COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC

1st SEMESTER MIDTERMS

LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

COMMUNITY HEALTH ASSESSMENT TOOLS Structured is where the nurse directs the talk based on
an interview guide.
The Community Health Nursing Process emphasizes the
active involvement of the clients in its care. In collecting Unstructured is where the informant guides the talk.
data, different methods may be utilized to generate
health data. COMMUNITY FORUM
Community Forum is an open meeting of the members
COLLECTING PRIMARY DATA of the community. “Pulong-pulong Sa Barangay” is an
illustration of a community forum This offers the nurse an
Observation information regarding community perceptions on their
- It is an act of extracting information from needs, health and health care.
subjects being studied.
FOCUS GROUP
A. OCULAR SURVEY OR WINDSHIELD SURVEY
- Focus group is made up of much smaller group
This involves rapid observation of a community and usually 6-12 member only
performed either by walking through it, driving or riding in - Assessment of health needs of specific groups
a vehicle.
SECONDARY DATA SOURCES
This gives the nurse a chance to observe:
ACT 3753 (Civil Registration Law, Philippine
PEOPLE. Legislature)
Spot vulnerable groups and people’s appearance.
Enacted in 1930, established the civil registry system in
ENVIRONMENT. the Philippines and requires the registration of vital
Terrain, Homes, Housing Density & Cleanliness, events such as births, marriages and deaths.
Vegetation, Street Animals
RA 7160 (LOCAL GOVERNMENT CODE)
FACILITIES / COMMUNITY RESOURCES
Health Facilities, Barangay Halls, School, Places of assigned the function of civil registration to local
Worship, Open Spaces governments and mandated the appointment of Local
(city / municipal). Civil registrars.
The nurse talks to people to know their perception of
“healthy community” and their “community facilities” PSA / NSO

B. PARTICIPANT OBSERVATION serves as the central repository of civil registries and the
PSA/ NSO Administrative and the Civil Registrar General
Purposeful observation of formal and informal of the Philippines.
community activities by sharing in the life of the
community. Helps in determining the following in a Reliable civil registration and vital statistics provide
realistic basis for program planning and implementation.
The birth and death registries are of particular
importance to the nurse, since they are sources of
fertility and mortality data.

● Either parent may also register the birth.

● The birth of a child should be registered within 30 days

community: from the occurrence of the birth at the Local Civil
Registry Office of city or municipality where the birth
FORMAL COMMUNITY occurred

- activities are barangay assemblies, school Presidential Decree 856. Sanitation Code
parent-teacher meeting, church meeting.
Office of the President, requires death certificate before
INFORMAL GATHERINGS burial of deceased
- are in variety of setting such as sari-sari store,
community recreation area or schools.

SURVEY
- It is made of series of questions for systematic
collection of information from a sample of
individuals or families in a community.

INFORMANT INTERVIEW

- Key informant interviews are qualitative in-depth

interviews with people who know what is going on in the
community. HEALTH RECORDS AND REPORTS
- The purpose of key informant interviews is to collect
information from a wide range of people— including Executive Order No. 352 (Office of the President,
community leaders, professionals, or residents—who Republic of the Philippines, 1996), the Field Health
have firsthand knowledge about the community. Service Information System (FHSIS)
INTERVIEW MAYBE STRUCTURED OR
UNSTRUCTURED
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

This is the official, recording and reporting system of the

National Statistical Coordination Board (NSCB) to ● b. Morbidity Report (M2) contains a list of all cases of
generate health statistics. disease by age and sex.

The FHSIS is an essential tool in monitoring the health 2. Quarterly Forms are usually prepared by the nurse.
status of the population at different levels. There should only be one Quarterly

A basis for: Form for the municipalities / cities with two or more
RHUs or health centers, consolidation is done under the
1) priority setting by local governments direction of the Municipality / City Health Officer.
2) planning and decision making at different levels
(barangay, municipality, district, provincial, and national) Quarterly forms are submitted to the Provincial Health
3) monitoring and evaluating health program Office.
implementation
a. Program Report (Q1) contains the 3- month total of
THE FHSIS MANUAL OF OPERATIONS (DOH-IMS, indicators categorized as maternal care, family planning,
2011) LISTS AND DESCRIBES THE FOLLOWING child care, dental health and disease control.
RECORDING TOOLS:
b. Morbidity Report (Q2) is a 3-month consolidation of
INDIVIDUAL TREATMENT RECORD (ITR) Morbidity Report (M2).

Individual Treatment Record (ITR) - foundation/building 3. Annual Forms

block - piece of paper - patient consultation record
a. A-BHS is a report by the midwife that contains
a. Complaints/presenting symptoms demographic, environmental and natality data.
b. Diagnosis
c. Treatment given b. Annual Form 1 (A-1) is prepared by the nurse and is
d. Date, name, address of patient, etc. the report of the RHU or health center. It contains
demographic and environmental data, and data on
TARGET CLIENT LISTS (TLCs) natality and mortality for the entire year.

Are the second building block of the FHSIS. These c. Annual Form 2 (A-2), prepared by the nurse, is the
service records have the following purposes: yearly morbidity report by age and sex.

a. To plan and carry out patient care and service delivery d. Annual Form 3 (a-3), also prepared by the nurse, is
since midwives and nurses use TCLs to monitor target or the yearly report of all deaths (mortality) by age and sex.
eligible populations for particular health services.
DISEASE REGISTRY
b. To facilitate monitoring and supervision of service A listing of persons diagnosed with a specific type of
delivery activities. disease in a defined population.
(1) priority setting by local governments
(2) planning and decision making at different levels Data collected through disease registries serve as a
(barangay, municipality, district, provincial and national) basis for monitoring decision making and program
management.
THE SUMMARY TABLE
The Department of Health has developed and
It is a 12-column table in which columns correspond to maintained registries for HIV / AIDS and chronic non
the 12 months of the year. communicable disease, particularly cancer, diabetes
mellitus, chronic obstructive pulmonary disease and
This record is kept at the BHS and has two components: stroke.
Health Program Accomplishment and Morbidity /
Disease. CENSUS DATA

The Summary Table is supposed to be updated on a It provides for a national census of population and other
monthly basis. The Health Program Accomplishment related data in the Philippines every 10 years.
provides the midwife with a tool for assessment of
accomplishments and a ready source for reports. The NSCB is the policy-making and coordinating body of
the PSS. NSO is the PSS arm that generates general-
The monthly summary of morbidity gives information on purpose statistics: population, employment, process and
the monthly trend of disease and serves as a source for family income / expenditures
the 10 leading cases of morbidity in the municipality /
city. During a census, people may be assigned to a locality by
de jure or de facto method. De jure assignment is based
Monthly Consolidation Table (MCT) is accomplished on the legally established place of residence of people,
by the nurse based on the Summary Table. whereas de facto is according to the actual is according
to the actual physical location of people.
The REPORTING FORMS are the following:
METHODS TO PRESENT DATA
1. Monthly Forms Are regularly prepared by the midwife
and submitted to the nurse who then uses the data to GRAPH
prepare the Quarterly Forms
Bar graph. To compare values across different
● a. Program Report ( M1) contains indicators categories of data
categorized as maternal care, child care, family planning Line-graph. Visual image of trends in data over time or
and disease control. The midwife copies the data from age
the Summary Table
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

Pie-chart. Show percentage distribution or show 1. Total population, geographic distribution, including
composition urban-rural index & population density
Scatter plot or diagram. Show correlation between two 2. Age and Sex composition
variables 3. Household size
4. Selected Vital Indicators such as growth rate, crude
PURPOSES birth rate, crude death rate & life expectancy at birth
5. Patterns of Migration
Inform health teams and members 6. Population Projections

Make member of community appreciate the significance B. SOCIO-ECONOMIC & CULTURAL VARIABLES
of health information in their lives Solicit broader support
Validate findings. 1. SOCIAL INDICATORS

COMMUNITY DIAGNOSIS 2. ECONOMIC INDICATORS

a. Poverty Level Income
(Freeman and Heinrich, 1981; and Muecke, 1980) b. Unemployment & Underemployment Rate
c. Proportion of Salaried & Wage earners to total
Determining community health status is a process called economically active population
community assessment. It is the process of community d. Types of industry present in community
diagnostics keystone in developing community health e. Occupation common in the community
nursing process. f. Communication network (whether formal or informal
channels) -health info or referral
(1) PHN collects data about community to find different g. Transportation systems (Road networks) accessible
factors that directly & indirectly influence health of health care
population.
3. ENVIRONMENTAL INDICATORS
(2) Analyze & seeks explanation to the occurrence of Consist of:
health needs & problem of community. A. Physical / geographical / topographical characteristics
o Land areas that contribute to vector problems
COMMUNITY DIAGNOSIS: TYPES o Terrain characteristics that contribute to
accidents or pose as geohazards zones
1.Comprehensive Community Diagnosis o Land usage in industry
- General information about the community o Climate / Season
b. Water supply
2.Problem-Oriented Community Diagnosis o population with access to safe, adequate water
Made to responds to a particular need of a target group supply
o Source of water supply
COMPREHENSIVE COMMUNITY DIAGNOSIS
c. Waste disposal
o % population served by daily garbage collection
AIM
system
to obtain general information of community
o % population with safe excreta disposal system
APPROACH: o Types of waste disposal and garbage disposal
system
(EPIDEMIOLOGIC APPROACH) determining prevalent
health conditions and risk factors 4. CULTURAL FACTORS
a. Variables that may break up the people into groups
(BEHAVIOR APPROACH) determining lifestyle, within the community such as:
behaviors, attitudes that affects their health • Ethnicity, Language, Race
• Social class Religion Political orientation
(SOCIO-ECONOMIC APPROACH) Determining socio- b. Cultural beliefs and practices that affect health
economic condition. c. Concepts about health and illness
PHN collects primary data about leading causes of
PROBLEM-ORIENTED COMMUNITY DIAGNOSIS illness & deaths & rates of occurrence. If he accesses to
recent, reliable secondary data, then he can also make
This assessment responds to particular need of a target use:
group. 1. Leading causes of Mortality
2. Leading Causes of Morbidity
-The PHN will investigate the community: the people, its 3. Leasing Causes of Infant and Child Mortality
environment. 4. Leading Causes of Hospital Admissions
5. Leading Causes of Clinic Consultation
PHN will identify the population affected characterize info 6. Nutritional data
specific to the problem: biophysical, psychological,
physical environment, socio-cultural & behavioral as well D. HEALTH RESOURCES.
as health system factors. • Essential element in delivery of basic services in
community.
ELEMENTS OF COMMUNITY DIAGNOSIS • PHN determines manpower, institutional & material
resources provided by states & those from private sector
A. Demographic Variables & other NGO.
B. Socio-Economic & Cultural Variables
C. Health & Illness Pattern It consists of:
D. Health Resources a. Manpower Resources
E. Political / Leadership Pattern MANPOWER Resources
• Categories of health manpower available
A. DEMOGRAPHIC VARIABLES • Geographical distribution of health manpower
• Manpower-population ratio
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

• Distribution of health manpower according to health  Structured and Unstructured interview

facilities (hospitals, rural health units, etc.) • face-to-face interview
• Distribution of health manpower according to type of • telephone interview
organization (government, non-government, health units, • individual interview
private) • group interview;
• Quality of health manpower • key informant interview (KII)
• Existing manpower development / politics d. Focus Group Discussion /FGD
Set a characteristic of the participants in terms of:
b. Material Resources • characteristics common to them
MATERIAL Resources • characteristics that will differentiate them from one
• Categories of health institutions available in the another
community • Participants are selected based on the variable being
• Hospital to population ratio studied
• Categories of health services available • A qualitative research technique utilizes for its value in
understanding & documenting human behaviors
E. POLITICAL / LEADERSHIP PATTERN • A FACILITATOR, will summarize & synthesize the
• Vital element in achieving goal of high-level wellness discussion to make certain that issues have clarified
among people. rather than confused participants
• Reflects action potential of state & people
• Address health needs and problems of the people. 5. Developing the instrument
• It mirrors SENSITIVITY of government to the people’s Instruments or tools facilitate the nurse’s data
struggle for better lives. gathering activities.
Most common are: Survey questionnaire, focus group
The nurse describes the following: discussion guide, key informant interview guide,
a. Power structures in the community (formal or informal) observation checklist.
b. Attitudes of the people toward authority
c. Conditions / events/ issues that cause social conflict / a. Survey Questionnaire Or survey instrument.
upheavals or that lead to social bonding or unification A form one uses to document the date being collected.
d. Practices / approaches effective in settling issues & Can be:
concerns within the community a. Interview schedule – PHN reads question & record
responds
Steps in Conducting Community Diagnosis b. Self-completed or self-administered questionnaire -
respondents read question & write down responses.
To define community health problems, it vital to
determine occurrence & distribution of selected b. Focus Group Discussion Guide
environmental, socio-economic & behavioral conditions Guide to facilitate course & flow of ideas on definite
both for comprehensive & problem-oriented com dx. topics / concepts among participants.
(Denver, 1980). Specify objective of discussion & characteristic of
participants
1.Determining Objectives
• The following questions should be answered: c. Key Informant Interview Guide
o a. What is the present health condition of people Person being interviewed is selected because of his
in the community? expertise or concern to the subject matter.
o b. Why are the people in the community in such Not necessary adhere to sequence
condition? What specific problems are causing Set of guided question about the subject. To be effective
these conditions? - Be conversant, have working knowledge about subject
o c. What are the roots of these problems? matter.
o d. What solutions will address the problems?
d. Observation Checklist
2. Defining the study population List of data that are manifestation of health needs or
• This may include the: problems.
o Entire population in the community or Physical, environmental hazards, health resources:
o Focused on a specific population. facilities, personnel, services
o Sample or sub-set of target population if a
6. Actual Data Gathering
complete enumeration of the desired population
• Preparation before interview:
is not feasible.
o meet teams involved in data collection.
o Instruments are discussed & analyzed. Modified
3. Determining the data to be collected
• Achieved by developing data collection plan in which or simplified Instruments because of time
objectives are used to guide data collectors. Data can be limitation and so as not to burden those limited
categorized as primary and secondary. education.
o Pre-testing the instrument
4. Collecting the Data o Data Collectors are given orientation & training
Methods Of Data Collection: on how to use the instruments.
o A role – play of data collection can be performed
a. OBSERVATION
• Extracting information from subjects by observing • Teach data collectors
behaviors & environment. PARTICIPATORY TOOLS & TECHNIQUE
• Ocular survey / Windshield survey • These are creative and innovative method that will
• Participant Observation increase participation of people in data collection
• These are alternative to customary household survey
b. RECORDS REVIEW because it takes too long to finish.
written information kept in folders, files or books
• PARTICIPATORY TOOLS & TECHNIQUE
c. INTERVIEWS
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

- Participatory tools are non-threatening & simplify data o With the aid of Flashcard in which an assigned
gathering number or letters will correspond to specific
category of choices.
Semi-structured Interviews o It offers CHOICES to respondent to select from
o Informal, guided interviews session in which & will serve as CATEGORIES for collating
some questions are pre-determined. A new responses.
question or lines of questioning arise during the o Use of flashcard to aid respondent select
interviews which is in response to answers from answer is performed for very young respondents
those interviewed. or respondents with limited education.

Analytical Games o Open – Ended Questions.

o This is for quick means of finding out an o Categories are created only after data collection
individual's or a group's list of priorities or is over. It is constructed from responses in
preferences. randomly selected questionnaires.
o Ex. Anung Dahilan at hindi kayu nag Family
Stories and Portraits Planning?
o short, colorful descriptions of situations Response 3 Mahal
encountered by PHN in the field. These also Response 14 Nakakataba
stories recounted by people Response 19 Walang pambili
Response 29 Sumasakit ulo ko pag nag-take
Diagrams ako ng pills
o Simple, schematic devices that presents Possible categories are: Financial: Responses 3,
information in readily understandable visual 9 Side Effects: Responses 14, 29
forms. These are analytical procedures, a
means of communication between and among Summarizing The Data
different people.
•Next step after categorizing responses
Workshop • Two (2) ways to summarize data.
o Bring people together. (1) Manually by tallying the data
o Outsiders can be introduced to participate (2) By using computer
actively in reviewing, analyzing & evaluating the •Tallying involves entering responses into prepared tally
information gathered. sheets showing all possible responses.
o An outsider is needed for their skills and
experience

• After the data gathering:

• PHN checks filled-up instruments to see its:
completeness, accuracy and reliability of information
collected.
• If with problems in accuracy or reliability, go back &
secure appropriate information. The only way to maintain
integrity and good quality of data for community
diagnosis.

7. Data Collation •For tallying by computers such as using software

This refers in putting the facts “together. such as EPIINFO involves the use of a Coding such as a
number or codes.
Two Data that are generated:
a. Numeric and
b. Descriptive Data

• Categories for classification of responses either

mutually exclusive and exhaustive.
• Others are: Summarizing Data from Fixed Response
8. Data Presentation
and
Presentation will depend on the data:
• Open – Ended Questions.
o Mutually Exclusive Choice. The choices do not
o NARRATIVE REPORTS
overlap. Responses fall only in one category
o Descriptive Data are presented in narrative
among set of choices. True for numeric and
descriptive data. reports
o Ex. Place of Origin Luzon Visayas Mindanao o Ex. Geographic data history of the community,
belief regarding health and illness
o Exhaustive Category. It anticipates all possible
o TABLE OR GRAPHS
answers that a respondent may give.
o Ex. Types of Infants Feeding o Numerical Data is presented using table or
Breastfeeding graphs because it is useful in showing key
Bottle Feeding information making it easier on the type of data
Condensed Milk being presented.
Evaporated
Am o Types of Graphs and its Data Function
Mixed Feeding  Line Graph. Shows trend or changes in
Breastmilk and Am data with time or age with respect to
Breastmilk and Formula Milk some other variables

o Summarizing Data from Fixed Response.

COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

 Bar Graph or Pictograph. For CRITERIA FOR SCALING ARE THE FF:
comparison of absolute or relative a. Nature of the Condition / Problem presented
counts and rates between categories Classified as:
 Histogram or Frequency Polygram. • a. Health status
Graphic presentation of frequency • b. Health resources
distribution or measurement • c. Health – related
 Proportional or Component Bar Graph
or Pie Chart. Shows breakdown of a b. Magnitude of the Problem
group or total where the number of • refers to severity of the problem This is measured in
categories is not too many. terms of proportion of population affected
 Scattered Diagram. Correlation data for
data variables c. Modifiability of the Problem
• The probability of reducing, controlling or eradicating
9. Data Analysis. the problem
• This is the MOST crucial stage in community diagnosis
• This involves the quantification, description and d. Preventive Potentials
classification of data • Probability of controlling or reducing the effects posed
• Triangulation is performed. Consistency and validity of by the problem
data is checked. This is necessary because there are
multiple sources of data which were collected using e. Social Concern
different methods. • Refers to the perception of the population or the
• To help the PHN view and analyze which are indicators community as they are affected by the problem
of health problems & which factors give rise to health
problems, patterns in terms of human relations, time &
space are analyze.
• Magnitude & extent of the problem & their implications
can be derived by comparing them with standard
values or norms.

PROBLEM TREE ANALYSIS APPROACH

• representative of sectors of community should be
present during data analysis. PHN can facilitate data
analysis with the use of “Problem Tree Analysis
Approach

“PROBLEM TREE ANALYSIS APPROACH.”

An analogy that leaves and branches conditions are
manifestations of the over state of the plant and cause
by WHAT IT GETS from the soil in terms of nourishment
from the roots.
Planning Cycle
• It is a participatory approach o The PHN writes data in
3 x 12 inches size cartolina and post it on wall o Using FACTORS THAT AFFECT PLANNING PROCESS
manila paper or board the PHN draws a big tree that - Existing Health Policies and Legislations
details leaves, branches, trunk & roots. - Level of Technology in the area Economic
Resources
o Instruct people to look at data written in cartolina - Presence of programs and institutions
o Think which is the main / central problem then post it in
TRUNK; cause of problem post in ROOTS; effects post What is Planning?
in BRANCHES & LEAVES Planning is a process which involves steps that would be
o Afterwards, people are ENCOURAGE to give opinions, taken in the future to attain desired end. It is performed
comments, & reactions or seek clarifications on what or to source out and allocate resources
how the others view the problems.
CONCEPTS OF PLANNING
10. Identifying the community health nursing
problems. Futuristic
Change oriented
• Defining community health nursing problems Dynamic Process
• Helps PHN & team to decide with people actions that Flexible
will effectively address & improve community’s health. Continuous
Systematic process
Categories of their health problems are:
Approaches to Planning Health
a. HEALTH STATUS PROBLEMS
Increased / morbidity, mortality, fertility, or reduced Participatory Planning for Community Health
wellness capability - Primary Health Care Approach. Emphasizes the
need to work with people' as equal partners
b. HEALTH RESOURCES PROBLEMS towards the goals of increased individual &
lack / absence of manpower, money, materials, community control political efficacy, improved
institutions necessary to solve health problem quality of community life & social justice.

c. HEALTH RELATED PROBLEMS THREE IMPORTANT APPROACHES

with social, economic, environmental & political factor Community Approach – empowers people
that aggravate the illness-inducing situations Integrated Approach - Considers other dimension of
health as such lifestyle, environment, health care system
11. Priority – setting
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

Comprehensive Approach – Strikes at the root of the

problem Involves the collection, analyzing process of synthesizing
interpreting and information in a manner that provides a
The PRECEDE-PROCEED model is a comprehensive clear picture of the health status of the community.
structure for assessing health needs for designing,
implementing, and evaluating health promotion and other
public health programs to meet those needs.

3 ACTIVITIES IN SOCIAL ANALYSIS

- Nurse gathers data about the health status of

the community
- Nurse identifies and explains the problems
- Nurse projects what situation needs to be
changed, developed, maintained

2. GOAL AND OBJECTIVE SETTING

This answers 'where do we want to go?"

This a process that formulates the goal and objectives of

the health program and nursing strategies

Goal is the desired end Objective are more precise.

3. STRATEGY AND ACTIVITY SETTING

This answers "How do we get there?"

This defines the strategies and the activities that the

nurse and community set to achieve in order to realize
the goals and objectives.

It implies the identification of resources. In here, the

nurse facilitates the definite strategy or approach in
health program.

Resources, constraints of the program are estimated

3 ACTIVITIES

o Designing the health programs or services

o Budgeting
o Making a time plan or schedule

4. Developing an Evaluation Plan

The Planning Cycle
This answers the question, "How do we know we are
1. SITUATIONAL ANALYSIS there?"

Answers the question, 'where are we now?"

COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

This determine if the program is relevant, effective,

efficient and adequate. It involves two process, Social Mobilization
observation and measurement. process of bringing together all societal & personal
influences to raise awareness of & demand for health
Two approaches in evaluating program are qualitative care, assist in delivery of resources & services &
method and quantitative method. cultivate sustainable individual & community
involvement.
Three aspects of a program are process, impact and
outcome. The nurse uses an indicator to measure Community Organizing
program.
01. social development methodology utilize to facilitate
the process of forming and sustaining self- reliant and
self-determining communities

02. Effecting change through community participation

means: changing condition within the community then
people’s behavior, introducing new program and policy
that would impact health.

COMMUNITY ORGANIZING PARTICIPATORY

RESEARCH

01 INTENTION
o promoting transformation among participants
being studied, be partners in entire phases of
research - from design, data collection, analysis
& dissemination
IMPLEMENTINGCOMMUNITYHEALTH
INTERVENTIONS 3 Approaches of Development

Community Organizing

PARTNERSHIP AND COLLABORATION

Partnership is a collaborative relationship between two
or more parties based on trust, equality and mutual
understanding for: achievement of a SPECIFIED GOAL.

Collaboration.
Org. helps each other enhance their capabilities in
performing their tasks, as well as provisions of services.

IMPORTANCE OF PARTNERSHIP &

COLLABORATION
Gives peoples opportunities to learn skills in group
relationship, interpersonal relations, critical analysis and
decision-making in terms of democratic leadership.
Definition:
ACTIVITIES On How to Get Started in Partnership ●Transforms apathetic, individualistic & voiceless poor
and Collaborative Work into a PARTICIPATORY& responsive community\
1. Nurse involve all stakeholders in the process of mobilizing for RESOLUTION of problem.
partnership and collaboration with people
2. Working together face risk together, they must know PHASES OF COPAR
and trust each other How it is done?
3. Determines how each org. views problems, proposes  Preparatory Phase
to solve the problem and perceived how org can solve  Organizational Phase
the problem.  Education & Training
4. Should agree on the kind or level of relationship on  Sustenance-maintenance
better accomplishing group goal considering needs and
available resources I. Preparatory Phase
5. When org. agreed on the type of relationship, a. Area selection
formulate ground rules to becomes basis of decision- • DESIGN Criteria
making. o ACTUAL selection of site
b. Community Profiling
ADVOCACY c. Entry d. Integration
The nurse as an advocate, helps empower the people to
make decisions and carry out actions that have potential Community profiling
to better their lives. Contact person
Activities Involved in Advocacy. Contact person will help look for others who will assist
> Informing people rightness of the cause PHN in doing community profiling
> Thoroughly discussing with people, the nature of
consequence Content of community profiling? • Overview of
> Supporting people’s right to make a choice & act on community characteristic (pop., health-related
their choice facility/services, community)
> Influencing other's opinion
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

Community profiling provides overview of:

demographics, community health-related services &
facilities.

Entry/integration
-Know their culture/lifestyle
-Courtesy call
-Live w/ people

Purpose of integration?
- Rapport
- Understand the problem…. undergoing their
hardship

Guidelines: integration
- Adapt lifestyle
- Modest dwelling
- Avoid raising expectations
- Participate in production process
- Make house call/seek people III. Education and Training Phase
- Participate in SOME social activities • Purposes are: strengthen org.& develop capability to
- Recognize role/position of local authorities attend to community’s basic health health-care needs.
(Famorca,2013)
Education &training phase
II. Organizational Phase a. Conduct Community diagnosis
- This phase consists of activities that leads to the b. Training of health workers
formation of people’s organization. c. Health service/ mobilization

a. SOCIAL PREPARATION Conducting Community Diagnosis

b. SPOTTING/DEVELOPING POTENTIAL LEADERS - Data serve as basis of health programs
c. SET UP COMMUNITY ORGANIZATION
d. CORE GROUP FORMATION A. Conducting Community Diagnosis.
This is performed to come up with the profile of the local
SOCIALPREPARATION health situation. Basis for health program and services to
- sensitization of people on the critical events of be deliver in community. Nurse will: Assist people in
their life: developing plan & actual conduct of community
- share their ideas on how to manage their diagnosis. Asset identify, analyze, understand implication
problem of data collected.
- motivating to take collective action regarding this
problem B. Training of Community Health Workers.
Purpose of social preparation? After presentation of the result of community diagnosis,
It deepens our ties w/ the people the community now decides the roles that the community
health workers are expected to perform.
Spotting /Developing Potential Leaders
Training of Community Health Workers (CHW)
Characteristics of potential leaders: • Nurse will: After Community Health Workers are
> Not Necessary highly educated, from affluent family of named, conduct a Training Needs Assessment (TNA) to
community know level of health skills and knowledge trainees
> Important: the people identify with him, understand & possess. TNA serve as basis of health skills curriculum
articulate the problems that beset them to focus on required competencies.
> Advantage If: has relative wide influence- among poor
& elite TRAINING
>Important Consideration: willingness to work for desired • Purpose is to develop the leaders’ skills, knowledge
change and attitude

Core group formation EDUCATION

- Consist of identified potential leaders • Aims to heighten their awareness or consciousness on
- Foundation of organization existing community problems & its correlation with
- Diff characteristic, youth, women, worker existing social realities
- Committee
Education and Training Phase: Health Services
CORE GROUP Provision and Mobilization
Consist of 8 to 10 members who possess leadership • Organization now leads in undertaking activities that
potentials formed into a cohesive working group will solve problems community is confronted with.
• Involve organization in collective work: gives
Tasks of core group opportunities to test & strengthen collective spirit,
build/enhance confidence.
• Nurse will: to prevent frustration on part of people,
consider resources available & problem prioritization to
be addressed at a given time, while strengthening
collective spirit & enhancing community health worker’s
confidence (Gesmundo, 2010).

Education and Training Phase: Leadership –

Formation activities
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

• Continuous and sustained process of community METHODS USED IN COPAR

leaders’ development
• Leaders learn engaging in actual organizational 1.Action-Reflection-Action-Session
activities such as: 2.Consciousness Awareness
• conduct of meetings, assessment, planning, 3.Participatory and Mass-Based
implementation, monitoring and evaluation of activities. 4.Group-Centered and not Leader-Oriented

SUSTENANCE – MAINTENANCE PHASE COPAR GATHERING DATA METHOD

a. Leadership-formation activities
b. Inter-sectoral collaboration 01 Transect walk
c. Phase out In Ocular Survey, ask group from community to lead
walk. Ask critical questions, allow them to analyze &
LEADERSHIP-FORMATION…CONTINUOUS draw conclusion
PROCESS
Learn in actual organization activities…conduct meeting, 02 MAPPING - Allows people to view community in
planning of activities different perspective and to people deal with it effectively
Project/program management RESOURCE MAP is a geographic map depending on
Formal leadership training…. ex. financial purposes can be their source of livelihood or physical
resources.
Inter-sectoral collaboration
THE NEED FOR RESOURCES WILL BE SOURCED HEALTH MAP
EXTERNALLY ... network / linkages Health worker respondents draws SPOT MAP. Highlight
PHN Responsible …. COORDINATION…W/ KEY houses identified with health problems, houses with
PEOPLE, INSTITUTIONS, AGENCIES vulnerable members,
FOR SUPPORT…ASSISTANCE
SEASONAL MAP OR CALENDAR – Shows various
Nurse will: facilitate, coordinate with organizations event / activity significant to community such as
agency, key people livelihood (e.g., harvest season), social events (e.g.,
Christmas), Historical Mapping (e.g., typhoon in Area)
A. Networking
relationship among org. - exchanging information about 03 Venn Diagram – Visual representation of social
each other's goal, objectives, services or facilities Result: support system Venn Diagram
aware of worth & capabilities, how each other contribute
to accomplishment of network's goals & objectives o Big Circle – represents community
o Small Circle inside Big Circle – representing groups/
B. Coordination organizations in community
Orgs. modify their activities in other to provide better o Draw inside most active / influential group in the
service to target beneficiary. time-consuming, requires community
more involvement & trust on the part of committed o small circle outside the big circle represents
organization organization outside the community such as public or
private (govt or private institutions). Proximity or distance
C. Cooperation of these circle will symbolize their degree of influence in
sharing of information & resources, make adjustments in the community.
respective agendas to accommodate other organizations
agenda BASIC QUALITIES OF COMMUNITY ORGANIZERS

D. Collaboration 01 Exemplary Professional & Moral Qualities

Level of Org. partnership in which org. help each other 02 Good Communication & Facilitation Skills
enhance their capabilities in performing their tasks, as 03Ability To Set Good Leadership
well as provisions of services. People becomes partners 04 Charismatic Personality – Draws People to
NOT competitors Organizing Work
05 Adapts/ Enjoys Working & Living, With Different
E. Coalition or Multi-sector Collaboration Types of People
Org & citizens form a partnership where all parties give 06 Empathize with People / Community He Is Working
priority to the good of the community; requires great With
investment in terms of time, trust & will to make a 07 Believes in Vision of Change, Development /
change Empowerment
08 Personal Conviction Consistent with Values,
F. Advocacy Work (Kohnke, 1982). Principles Being Advocated
Informing people about the rightness of the cause
Thoroughly discussing with the people the nature of the Core Principles in Community Organizing
consequence supporting people’s right to make a choice
& act on their choice Influencing other's opinion. PEOPLE - ORIENTED
People and ends of development; Community means are
PHASE- OUT development is the process and the outcome.
Purpose:
• To practice independence Participative
Plans monitoring & ff-up Community is prime-mover & determinants rather than
beneficiary of health efforts, critical for success. Evident
V. PHASE-OUT in involvement: well-informed, aware of their potentials
• Community gradually shoulders greater responsibility in for participation. Decision making is in hand of ordinary
managing health care needs. people not among, elite. Distinction is not made among
• Nurse gradually prepares the turnover of work, develop different groups & different personalities
plan of monitoring, follow-up of activity until full
disengagement and phase-out DEMOCRATIC
COMMUNITY HEALTH NURSING 2 (POPULATION GROUPS AND COMMUNITY AS CLIENTS) LEC
1st SEMESTER MIDTERMS
LOPEZ, MARY ANN E.
Silo, Maegan D. | BSN 3-1

Empower disadvantaged population. Allows people to COMPARISON OF COMMUNITY ORGANIZING AND

recognize, analyze needs & articulate aspirations, HEALTH EDUCATION
Decisions are from whole people/common people than
the elite or leader alone. COMMUNITYORGANIZING
> work carried out by nurse, seeking wider community
DEVELOPMENTAL participation in decision-making in activity to impact
Directed in changing underlying situation. Through positively in health
empowerment of marginalized people. Community gains > strengthen member capability in problem-solving &
insights, hones capabilities & develops. Later take leads decision-making skills for self-reliant development
in wholistic improvement of community.
H E A L T H E D U C A T I O N
PROCESS– ORIENTED > nurse influence, change & modify attitudes, behavior of
It is a process of change, allows community to internalize individuals, nurse efforts towards organizing, mobilizing
it & embrace process, requires time. It is dynamic with people to initiate, sustain change as a group or an
evolving community situation & monitoring & periodic organization
review
COMPARISON OF TRADITIONAL RESEARCH
GOALS OF COMMUNITY ORGANIZING APROACH & COPAR

1. People’s Empowerment DECISION - MAKING

process of community organizing allows people to Traditional: Top - Down
develop their capacity to maximize control over situation.
Start placing control over own hands. COPAR: Bottom – up

2.Build permanent Structures & People’s EMPHASIS

Organization
Establish & sustain permanent structures that will Traditional: Expert / Nurse Driven Process Much
support their needs premium is given on data or output
COPAR: Community- Driven Process Premium is placed
3. Improved Quality of Life on the process
Manifested by collective involvement in decision making
& community action on matters that would impact their ROLES
lives.
Traditional: Nurse (N). is researcher, Community (C) as
Basic Values in Community Organizing objects/subject of research- respondents DATA
ANALYSIS (PAR) - by N & presented to people
01 Human Rights COPAR: N is facilitator; C as researcher DATA
Universal principle anchored on belief of worth & dignity ANALYSIS - by community collectively
of people. Right of life, self-determination & development
METHODOLOGY
02 Social Justice
Equitable access to opportunities, Equitable distribution Traditional: Research-tool & methodology are pre-
of resources & power determined / pre-packaged by N
COPAR: Research tool & methodIdentified & developed
03 Social Responsibility by community
People should reach out through & move jointly with
others in meeting common needs & problems OUTPUT

Emphasis of Community Organizing in Primary Traditional: Submitted to agency, published,

Health Care Recommendations based on finding
COPAR: Conclusion / documentation made by C. leads
01 People from the community working together to solve to agreed C. actions/ projects. Then whole research
their own problem CONTINUES until it becomes part of C. life toward C
02 Internal organizational consolidation as prerequisite Development. C members formulates recommendations
to external expansion
03 Social movement first before technical change
04 Health reforms occurring the broader context of social
transformation

AREA OF EVALUATION AND PARAMETERS

PROGRAM
Were goal, objective of project/program achieved? What
strategies were implemented? What worked? What did
not? What is the overall impact of project? How were
organization resources & community utilized?

ORGANIZATIONAL
Were the vision, mission, goal achieved? How are the
organizational policies being implemented? What is the
level of participation in the affairs of community? How
were the resources of organization utilized? What type of
interpersonal relationship is shared among members of
organization, among leaders and members of
community?