Community Research

• COMMUNITY ORGANIZING
 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 bythe people
 COMMUNITY ORGANIZING
VALUES
1. Human Rights – are universally held principles
anchored mainly on the belief in the worth and
dignity of people
2. Social Justice – equitable access to opportunities for
satisfying people’s basic needs and dignity
3. Social Responsibility – is premised on the belief that
people as social beings must not limit themselves to
their own concerns but should also reached out to
and move jointly with others in meeting common
needs and problems
 COMMUNITY ORGANIZING
CORE PRINCIPLES IN COMMUNITY ORGANIZING
1. Community organizing is people centered –
people are the means and ends of the
development and community empowerment
is the process and outcome
2. Community organizing is participative – the
participation of the community in the entire
process should be ensured
 COMMUNITY ORGANIZING
3. Community organizing is developmental
the community will eventually gains insights, hones
their capacities and develops their confidence in
themselves and in each other that will allow them
to take the lead in the holistic improvements of the
community

4. Community organizing is process oriented

Community organizing is dynamic, monitoring and
periodic review of plans are necessary
 COMMUNITY ORGANIZING
5. Community organizing is democratic
It should empower the disadvantaged
population. It is a process that allows the
majority of people to recognize and critically
analyze their difficulties and articulate their
aspirations
 COMMUNITY ORGANIZING
GENERAL PHASES OF COMMUNITY ORGANIZING
1. Preparation Phase
2. Organizing Phase
3. Education and Training Phase
4. Intersectoral Collaboration Phase
5. Phase Out
COPAR IN NURSING CURRICULUM
• Community Organizing as adopted by the
nursing curriculum may take on a different
flavor but have the same substance
 COMMUNITY ORGANIZING
PARTICIPATORY ACTION RESEARCH
(COPAR)
• A collective participatory, transformative ,
liberative, sustained and systemic process of
building people’s organizations by mobilizing
and enhancing the capabilities and resources
of the people for resolution of their issues and
concerns towards effecting change in their
existing, oppressive and exploitative condition

(1994 National Rural Conference)

 COMMUNITY ORGANIZING PARTICIPATORY
ACTION RESEARCH (COPAR)
• A process by which a community identifies its
needs and objectives, develops confidence to
take actions with respect to them and in doing
so, extends and develops cooperative and
collaborative attitudes and practices in the
community

(Ross, 1967)
 COMMUNITY ORGANIZING PARTICIPATORY
ACTION RESEARCH (COPAR)
• A continuous and sustained process and educating the
people to understand and develop their critical
awareness of their existing conditions: 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

(Community Organizing: A Manual of Experience, PCPD)

 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
dynamic, participatory and politically
responsive community.
 IMPORTANCE OF COPAR
• 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 OF COPAR
• 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.
 PHASE 1 – PRE ENTRY
A. Preparation of the Institution
B. Site Selection
C. Conduct Preliminary Social Investigation
D. Identification of Potential Barangay
 PHASE 1 – PRE ENTRY
• Is the initial phase of the organizing
process where the community organizer
looks for communities to serve and help.
Activities include:

A. 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.
 PHASE 1 – PRE ENTRY
B. 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
– 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.
 PHASE 1 – PRE ENTRY
C. Conduct Preliminary Social Investigation
• Conduct of ocular observations, noting accessibility, geography,
terrain, settlement patterns and physical resources
• Use data from various government offices like RHUs
• Use of secondary data from other community based health programs
• Coordination with extension workers from government and NGO

D. Identification of Potential Barangay

• Conduct informal interviews with community residents and take note
of political undertones because these may affect organizing activities
• Assess if COPAR is needed in the area
 PHASE 2 - ENTRY
A. Guidelines for Entry
B. Activities in the Entry Phase
Integration
C. Social Investigation
D. Identification of Potential Leaders
E. Provision of Health Services
 PHASE 2 - ENTRY
• 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.

A. Guidelines for Entry

• Recognize the role of local authorities by paying them visits to
inform their presence and activities.
• 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.
 PHASE 2 – ENTRY
B. Activities in the Entry Phase
Integration
• The process of establishing rapport with the people in
continuing effort to imbibe community life.
• Through integration we will become one with the
people in order to:
– Immerse him/herself to the community life and be
accepted as a member of community
– Experience the liberating aspect of culture and how it gives
strength to the people as a group
– Understand deeply the culture, economy, leaders, history
and lifestyle of the community
– Be more tolerant, realistic and committed to working for
the development of poor communities
 PHASE 2 – ENTRY
• Methods of integration
• Participation in economic production activities of the
people
• Conducts house to house visits
• Participation in social activities like birthday celebration
and feasts
• Conversing with the people where they usually gather
like in stores, waterwell, church etc
• Helping out with household chores
 PHASE 2 – ENTRY
C. Social Investigation Data for Social Investigation
1. physical/geographic area
• also known as 2. Demographic area
3. Economic conditions
COMMUNITY STUDY 4. Mortality and morbidity
5. Food supply and nutrition
• Systematic and scientific 6. Cultural patterns (health
process of collecting, beliefs and practices)
7. Health services and facility
collating and analyzing 8. Education
data to draw a clear 9. Community leadership and
organization
picture of the community 10. Development agencies
11. Community problems as
articulated by the people
 PHASE 2 – ENTRY
D. Identification of Potential Leaders
They are considered the future community organizers and
possible partners to the delivery of health services to the
community

• They are also expected to form and lead the community

Health Organization (CHO) and take on managerial roles in
the community program must belong to the poor sector in
the community
Ø Respected member of the community
Ø Responsive and willing to work for change
Ø Possess good communication skills
 PHASE 2 – ENTRY
D. Identification of Potential Leaders
CORE GROUP FORMATION
– Potential leaders are formed into a core group, a transitional
phase towards CHO formation
– Group of 8 – 10 individual, community residents who possess
leadership potential

FUNCTION
1. Social preparation of the community
2. Aid in the conduct of community diagnosis
3. Setting up of CHO, identify BHW
4. Mobilization of the community
5. Participation in the delivery of essential health services
 PHASE 2 – ENTRY
FOUR DISTINCT & INTERRELATED STRATEGIES
DONE IN THE CORE GROUP FORMATION PHASE
1. Integration with the core group members
2. Deepening social investigation
3. Training & education of core group members
4. Mobilization of core group
 PHASE 2 – ENTRY
TRAINING OF CORE GROUP
• Local health situation
• National health situation
• PHC – concept, principles & strategies
• Conduct of community survey and community
diagnosis
• Team building
 PHASE 2 – ENTRY
TRAINING OF BHW
• local health situation
• National health situation
• PHC
• Common illnesses in the community
• Maternal and child care, including Family planning
• Common emergencies and 1st aid
• Environmental sanitation
• Traditional medicine
• Public health referral system
• Recording and record keeping
 PHASE 2 – ENTRY
E. Provision of Health Services
• To respond to acute health problems
• To provide immediate interventions
• To put emphasis on the preventive aspects of
health care
• To enhance the integration of the community
organizer in the community
 PHASE 3 – ORGANIZATION &
BUILDING
• 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.
ACTIVITIES:
1. Preparing the community for organization building
2. Organizing the CHO
3. Training and Education for the CHO
4. Setting up the CHO
 PHASE 3 – ORGANIZATION &
BUILDING
PARTICIPATORY REASEARCH:
• Approach in community diagnosis, means actively
involving the community in the planning,
implementation and evaluation of the community
diagnosis
• OBJECTIVES:
– To encourage awareness and articulation of the people’s
condition to help them develop competence in changing
their situation
– To assist in organization building by harnessing both
human and material resources in responding to
community needs
 PHASE 3 – ORGANIZATION &
BUILDING
PARTICIPATORY ACTION RESEARCH TRADITIONAL RESEARCH

People as researchers and as active People as object of research

collaborators of change and development

Veers away from dependence on outside Researcher is an outsider

researchers

PAR tries to come up with the real desire Researcher has pre conceived theoretical
and problems in the community frameworks and biases
 PHASE 4 – SUSTENANCE &
STRENGTHENING
• 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.
 PHASE 4 – SUSTENANCE &
STRENGTHENING
• Develop financial and management system
• Assess and replan community health programs
• Institutionalize linkages, networking and referrals
• Continuing needs based education of leaders
• Formulation and ratification of constitution and by
laws
• Apply for SEC registration/ LGU accrediatation
• Negotiate for absorptionof BHWs by the LGU
• Affiliation with other groups
• EVALUATION/PHASE OUT OF EXTERNAL ORGANIZERS
Thank You!