Term: First Semester S.Y.

2023-2024
Dates: Week 15 – November 20-22, 2023
Class Schedule: 7:00AM – 3:00PM shift
No. of Hours: 8 hours per day

Learning Outcomes
At the end of this module, you are expected to:
1. Review the concepts of community health nursing, Philippine health care delivery system, expanded
program on immunization, epidemiology, and vital health statistics.
2. Utilize presented information to calculate for the morbidity, mortality, and fertility rates of a community.
3. Explain appropriate nursing interventions per problems identified.
4. Apply bioethical concepts/principles, core values, and nursing standards in the care of population
groups and communities.

As you start with this module, you are free to consult and coordinate with me. Be sure to get my email
address and contact number for collaboration and assistance. Just keep going, you can do it!

Hello, future nurse!

Welcome to your sixth module. You have first learned about this concept back when you took Community
Health Nursing when you were a second-year nursing student. You learned about what community health
nursing is, what is primary health care, what is the healthcare delivery system in the Philippines, and what
are the programs of the Department of Health. Just recently, you have also been taught about Community
Organizing and Participatory Action Research. Let us have a review of these concepts and see how much
you recall.

Phases in COPAR
According to Sr. Carmen Jimenez, the phases of COPAR are as follows (7):
1. Pre-Entry
2. Entry
3. Community Diagnosis / Study
4. Community Organization / Capability-Building Phase
5. Community Action
6. Sustenance and Strengthening Phase
7. Turn-Over / Phase-Out

According to the University of Sto. Tomas – NSTP (2012), however, the phases of COPAR are as
follows (10):
1. Pre-Entry
2. Entry into the Community
3. Community Integration
4. Social Analysis
5. Identifying Potential Leaders
6. Core Group Formation
7. Community Organization
8. Action Phase
9. Evaluation
10. Exit and Expansion Phase

Despite the apparent difference in the number of phases contended by the two proponents, however, the
phases and the chronology of each phase actually are similar, starting from Pre-Entry and ending the
whole process with the Turn-over or Exit and Expansion Phase. At the end of the day, both proponents
intend that, at the end of the completion of each phase, a self-reliant community will be produced.

Are you done reading? Great! You are now ready for the next section of this module
Focus: Community Organizing – Participatory Action Research (COPAR)
You have learned about the phases of COPAR a while ago. This time, you need to provide the salient
activities for each phase and what should the nurses do and remember in each of the phases. You may
write in a separate paper if the boxes provided are too limited for you. Best of luck!

COMMUNITY SCENARIO

Disclaimer: This community scenario is not based on a real case. This is made entirely for the purpose of the group case
presentation.

The BSN13F Group 28 will be having their community health

nursing II rotation for 2-weeks in Barangay El Salvador in Toril.
They were assigned by the Barangay Captain, Brgy. Captain
Michelle Dee, in Purok 2 for their community exposure.

The students are now expected to conduct activities relating to the

concept of COPAR in Barangay El Salvador. The barangay is
known to be struggling out of all the barangays in Toril DIstrict.

Phases in COPAR Activities Nurse’s Responsibilities

The group chooses to follow the 7 Phases of COPAR by Sister. Carmen Jimenez, DC

● Formulate overall objectives for the ● Make sure that the objectives are
2-week stay in Barangay El Salvador. SMART, specific, measurable,
Making sure that the objectives also is attainable, realistic, and
anchored to the Davao Doctors college time-bounded.
mission, vision, and core values ● Assigned leaders and key-persons
● Assign leaders and key-persons for the should be responsible. These are
2-week stay in Barangay El Salvador. essential for the overall progress
Who is the group’s of the community organizing.
○ Community organizer/Team ● During community consultations
leader and dialogues with the
○ Training coordinator community leaders and the
○ Health service coordinator barangay residents, good
○ Budget coordinator behavior and conduct should be
Pre-entry phase ● Community consultations/dialogues implemented. Language that is
○ Make an appointment with the being used during these dialogues
village/community leaders alongside should be easy to understand for
with the Barangay Captain Michelle the barangay residents. (Ex. Use
Dee. of Bisaya-Tagalog)
○ Discuss with the village/community ● Thoroughly assess potential
leaders about the usual problem of community health project sites,
 the community, the census, the considering demographics,
number of families belonging to prevalent health issues, existing
Barangay El Salvador Purok 2 and so healthcare infrastructure, and
on. socio-economic conditions.
○ Discuss if the barangay is in peace Actively engage with
and order. community members, utilizing
○ Discuss if the barangay is accepting participatory approaches to
of the possible programs that the understand their needs and
students will implement during their involve them in
stay. decision-making.
○ Discuss if the area is being served by ● Assess the chosen site's
similar agencies or programs. accessibility for both
○ Formulate good objectives targets healthcare providers and
for the community based on the community members,
dialogue with the village/community considering infrastructure,
leader. transportation, and
● Setting of issues/considerations related communication. Apply DOPES
to site selection criteria to gauge community
○ Consider the “DOPES” and “Virgin” need and vulnerability,
community people as a examining factors like family
consideration for site selection. income, opportunities, and
● Development of criteria for site health status. Employ VIRGIN
selection criteria to identify communities
○ Development of criteria must be untouched by existing
aimed towards helping a struggling organizations or COPAR,
and unserved community emphasizing areas lacking
○ DOPES criteria may be employed. health interventions. Conduct
This stands for Depressed, the selection process ethically
Oppressed, Poor, Exploited, and culturally, respecting
Struggling. community autonomy and
■ High % of family income obtaining informed consent for
below National poverty potential health interventions.
threshold ● Initiate contact with local
■ Lack of income opportunities government units (LGUs) to
of the residents inform them of the planned
■ Poor health status - application of the COPAR
malnutrition rate, infant approach in the identified
mortality rate, lack of community. Clearly articulate
sanitary toilets, incidence of the potential impact of the
communicable diseases project on community health
○ VIRGIN community criteria may be and well-being. These
employed. This may mean that the communications specifically
community is not yet touched by highlight areas where
any existing organization or has not assistance is needed, whether
undergone the COPAR approach in the form of monetary
yet. support, expertise, or in-kind
● Networking with local government units contributions.
(LGUs), NGOs and other departments ● Confirm demographic details
○ Reach out to the LGUs regarding and establish transparent
the plan of applying the COPAR communication channels with
approach to the identified the community leader. Obtain
community. informed consent and respect
○ Reach out/Solicitation to other the autonomy of community
NGOs regarding the planned members during the site
 COPAR application to the selection process.
identified community. Also, asking Comprehensively document
for any assistance (Ex. monetary findings and decisions,
assistance). including community
● Site selection consultations.
○ Determine if Barangay El Salvador ● Identify healthcare facilities
Purok 2 is fit for the DOPES and and basic utilities, and
virgin community criteria. establish communication with a
○ Ensure that Barangay El Salvador designated contact person in
has 100-200 families as its the barangay.
constituents. Confirm to the ● Document demographic details,
village/community leader about taking into account the number
the total population of the of family members, age groups,
barangay and any specific health
● Preliminary social investigation (PSI) considerations that may be
○ Conduct a record review of the relevant.
existing information and data ● Evaluate transportation options
about the barangay. Ask for these and infrastructure to ensure
data from the office of the that healthcare providers can
barangay or the barangay health easily reach the community and
unit that residents can access health
○ Identify if there is presence of services efficiently. Moreover,
community health centers, student nurses should take note
hospitals, care facilities and so on. of natural features such as hills,
○ Identify if there is a presence of bodies of water, and any
water and electricity connection. geographical challenges that
○ Identify the possible contact might impact healthcare
person in the barangay. delivery.
● Prepare a list of families that are in the ● Document relevant details such
barangay. as the topography, land use
● The group will now conduct an ocular patterns, and the presence of
survey and house-to-house interviews of key landmarks. Simultaneously,
the barangay that is assigned to the demographic data should
group. Taking note of the following: include age groups, family
○ Accessibility sizes, and other pertinent
○ Geographic terrain information that contributes to
○ Settlement patterns a nuanced understanding of the
○ Safety community's composition.
○ Available physical resources ● Encourage collaborative
○ Number of families decision-making and community
● Develop a community profile from engagement in the
the data that is observed by the development and
students in the area. implementation of effective
○ Community profile must health initiatives.
include – geography and
demographic profile,
socio-economic status,
infrastructure/physical
resource, health conditions
and problems, and the
community problem
● Coordinate with the LGU and the
barangay officer.
● Conduct staff meeting with the
 community leaders or residents of the
barangay about the following:
○ Project proposal
○ vision , mission, and
objectives
○ Assistance expected from the
students
○ The local health situation
○ Level of expectations
○ Upcoming activities
● Conduct staff planning and strategy
for the entry phase.

Entry phase ● Integrate with the barangay ● Actively engage with the
residents. Establish rapport to the barangay residents and the
residents and the staff involved. staff showing empathy and
● The students will communicate with respect to establish trust and
the residents and ask about the rapport.
barangay’s history, lifestyle, ● Engage in conversations with
community life, hopes and the residents with active
aspirations. listening and showing genuine
● Conduct home visits interest.
○ Vital signs checking ● Interact with the residents on
○ Physical assessment checking how they can see their
○ Health teaching community a year from now in
○ Survey order to know the concerns
● Helping with the barangay residents they have been experiencing.
with their day-to-day activities to get ● Motivate residents to share
to know them more. (Collecting their ideas on how they manage
water, baby setting, cleaning their their concerns in their
backyards, etc.) community.
● Conduct deep social investigation ● Check vital signs, perform
○ Identify the issues in the physical assessments, integrate
barangay health teachings, and
○ Identify the measures the interviews during home visits.
residents make when they ● Elaborate to the residents the
have a community problem importance of their active
● Inform the residents about the participation in identifying the
proposed plan based on the identified problem in their community
problem by the students. and how they can participate.
○ House-to-house information ● Explain precisely the proposed
dissemination plan using the language they
○ Small group discussion with can easily understand.
the barangay workers ● Document any community-made
● Prepare for the possible core group solutions during issues or crisis
members for the barangay. that occurred.
○ Explain to the core group
what is their function and
role in the community
○ Identify possible community
health workers or CHWs
● The students will conduct basic
health services
○ Vital signs checking
 ○ Weighing children
○ Assessing the community as a
whole
● Present to the barangay the results of
the survey and interviews conducted
by the students.

Community ● The students will now use the ● Ensure that the research process is
Diagnosis/Stud Participatory action research in this conducted accordingly, that focus
phase. on community health.
y
● Use the results of the community ● Analyze the data collected for us
study for making the list of the to identify the health needs and
community problems that are priorities of the community.
perceived by the community ● Student nurses should facilitate
residents. and guide community members.
● Be knowledgeable of the prevalent
diseases, health practices, and
environmental factors and conduct
health evaluations, addressing
physical, mental, and social
aspects of health.
● Cultural awareness should be given
importance since it is vital in
respecting and understanding
others beliefs in the community.
● Make sure that the voices of the
community members are heard.

Community ● The core group members alongside ● Conduct health assessments to

Organization/ the students will conduct an Election ensure that participants are fit to
of officers. engage in the election process.
Capability-Build
● Determine the roles of each core This may include screening for
ing Phase group member. symptoms of illness.
● Conduct team building activities with ● Conduct skills assessment for
the core group members. They may each member to identify areas of
also include other responsible expertise, training needs, and
residents in the activity. potential leadership roles based
● Conduct an on individual skills check.
Action-reflection-action-session ● Provide guidance on safety
which will provide training and precautions to prevent injuries
evaluation. during team building activities.
● Conduct self-awareness leadership ● Provide help for mental
training small discussion/seminar well-being by noticing if someone
among the core members or the seems stressed or upset during
potential leaders of the barangay. the talk or meeting. Give
○ Divide the core group information, suggest places to get
members into smaller groups help, or guide them on how to
and let them decide what are find support for their mental
the problems they have health if they need it. Create a
identified in the community friendly and helpful atmosphere
based on the results the for everyone’s well-being.
students presented to them. ● Help the smaller groups find
health issues in the community
using the information given. Make
 sure they really look into health
problems and talk about ways
nurses or the community can help
fix these issues.

Community ● The students train the core ● Evaluate the health requirements
Action members/potential leaders of the of the main members/future
barangay. leaders, give lessons on important
○ Endorse the core topics like first aid and
members/potential leaders cleanliness, and make sure they
to Barangay Captain Michelle stay healthy throughout the
Dee. training.
○ Register them to the LGU if ● Collaborate with core
needed. members/potential leaders to
● The core members/potential leaders find activities that can improve
of the barangay will be asked by the health in the community. Give
students to propose an activity that is advice on ways to promote health
deemed needed for the barangay. and prevent diseases to make the
● Implement the proposed activity of suggested activities better.
the core members/potential leaders. ● Watch over the health parts of
The students will assist the core the activity, making sure it's safe.
group with their activity. Provide on-site health support,
such as first aid services, and
address any health-related
concerns that come up during the
activity.

Sustenance and ● Assist the core group members with ● Monitor the financial and
strengthening developing the financial and management system used and
management system for the make sure that the assigned
Phase
barangay. resources are used well to
● Assist the core group members with promote the overall health and
their registration to the Security and well-being of the community.
Exchange commission to legalize ● Educate and inform the core
their existence. group members about the
● Institute continuing education and importance rules with the SEC to
upgrade of knowledge, skills, and make sure their organization is
attitudes of the community leaders, recognized
barangay health workers, and ● Create and work together about
barangay office members. ongoing learning programs that
are made to fit the specific needs
of community leaders, barangay
health workers, and barangay
office members.

Turn-over/Phas ● The students will inform the

e-Out phase community residents that they will ● Provide thorough education on
now be leaving the community. Ask self - care, including medication
them to fully cooperate with the core management, symptom
group members/barangay leaders. recognition and strategies for
● The students will endorse the maintaining overall health.
barangay leaders/core group ● Continuously monitor patients
members to Barangay Captain progress and response to the
Michelle Dee and all concerned transition.
 personnel. ● Implement a plan for follow up
● The students will conduct a follow-up care, ensuring patients receive
session with the residents and the appropriate support and
barangay leaders/core group monitoring.
members if needed. ● Advocate for patients preference
during turn over. Ensuring their
preferences are considered and
respected.
● Ensure that all necessary
information about the patient are
being conveyed to the receiving
healthcare team.

Reference/s:

Carmen, J.E. (2008). Community organizing participatory action research for community health
development. C&E publishing, Inc.

It has been mentioned that the most essential element in COPAR is COmmunity
PARticipation. In this regard, you, as the community health nurse, must ensure that the
community will elect a leader to whom they will not need to have difficulty reaching out
to discuss community problems. You will also ensure that the place where the
community members will gather and meet to discuss health-related problems that
concerns the community is agreeable to all of the residents of that community. To this
end, answer the following question(s):

What are the considerations that need to be kept in mind when selecting a leader
within the community and the place of gathering to discuss community problems
in the community? Discuss.

The process of choosing a leader within a community and deciding on the

suitable location for addressing social issues are essential considerations that need
careful consideration. First and foremost, the selected leader should exhibit
attributes such as honesty, empathy, and effective communication skills. Integrity
guarantees that the leader behaves in a morally honest and open manner, therefore
earning the trust of community members. Empathy enables the leader to comprehend
the many needs and concerns of the community, developing a sense of unity.
Competent communication abilities are crucial for transmitting information,
establishing agreement, and settling disputes. In addition, it is crucial for the leader
to possess a deep comprehension of the community's values, culture, and history. This
will enable them to make decisions that are in accordance with the community's
identity.

In terms of site selection, accessibility and inclusion are important

considerations. The location should be conveniently reachable for all community
members, taking into consideration variables such as transportation, proximity, and
physical barriers. This guarantees the participation of a wide variety of opinions in
discussions. Inclusion includes the establishment of a hospitable setting that caters to
persons with different capabilities, ensuring their active engagement in the
conversation. Furthermore, the selected location should be unbiased and free of any
associations that may influence the discussions.This promotes the development of a
transparent and unbiased environment where community issues may be handled in an
objective manner.

In addition to this, it is vital to take into consideration the cultural and social
dynamics of the community. It's possible that certain communities have areas that are
historically significant or have served as usual gathering places, both of which hold
symbolic importance. The selection of such venues has the potential to strengthen
feelings of shared pride and identity. However, it is essential to find a balance
between practicality and tradition and to make certain that the location selected is
able to meet the requirements of the whole community.

In conclusion, the selection of a leader and the choosing of a meeting site are
both complex procedures that need an in-depth appraisal of individual attributes, the
dynamics of the community, and the considerations of the logistics involved. A
community may build a foundation for meaningful conversations and collaborative
problem-solving by placing an emphasis on honesty, empathy, effective
communication, accessibility, inclusion, and cultural sensitivity. This, in turn, will
contribute to the general well-being and unity of the community's members.