Community Health Nursing II (Population Groups and

Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson Title: COMMUNITY ORGANIZING, COMMUNITY Materials:

IMMERSION
Pen, paper, index card, book, and class List
Learning Targets:
At the end of the module, students will be able to:
1. Outline the steps to be taken in applying the community References:
organizing;
2. Differentiate traditional research approach or community Famorca, Z., Nies, M., McEwen, M. (2013).
organizing participatory action research; Nursing Care of the Community. Singapore:
3. Differentiate practiced community organizing participatory action Elsevier
research to the ideal; Other References:
4. Discuss the concept of Community Immersion Nursing Program;
and, Cuevas, F. P., (2007). Public Health Nursing
5. Acknowledge the importance of Community Nursing in the Philippines (10th edition). Manila,
Program in their growth as future nurses. Philippines.
De Belen, R. & De Belen, D. V., (2008). A
Praxis in Community Health Nursing. 1672
Quezon Avenue South Triangle, Quezon City.

Maglaya, A., (2004). Nursing Practice in the

Community (4th edition). Philippines

A. LESSON PREVIEW/REVIEW

Instruction: Answer the following problem. Show your computation.

You are computing the crude death rate of your municipality, with a total population of about 18,000, for last year. There
were 94 deaths. Among those who died, 20 died because of diseases of the heart and 32 were aged 50 years or older.
What is the crude death rate?

Answer:

In the past year, Barangay A had an average population of 1655. 46 babies were born in that year, 2 of whom died less
than 4 weeks after they were born. There were 4 recorded stillbirths. What is the neonatal mortality rate?

Answer:

B. MAIN LESSON

Community organizing as a process consists of steps or activities that instill and reinforce the people’s self- confidence
on their own collective strengths and capabilities (Manalili, 1990).

It is the development of the community’s collective capacities to solve its own problems and aspire for development
through its own efforts. It entails harnessing and developing the community’s capacities to recognize a community
problem, identify and implement solutions, and monitor and evaluate the efforts in resolving the problem.
Community Organizing

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Is a continuous process of educating the community to develop its capacity to assess and analyze the situation (which
usually involves the process of consciousness raising), plan and implement interventions mobilization), and evaluate
them.

Basic Values in Community Organizing

⎯ Human Rights
⎯ Social Justice
⎯ Social Responsibility

Core Principles of Community Organizing

⎯ People Centered
⎯ Participative
⎯ Democratic
⎯ Developmental
⎯ Process-Oriented

Phases of Community Organizing

1. Pre-entry
⎯ Involves in Preparation and includes knowing the goals of the community organizing activity or experience
⎯ It may also be necessary to delineate criteria or guidelines for site selection.
⎯ Making a list of sources of information and possible facility resources, both government and private, is
recommended.
⎯ Skills in community organizing are developed on the job or through experiential approach.
⎯ Novice community organizers, such as student nurses on their related learning experience, are therefore not
unusual.
⎯ For novice organizers, preparation includes a study or review of the basic concepts of community organizing.
⎯ Although the affective domain is not easy to change, self-examination helps the organizer identify attitudes –
both positive and negative – that may influence effectiveness.
⎯ Proper selection of the community is crucial.

Identification of:
✓ Possible barriers
✓ Threats
✓ Strengths
✓ Opportunities at this stage is an important determinant of the over-all outcome of community organizing

Communities may be identified through different means:

✓ Initial data during ocular survey
✓ Review of records of a health facility
✓ Review of barangay profile, and so on
✓ Referrals from other communities or institutions
✓ Through series of meetings
✓ Consultation from local governments (LGUs) or private institutions

Basic criteria
✓ Geographically isolated and disadvantaged area
✓ Community perceives that they need assistance
✓ Shows sign of willingness
✓ No obvious threat for safety
✓ No other organization working with same services
✓ Partnership among other sectors is feasible

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 2

 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

2. Entry into the Community

⎯ This phase formalizes the start of the organizing process.
⎯ This is the stage where the organizer gets to know the community likewise gets to know the organizer.
⎯ Courtesy calls to local formal leaders
⎯ Visit informal leaders like elders, local health workers, traditional healers, church leaders and local neighborhood
association or other contact persons who may facilitate the subsequent phases of the organizing process

Considerations in the Entry Phase

▪ Community organizers must clearly introduce themselves and their institution to the community
▪ Clear explanation of the vision, mission, goals, programs and activities must be given in all initial meetings and
contacts with the community.
▪ Community organizer must have a basic understanding of the target community.
▪ Preparation for the initial visit includes
▪ Gathering basic information on socioeconomic conditions, traditions including practices, overall physical
environment, general health and illness patterns, and available resources.
▪ Informal meeting with contacts who have been to the area or some residents of the community prior to entry will
be useful.
▪ Avoid raising unrealistic expectations in the community.
▪ Goal: Build up the confidence and capacities of people
▪ 2 strategies in gaining entry into a community which can be COUNTERPRODUCTIVE
▪ Padrino or patron. When patron tries to boost the community organizer’s intended output to the community, this
will create false hopes
▪ Bongga entry. Easiest way to catch the attention and gain the approval of the community. This strategy exploits
the people’s weaknesses and usually involves dole-outs (free medicine, food ant thers). This creates
unreasonable expectations and contradicts the essence of community organizing.

3. Community Integration
⎯ Community integration or pakikipamuhay is the phase when the organizer may actually live in the community in an
effort to understand the community better and imbibe community life. The establishment of rapport between the
organizer and the people indicates successful integration.
✓ Integration requires IMMERSION in a community life.
✓ Organizer’s conduct as well as manner of dressing must be in accordance with the norms of the
community

Styles of Integration
⎯ “Guest” status
✓ Visits the community as per schedule
✓ “now you see, now you don’t”
⎯ Boarder style
✓ Rents a room or house in a village
✓ Lives with his own lifestyle
✓ Does not share life with the community
⎯ “Elitist” style
✓ Lives with the barangay chairman or some other prominent person in the community
✓ Frequently with the barangay officials People-centered approach integration

⎯ Community organizers enter into a community with a well-conceived plan.

⎯ They establish contact with villagers and become THEIR ALLIES
⎯ Organizers develop a deeper relationship through various techniques
⎯ Pagbabahay-bahay or occasional home visit, observe house routines to avoid inconvenience
⎯ Huntahan. Informal conversations in the village poso during laundry time, basketball court and sari-sari store
⎯ Participation in the production process
✓ Participates in farming, fishing or any livelihood activities of the community

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

✓ This practice allows the organizer to experience the life of the people in the community. Hence, they will
understand them better.
⎯ Participation in social activities
✓ Attending fiestas, weddings, baptismal celebrations, funeral wakes and other activities of the community that
carry social meaning and importance.
✓ Community organizers should remain as role model, gambling and drinking alcoholic beverages with them is
prohibited.

4. Social Analysis
⎯ This is the process of gathering, collating and analyzing data to gain extensive understanding of community
conditions, help in the identification of problems of the community and determine the root cause of these
problems.
✓ Known also as social investigation, community study, community analysis, or community needs
assessment
✓ In nursing practice this is often called as community diagnosis with emphasis given to health and health-
related problems
✓ Comprehensive analysis
• Demographic data
• Sociocultural data
• Economic data
• Environmental data
• Data on health patterns (morbidity, mortality, fertility) and
• Data on health resources

5. Identifying Potential Leaders

Since organizing is not a job of one person, it is imperative that the organizer identifies partners and potential leaders who
will help lead the people.

Desirable characteristics of potential leaders

✓ Represent the target group/community (E.g., farmer if it is a farmers group)
✓ Possess or display leadership qualities
✓ They have the trust and confidence of the community
✓ Express belief in the need to change the current undesirable situation in the community, that change is possible, and
that change must start with members of the community
✓ Willing to invest time and effort for community organizing
✓ Must have potential management skills

The community organizer must bear in mind that the prevailing culture or social structure in some communities tends to
make ordinary people shy away from leadership roles, and instead, prefer to work in self-effacing supportive roles. Some
community members may equate leadership ability with education or wealth. Thus, one of the challenges of community
organizing is the training and preparation of the potential leaders. This requires consistency and persistence in the training
and thereby encouraging them and giving their opportunities to assume various roles in community activities. The key is to
allow time for them to develop and gradually assume leadership role.

6. Core Group Formation

As the organizer works with potential community leaders, the membership of the group is expanded, as necessary, by
asking them to invite one or two of their neighborhood or friends. These new recruits must also be from the community
sharing the same problems the group seeks to correct, while at the same time believing in the same core values,
principles, and strategies the group is employing.

⎯ Keep the group manageable, 8 and 12 members

⎯ Initially forming a single group is suggested but as the community gets better organized, the first group may have
separate groups or committees
⎯ Formation of a viable, functioning core group is the focal point of community organizing

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

✓ Requires series of training sessions to transfer the technology of organizing, enabling the core group to take
charge
✓ Essential component of core group formation: reinforcement of the social consciousness of the members,
particularly in terms of analyzing the root causes of community problems
✓ The formation program may focus on self-awareness and development of community health leaders
✓ Negative factor must be addressed so as not to affect the outcomes of the community organizing efforts

7. Community Organization
Through various means of information dissemination, the core group, with the assistance of the organizer, instills
awareness of common concerns among other members of the community. Subsequently, on the initiative of the core
group, the community conducts an assembly or a series of assemblies, with the goals of arriving at a common
understanding of community concerns and formulating a plan of action in dealing with these concerns. Collective decision
making must dictate what projects and strategy must be undertaken. The organizer must remember that it is their project
to be done in their community. The organizer must let them decide.

If the community decides to formalize the organization, it must have the following characteristics:
⎯ An organizational name and structure
⎯ A set of officers recognized by the members of the community
⎯ Community and bylaws stating the vision, mission and goals (VMG) rules and regulations of the organization and
duties and responsibilities of its officers and members

The community may then decide to seek legal recognition by registering the organization with the appropriate government
agency, such as the Securities and Exchange Commission or the Cooperatives Development Agency. Recognition by the
LGU completes the process.

Gaining legal recognition paves the way for the organization’s participation in the Barangay, Municipal or City
Development Council as provided in the Local Government Council as provided in the Local Government Code (RA
7160). The organization may also establish linkages and networks with other government agencies, nongovernment
organizations/agencies, or other people’s organizations that will further strengthen and expand the organization,
facilitating the attainment of its goals and objectives.

8. Action Phase
Also known as the MOBILIZATION phase, the action phase refers to the implementation of the community’s planned
projects and programs.

Important considerations during the mobilization phase are as follows:

1. Allow the community to determine the pace and scope of project implementation. The community may start with
simple barangay projects, such as Tapat Ko Linis Ko or clean and green. As the organization gains experience and
develops, it will move toward more complex programs, like coastal resource management or a community material
recovery facility.
2. The process is as important as the output. A project may fail but as long as the community gains valuable experience
and learns from the process, it is not failure in itself.
3. Regular monitoring and continuing community formation program are essential. Throughout the mobilization, regular
meetings must be conducted for monitoring and continuous training for community leaders.

9. Evaluation
Evaluation is a systematic, critical analysis of the current state of the organization and or projects compared to desired or
planned goals or objectives. Ideally, evaluation is done periodically during mobilization (i.e. formative evaluation) to allow
revision of strategies when needed and at the end of the prescribed project period (i.e. summative evaluation).
In community organizing, there are two major areas of evaluation: program-based evaluation and organizational
evaluation.

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Area of evaluation General evaluation parameters

Program-based ✓ Were the goals and objectives of the program/project

achieved?
✓ What strategies were implemented? What worked? What did
not?
✓ What is the over-all impact of the project on the community?
✓ How were the resources of the organization and community utilized?
Organizational ✓ Were the vision, mission and goals of the organization
achieved? How are the organizational policies being
implemented?
✓ What is the level of participation in the affairs of the
community organization?
✓ How were the resources of the organization utilized and managed?
✓ What type of interpersonal relationships is shared among the members
of
✓ the organization, among leaders, and the members of the community
organization?

10. Exit and Expansion

From the start, the organizer must have a clear vision of the end with a general time frame in min. As articulated by
Manalili (1990), “the best entry plan is an exit plan.” The time of exit should be mutually determined by the organizer and
community during a meeting for monitoring and evaluation.

Indications of readiness for exit by the community organizer should include:

⎯ Attainment of the set goals of the community organizing efforts,
⎯ Demonstration of the capacity of the people’s organization to lead the community in dealing with common problems,
and
⎯ People empowerment as manifested by collective involvement in decision making and community action on matters
that impact their lives

During the Exit Phase:

⎯ Organizer start exploring another community to organize
⎯ While expanding to another area, the organizer stays in touch with the first community, periodically visiting as friendly
consultant

Goals of Community Organizing

1. People’s Empowerment
2. Building People’s Organizations
4. Improved quality of life

Participatory action research (PAR)

⎯ Is an approach to research that aims at promoting change among the participants. Members of the group being
studied participate as partners in all phases of the research, including design, data collection, analysis, and
dissemination (Brown et al., 2008).

Community Organizing Participatory Action Research (COPAR)

⎯ Is a community development approach that allows the community (participatory) to systematically analyze the
situation (research), plan solution, and implement projects/programs (action) utilizing the process of community
organizing. It is essentially a research project done by the community that leads to actions that improve conditions in
the community.

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Points of Comparison Traditional research approach COPAR

Decision Making Emphasis ⎯ Top down ⎯ Bottom-up
⎯ Expert/nurse driven process ⎯ Community-driven process
⎯ Much premium is placed on the data
and output
Roles ⎯ Nurse as researchers; the ⎯ Community members as
community members are subject or researchers; the nurse is a facilitator
objects of research, usually and recorder. Data analysis is done
respondents of the research collectively by the community.
instrument.
⎯ Data analysis is done by the nurse,
and then presented to the
community.
Methodology ⎯ Research tools and methodologies ⎯ Research tools and methodologies
are predetermined/prepackaged by are identified and developed by the
the nurse-organizer. community.
Output ⎯ Upon completion, the study is ⎯ Conclusions and recommendations
packaged and submitted to the are made by the community. These
agency, and published. will lead to agreed community
⎯ Recommendations are made by the actions/projects, the whole research
researcher based on the findings of cycle continues until it becomes part
the study. of community life, leading towards
community development.
⎯ Community members formulate the
recommendations.

COMPONENT PRACTICED COPAR IDEAL COPAR

Time frame/mode of exposure ⎯ Sometimes 8-16 hours/week for 2-4 ⎯ 3-6 weeks immersion
⎯ weeks depending on the time allotted ⎯ 3-6 weeks duty, 8 hours duty; 5-6
by the school days/week

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Methodology/Survey form ⎯ Use of ready-made survey from the ⎯ It will vary from the needs of the
school community and the methodology is
⎯ Some use survey but just collect data the surveying participants
from previous study
Problem statement ⎯ Misjudging complex problems as ⎯ After the survey and analysis has
simple problems. been done. Problem will be coming
⎯ Not considering the result of the from the survey form
survey form rather pay attention to ⎯ Any problems too big should not be
the concern of the few individuals. prioritized

Implementation ⎯ Fish effect One day program ⎯ Fishing rod effect Programs should
not be one-time affair

Evaluation ⎯ Results are manipulated No re- ⎯ Reality acceptance

implementation ⎯ After evaluation, there must be re-
implementation if needed or
program must be revised
depending on the result

Community Immersion
Community immersion (CI) is a related learning experience program requiring student nurses to live and work within a
selected remote community. Students learn about nursing care for diverse populations in the community settings during
this two-week clinical immersion experience. Topics such as primary health care, epidemiology, environmental health,
health promotion, disease prevention and management, and individual, family, and population-centered nursing will be
covered. Furthermore, students learn about rural public health systems, the role of a public health nurse, as well as the
wide range of programs and issues present in remote community.

The CI program is a community-based learning approach that has been further strengthened by the World Health
Organization, which defines the social accountability of medical schools as “the obligation to direct education, research
and service activities towards addressing priority health concerns of the community”.

From both a public health perspective and an educational perspective, immersion of student nurses in the community
raises awareness of future nurses of the health needs of the community and of the psychosocial dimensions of any health
problem. Student nurses who experienced living within the remote community have been reported to have a positive
impact on their future community engagement, giving them the opportunity of an early experience.

General objective:
⎯ The general aim of the community immersion program is to prepare future nurses to be competent staff PHN.

Specific Objectives:
The community immersion program aims to:
1. train future nurses to respond to the health problems of individuals in their complexity, and strengthens their ability to
work with the community;
2. develop student nurses’ leadership capabilities;

3. enhance their basic nursing skills and accountability to client care;

5. strengthen their interpersonal skills;
6. increase their commitment to the caring profession; and
7. improve their management skills with a scientifically inquisitive research-oriented mind.

CHECK FOR UNDERSTANDING

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 8

 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

1. In the Pre-entry phase of the COPAR process, a preliminary social investigation is conducted to aid in the selection of
the site. Nurse Rashan helped in identifying the community for COPAR. Which of the following is not a criterion to be used
when selecting an area for COPAR?
A. Area must have no serious peace and order problem
B. Must have a population of 100-200 families
C. Economically not depressed
D. No similar groups holding the same program
E. No strong resistance from the community
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

2. In Pre-entry Phase, which of the following activities should be done in choosing the final community?
A. Determining the outcome of the program in the community
B. Developing programs with the community
C. Community decides to formalize organization
D. Take note of political development
E. Conducting formal interviews with community residents and key informants
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

3. As part of the Pre-entry phase of COPAR, which of the following implies that the potential host family is not good to live-
in?
A. House is strategically located in the community
B. Neighbors are hesitant to enter the house
C. No member of the host family should be moving out in the community
D. Should not belong to elite/rich segment
E. None of these
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

4. Nurse Natasha is in the Social Analysis phase of COPAR if she is doing which of the following activities?
A. Setting up linkages and network referrals
B. Training of CHO workers
C. SALT (self-awareness leadership training)
D. Implementation of livelihood projects
E. Conduct community diagnosis
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

5. Evaluation is a systematic, critical analysis of the current state of the organization and/or projects compared to desired
or planned goals or objectives. In evaluation, there are two areas of evaluation, one of which is program-based evaluation.
The following are the evaluation parameters for program-based, except:
A. Were the goals and objectives of the program/project achieved?
B. What strategies were implemented? What worked? What did not?
C. What is the level of participation in the affairs of the community organization?

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 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

D. What is the overall impact of the project on the community?

E. None of these
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

6. Methodologies are determined by the community.

A. COPAR
B. Traditional research approach
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

7. The data analyst is the nurse

A. COPAR
B. Traditional research approach
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

8. Which among the following best describes community immersion program (CIP)?
A. CIP refers to hands-on experience in a community nearby.
B. It is a related learning experience program which requires student nurses to live and work in the community.
C. Student nurses implement public health programs.
D. Student nurses assume the role of a public health nurse to a selected population.
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

9. The main aim of conducting an immersion program to a remote area is:

A. For the students to learn
B. For the students to apply their basic skills
C. Bring the health programs to people who cannot access it
D. To give to the people what they need
Answer: ________
Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

10. Community Immersion program aims student nurses to develop their:

1. Competency in basic nursing skills
2. Interpersonal skills
3. Understanding regarding their social accountability
4. Leadership skills Choices:

A. 1, 2, 3 and 4
B. 1, 3 and 4
C. 2, 3 and 4
D. 1, 2 and 4
Answer: ________

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 10

 Community Health Nursing II (Population Groups and
Community as Clients)

Module #8 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Rationale:________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

C. LESSON WRAP-UP

AL Activity: Formative Assessment

This strategy focuses on the assessment of your learnings after a lesson. You must answer the following questions, as
honest as possible, based on your own understanding.

1. What specific part of the Main Lesson for this session do you find the most confusing?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_____________________________________________________________________

2. What makes your answer in #1 confusing? What is the question in your mind?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_____________________________________________________________________

3. Since that is your most confusing lesson, what are the interventions that you must do to understand the topic?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_____________________________________________________________________

THIS DOCUMENT IS THE PROPERTY OF PHINMA EDUCATION 11