SUBJECT: PRIMARY HEALTH CARE (PHC) 2

LESSON 1: APPROACHES TO COMMUNITY

DEVELOPMENT
COMMUNITY:
 is a social unit (a group of living things) with commonality such norms, religion, values,
customs or identity
 is a social group determined by geographical boundaries and/or common values and
interests.
World Health Organization

COMMUNITY ORGANIZING:
 is a social development approach that aims to transform the individualistic and voiceless
poor into a dynamic, participatory, politically responsive communities.
• is a process of helping the people move from problem identification to problem solution.
• a process by which a community identifies its needs and objectives, develops the confidence
to take action in respect to them, and in so doing, extends and develops cooperative and
collaborative attitudes and practices in the community. (Ross, 1967)

Characteristics of Community Organizing:

1. CO is transformative - it seeks to effect change, to liberate the poor from the yoke of
powerlessness.
2. CO is collective – it requires concerted effort of a significant number of people who have a
common problem and share the same vision
3. CO is sustained – there can be no real organizing if the process itself and the corresponding
results are short-lived. The process is dynamic and is always evolving.
4. CO is systematic – it is a strategy with a set of tactics planned by the CO
5. CO is sustained – there can be no real organizing if the process itself and the corresponding
results are short-lived. The process is dynamic and is always evolving.
6. CO is participatory process – it emanates from the bottom-up and is not something imposed
from the top-down.

DEVELOPMENT is defined as a multi-dimensional process involving major changes in social

structures, population, attitudes and national institutions as well as acceleration of economic
growth, reduction of inequity and eradication of absolute poverty. The goal of development is to
have a better life.

COMMUNITY DEVELOPMENT:
• is an organized effort of people to improve the conditions of the community life and the
capacity of the people for participation, self-direction and integrated efforts in community
affairs in which development is accomplished by the people.
• It seeks self-help, voluntary participation, and cooperation of the people in the community
but usually with technical assistance from government or voluntary organizations.

PARTICIPATORY ACTION RESEARCH (PAR)

• An investigation on problems and issues concerning the life and environment of the
underprivileged in society by way of a research collaboration with the underprivileged,
whose representatives participate in the research process as equal partners—that is
researchers themselves, rather than outsiders doing research upon them or upon their
problems.
PORD Program of International Labor Organization,1990

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

Comparison of Traditional and Participatory Research:

Traditional Research Participatory Action Research

Research for purpose of identifying and Research seeks social transformation
meeting individual needs within existing social
systems
Community problems or needs are defined by The research problems are defined by the
experts or the external researchers to community members themselves who are
community group and considered neutral or viewed as “experts of their own reality”
non-biased
The research problem is studied by the The community group undertakes the
researchers who control the research process investigation or research process from data
collection to analysis. External researchers
work alongside the community group
Recommendations for community are based on The community formulates recommendation
researcher’s findings and analysis and an action plan based on research outcome

• The essential element of PAR is Participation

 main actors – beneficiaries/community
 involves people to do research, to be trained and to do action
 empower people:
 to identify the problem
 to analyse the problems (cause & effects, interrelationships)
 to act & respond to their own problems

COMMUNITY PARTICIPATION:

A process by which people are enabled to become actively and genuinely involved in defining the
issues of concern to them, in making decisions about factors that affect their lives, in formulating
and implementing policies, in planning, developing, and delivering services and in taking action to
achieve change.

LESSON 2: COMMUNITY ORGANIZING PARTICIPATORY

ACTION RESEARCH (COPAR)

PHASE 1: Pre-Entry Phase

 The initial phase of community organizing process where the community organizer/student
looks for the communities to serve or help. (Untalan 2005).
 These are activities done before going to the community (Jimenez, 2005)

 Institutional (School) Level:

 Set the Objectives & Guidelines of the COPAR immersion
 Coordinator for Student Community Immersion plans with the team (schedule,
potential community, supervision, monitoring, evaluation)
 Training of the students (CO, COPAR)
 Development of criteria for site selection
 Preparation of logistics (budget, supplies, plans, vehicles, permits, others) for
immersion
 Site selection
 Using the defined criteria, identify the community for exposure/COPAR site
 Community Consultations/Dialogues
 Conduct informal dialogue (random) with community leaders or barangay officials
and community members
 Setting of issues/considerations related to site selection
 Initial identification of health issues or problems in the community
 Networking with LGU, NGOs, and other departments
 Identification of possible partners (NGOs, CSOs, POs)

COPAR PHASE I: PRE-ENTRY PHASE SUMMARY:

Outputs:
1. Set Objectives & guidelines for immersion
2. Identified site for immersion based on the criteria
3. Community Organizer/Students trained on COPAR
4. Coordinated with the LGU/community for the immersion
5. Logistics (budget, supplies, plans, vehicles, permits, others) made available

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

PHASE 2. Entry Phase

Step 1: Immersion/Integration with the community

 a basic continuing process by which the organizer becomes one with the poor by
immersing himself/herself in the community

PURPOSES:
 Get to know the culture, economy, leaders & lifestyle of the community
 Come to respect the people
 To be accepted as member of the community

How it is done?
 at the beginning of the COPAR process, live with poor for at least 3 months
 visit as many people as possible in the community
 Listen and/or take part in small talk & informal group discussions
 Share the people’s housing, food, entertainment & meetings

Step 2. Preliminary Social Investigation (PSI)

The process of looking systematically for issues around which to organize the people by
gathering their true sentiments, attitudes and knowledge concerning their situation.

Purposes:
• Become informed about the community
• Identify potential issues which might galvanize people to action

How?
• Study existing documents/reports on the people’s problem and maps which provides
pertinent data
• Learn from the people themselves by observation, engaging in dialogue and talking to key
informants of the community

Step 3. Leader Identification

 the systematic process of identifying indigenous leaders in the community who can help
facilitate the change process through SOCIOGRAM

Purposes:
 identify the key persons, opinion leaders and isolates in the community
 get the indigenous leaders to express their support

HOW?

1. Discreetly gets each community resident to tell the CO:

a) whom does the resident approach/consult within the village about a community
problem?
b) whom does the resident trust to lead/manage a community project?
2. After asking a majority of the community residents draw a sociogram based on the responses

3. Analyze the sociogram & identify the key persons, opinion leaders & isolates
Key person – is the star, he/she is the person who is approachable by most people; an
obvious leader

Opinion leader – who is approached by the key person and is therefore, the person behind
the key person’s opinions and ideas

Step 4. Consultation, Coordination, Dialogue with the community

 The first in a series of crucial community consultation to decide on:
 Identify & prioritize problem
 Commit or not on the conduct of research on the prioritized problem

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

COPAR PHASE 2: ENTRY PHASE SUMMARY

Step 1: Immersion/Integration with the community

Step 2. Preliminary Social Investigation (PSI)
Step 3. Leader Identification
Step 4. Consultation, Coordination, Dialogue with the community

PHASE 3. Community Diagnosis Phase

Community Diagnosis (ComDx) is a critical organizing task designed to awaken or raise the
consciousness among the poor regarding their community situation & dignity.

Step 1: Selection of the Research Team

 The community will identify the members of the Research Team using their own criteria
Sample criteria:
o Can read & write
o Can give time to the training & actual research
o Willing to go around the community
o Trusted by the community

Step 2. Training of the Research Team

 Usually a 3-day training of local researchers on PAR. At the end of the training, the
RT have formulated & tested their research tools
 Topics:
 PAR vs. Traditional Research
 Formulation of Research Tools
 Survey questionnaire
 Observation
 Review of records
 Group discussion (FGD)
 Participatory Rapid Appraisal (PRA) tools

How to formulate the Research Guide:

a. Identify & prioritize issues or problems (based on the PSI & community consultation)
Example of issues:
1. Malnutrition
2. Home deliveries
3. Access to potable water
4. Lack of sanitary toilet

b. Identify the data needed regarding the prioritized problem

Sample Problem: Malnutrition and Home Deliveries
Data Needed on Nutrition Data Needed on Home Deliveries
 No. of 0-5 years old children  No. of pregnant women by purok
 No. of malnourished children  Age bracket of pregnant women
 No. of visits by RHU staff to the  No. of deliveries at home
malnourished  Reasons for home delivery
 Type of food served to  Presence of birthing facility in the barangay
malnourished  Availability of midwife during delivery
 Immunization received

c. Identify the Key Informant

Data Needed Key Informant
No. of 0-5 years old children Mother & Father
Midwife
No. of Malnourished children Mother & Father
Midwife
No. of visits by RHU staff to the Doctor
malnourished Midwife
Nurse
Type of food served to the Mother/Father
malnourished
Immunization received Midwife
Mother
PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF
 d. Selection of Research Methods

Data Needed Key Informant Research Methods

No. of 0-5 years old children Mother/Father Interview
Midwife Review Records
No. of malnourished children Mother/Father Review of BHW
Midwife records
Factors causing malnutrition Mother Group discussion
Father
No. of visits by RHU staff to the Doctor Interview
malnourished Midwife
Nurse
Type of food served to the Mother/Father Interview
malnourished Observation
Immunization received Midwife Review of Records
Mother Interview

e. Classification of data according to research methods

Data Needed Research Methods

• No. of 0-5 years old children Interview
• No. of visits by RHU staff to the
malnourished
• Type of food served to the
malnourished
• Factors causing malnutrition Group Discussion
• No. of malnourished children Review of BHW records
• Immunization received
• Type of food served to the Observation
malnourished

f. Formulate the Research Tools

Data Needed Research Methods Research Tools
• No. of 0-5 years old Interview • Survey form/Household
children Interview questionnaire
• No. of visits by RHU staff • Individual
to the malnourished • Tabular form
• Type of food served to
the malnourished
• Factors causing Group discussion • Focus Group Discussion
malnutrition (FGD) Guide
• No. of malnourished Review of BHW Records • Record Book
children • FHSIS
• Immunization received
• Type of food served to Observation • Record Book
the malnourished

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

RESEARCH TOOLS:

1. Individual Survey Form

2. Tabular/Columnar Questionnaire
• Paper-saving
• Easy to tabulate

Name of Barangay: ________________

No. of households: _____ No. of Families: _____________

Name of No. of Children No. of 0-1 year old No. of 0-6 years
Household Head (Gidaghanon sa Anak) children old children
(Bana & Asawa)

3. Focused Group Discussion

Data Needed Research Method Research Tool

 Factors causing Group Discussion Focus Group Discussion
malnutrition Guide
 Food served to
malnourished children

In FGD, appoint the Facilitator that will lead the discussion and the Documenter that will
document the proceedings of the discussion

4. Other Tools: Participatory Rapid Appraisal Tools (PRA)

a) Seasonal Diagram

Seasonal Diagram of Common Illnesses in Barangay Mabunga

Diseases J F M A M J J A S O N D
Fever X
Cough X
Dengue X X
Sore eyes X X
Diarrhea X X

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

 Seasonal Diagram of Climate

J F M A M J J A S O N D
Ting-init x x x
Ting ulan x x x x

g. Pre-test & Finalization of the Research Tool (survey questionnaire)

 Select sample communities that will undergo the survey to pretest the research
tools
 The pretest will determine how long the survey will take, are the questions valid
and understandable at the level of the respondents, will the objectives of the
survey be achieved using the tools?
 Findings of the pretest will be used to improve the research tool

h. Planning for the actual data gathering

 Setting of the Schedule
 Identifying the Team composition/Assignment/Tasking
 Logistics preparation

i. Actual Data Gathering

 Actual house to house survey
 FGD
 Review of Records/Secondary Data
 PRA

Step 3: Training on data validation

 The training will include discussion of data tabulation and consolidation and analysis of
data

Step 4: Community Validation & Presentation of the community study/diagnosis and

recommendations
 Validate the data gathered
 Use creative visual aids in presenting the data

Step 5: Project Planning

 The people move from a deeper understanding of their reality to planning a course of action
aimed at transforming that reality
 Another group of people will be identified to become the Local Planning Team (COPAR,
Canave-Anung, 1992)
 The LPT will prepare the Community Action Plan or Project Proposal and/or Resolutions
seeking assistance from local or international funders

Step 6: Core Group Formation

 Development of criteria for selection of the core group members
 Defining roles, functions and tasks of the core group
 Coordination, Dialogue, Consultation with other community organizations
 Self-Awareness and Leadership Training & Action Planning

COPAR PHASE 3 SUMMARY

Step 1: Selection of the Research Team

Step 2. Training of the Research Team
Step 3: Training on data validation (includes tabulation, and preliminary analysis of data)
Step 4: Community Validation & Presentation of the community study/diagnosis and
recommendations
Step 5: Project Planning
Step 6: Core Group Formation

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

PHASE 4. Community Organizing & Organization Building Phase

 The organization-building phase cannot be easily distinguished from the other phases.
 It is the phase that can begin as early as the time when the CO facilitates the Entry Phase
 In the Entry Phase, the people decides to create a core group (Step 13)-it is already a
step in Organization building

Step 1. Organization Making

 Formalizing the core group into a People’s Organization

Step 2. Structuring the Organization

 Initial formation stage
 Formulation of Vision and Mission
 Developing the Organizational Structure
 Drafting of the Constitution and By-Laws & Policies & Financial System
 Working out legal requirements (SEC or CDA)
 Formation of committees (education, membership, etc.)

Step 3. Organizational Development

 Training of officers and members
 Team building
 Action-Reflection-Action
 Resource Mobilization
 Networking and Collaboration

PHASE 5. COMMUNITY ACTION/IMPLEMENTATION PHASE

 Witnesses the mobilization of the community in accordance to the action plan earlier
agreed upon.
 the duration of this phase depends upon the intricacies of the project, the speed by which
the external resources are delivered and the community’s resolution to overcome petty
squabbles in order to attain a higher goal

Step 1. Initial identification & implementation of resource mobilization schemes

 Preparation of Barangay Resolution asking for funding
 Preparation of project proposals to potential funding agencies
 Initiate resource mobilization activities (raffles, contribution, donations, etc.)

Step 2: Implementation of the activities or projects based on the action plan

 Service delivery
 Training

Step 3: Monitoring & evaluation of the services or projects

 Site inspection & assessment
 Determine achievement of plans and objectives

PHASE 6: SUSTENANCE & STRENGTHENING PHASE

 Formulation and ratification of constitution and by-laws

 Identification & development of “secondary leaders”
 Setting up & institutionalization of financing scheme for community health
programs/activities
 Formalizing and institutionalization of linkages, networks and referral systems
 Development & implementation of viable management system and procedures, committees,
continuing education/training of leaders, health workers, community residents
 Continuing education and upgrading of community leaders, health workers, organization
members
 Development of medium/long term community health and development plan

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

PHASE 7: PHASE OUT/EXIT PHASE

The last and final phase marks the end of the CO’s stay in the community and the NGO’s turn over to
the People’s Organization of its direct responsibility for organizational growth. (COPAR, Canave-
Anung, 1997)

Leaving the immersion site & Documentation (COPAR, Estrada Castro, 2012; (COPAR, Tuesca-
Untalan, 2005)

COMPARISON OF THE COPAR ACCORDING TO THE DIFFERENT AUTHORS

COPAR COPAR COPAR COPAR

Sr. Carmen Jimenez Luz Canave-Anung Estrada-Castro Tuesca-Untalan
(IPHC Experience)
Pre-Entry Community Diagnosis Pre-Entry Phase Pre-Entry Phase
a. Pre-Research
(Pre-Entry)
b. Research (Entry
Phase)
Entry Phase Community Planning Entry Phase Entry Phase
Phase
Community Project Formation Phase Organization-Building
Study/Diagnosis Implementation Phase Phase
Phase (Research
Phase)
Community Monitoring & Organization Building Sustenance &
Organization & Evaluation & Phase Strengthening Phase
Capability Building Reflection Phase
Phase
Community Action Organization Building Sustenance & Phase Out
Phase & Strengthening Strengthening Phase
Phase
Sustenance & Exit Phase Phase Out
Strengthening Phase

LESSON 3: CARE ENHANCEMENT QUALITIES OF HEALTH

WORKERS IN COMMUNITY SETTING
BARANGAY HEALTH WORKER (BHW)
 refers to a person who has undergone training programs under any accredited government
and non-government organization and who voluntarily renders primary health care
services in the community after having been accredited to functions as such by the Local
Health Board in accordance with the guidelines promulgated by the Department of Health
(DOH).

Roles & Responsibilities of BHWs:

1. BHW as Community Organizer:

Shall participate in organizing & mobilizing the community towards self-reliance by:
 Maintaining regular communication with community leaders and professional health
workers
 Provide linkage between the community and local health agencies
 Assist the community to develop a health plan and to take action to promote their health
and well-being
 Facilitate the community members to identify and respond to their community health
problems
 Keeping records of the work activities on health
 Develop appropriate knowledge and skills among community members to promote their
participation in local health initiatives

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

2. BHW as Health Educator
Shall provide knowledge and skills to the community members in the prevention &
management of simple illnesses by:
 Conducting health classes and/or household teachings
 Updating knowledge of communities on relevant health issues
 Distributing appropriate information, education and communication materials

3. BHW as Health Care Service Provider

Shall render primary health care services to the members of the community by providing
primary health care services as defined in Section 5 (d) of Rule 1 for which he/she is trained.
Section 5 (d): Primary Health Care Services are essential health care services such as:
• Education on prevailing health problems, the methods of preventing and controlling them
• Promotion of adequate food supply and proper nutrition
• Basic environmental sanitation and adequate supply of safe water
• Maternal and child health including family planning
• Immunization against major infectious diseases
• Prevention and control of locally endemic diseases
• Appropriate treatment of common diseases and injuries
• Promotion of mental health
• Prevention of oral-dental diseases & promotion of dental health
• Provision and proper use of essential drugs and herbal medicines
• Access and utilization of hospital care as centers of wellness
• Refer patients with complication and those suspected to have communicable disease to the
appropriate health center or hospital
• Monitor the health status of the household members under his/her area of service coverage
• Keep records of health services in the community and the health station
• Ensure the proper maintenance of health station and the safe custody of its equipment,
medical supplies and health records

Qualities of a Health Worker:

1. Efficient
o plans with the people, organizes, conducts, directs health education activities according to
the needs of the community
o knowledgeable about everything relevant to his practice; has the necessary skills expected
of him

2. Good listener
o hears what’s being said and what’s behind the words
o always available for the participant to voice out their sentiments and needs

3. Keen observer
o keep an eye on the proceedings, process and participants’ behaviour

4. Systematic
o knows how to put in sequence or logical order the parts of the session

5. Creative/Resourceful
o uses available resources
6. Analytical/Critical thinker
o decides on what has been analysed

7. Tactful
o brings about issues in smooth subtle manner
o does not embarrass but gives constructive criticisms

8. Knowledgeable 
o able to impart relevant, updated and sufficient input

9. Open
o invites ideas, suggestions, criticisms
o involves people in decision making
o accepts need for joint planning and decision relative to health care in a particular situation;
not resistant to change
10. Sense of humor
o knows how to place a touch of humor to keep audience alive

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF
11. Change agent
o involves participants actively in assuming the responsibility for his own learning

12. Coordinator
o brings into consonance of harmony the community’s health care activities

13. Objective
o unbiased and fair in decision making

14. Flexible
o able to cope with different situations

LESSON 4: CONFLICT MANAGEMENT

WHAT IS CONFLICT?
Disagreement or incompatibility of goals, principles, feelings or interests
(Runde & Flanagan, 2007)

Can I avoid conflict? No!

It is ‘natural, inevitable, necessary, and normal, and that the problem is…
not the existence of conflict but how we handle it…’

CONFLICT MANAGEMENT - is the process of limiting the negative aspects of conflict while

increasing the positive aspects of conflict. The aim of conflict management is to ENHANCE
LEARNING and GROUP OUTCOMES

What is the impact of conflict to you and the team?

Functional Dysfunctional
(constructive/growth mindset) (destructive/fixed mindset)
Stimulates creativity and new ideas Diverts energy from work
Motivates change Wastes resources
Better awareness of themselves Breaks down cohesion
Promotes organizational morale Increases hostility and aggressive behaviors

Five different modes for responding to conflict situations:

1. Competing is assertive and uncooperative—an individual pursues his own concerns at the
other person's expense. This is a power-oriented mode in which you use whatever power
seems appropriate to win your own position—your ability to argue, your rank, or economic
sanctions. Competing means "standing up for your rights," defending a position which you
believe is correct, or simply trying to win. Competing is best used:
a) When quick decisive action is vital; e.g. emergencies
b) With important issues where unpopular courses of action need implementing such as
cost cutting, or enforcing unpopular rules and discipline
c) With issues vital to company welfare when you know you are right
d) To protect yourselves against people who take advantage of you
  
2. Accommodating is unassertive and cooperative—the complete opposite of competing.
When accommodating, the individual neglects his own concerns to satisfy the concerns of
the other person; there is an element of self-sacrifice in this mode. Accommodating might
take the form of selfless generosity or charity, obeying another person's order when you
would prefer not to, or yielding to another's point of view. Accommodating is best use:
a) Wrong- when you realize you are wrong, to allow a better position to be heard, to learn
from others
b) Others- when the issue is much more important to the other person than to yourself
c) Relationship-  when preserving harmony and avoiding disruption are especially
important
d) Losing-  when continued competition would only damage your cause, i.e., when
outmatched and losing
e) Development- to aid in the managerial development of subordinates by allowing them
to experiment and learn from their own mistakes
f) Social credits- to build up social credits for later issues which are important to you

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

 3. Avoiding is unassertive and uncooperative—the person neither pursues his own concerns
nor those of the other individual. Thus he does not deal with the conflict. Avoiding might
take the form of diplomatically sidestepping an issue, postponing an issue until a better
time, or simply withdrawing from a threatening situation. This is best use:
a. Cool down- to let people cool down; i.e., to reduce tensions to a productive level and
regain perspective and composure.
b. Others- when others can resolve the conflict more effectively
c. Unimportant or trivial- when an issue is trivial, of only passing importance, or when
other more important issues are pressing.
4. Collaborating is both assertive and cooperative—the complete opposite of avoiding.
Collaborating involves an attempt to work with others to find some solution that fully
satisfies their concerns. It means digging into an issue to pinpoint the underlying needs and
wants of the two individuals. Collaborating between two persons might take the form of
exploring a disagreement to learn from each other's insights or trying to find a creative
solution to an interpersonal problem. Collaborating is best use:
a. Commitment- to gain commitment by incorporating other's concerns into a
consensual decision
b. Learn- when your objective is to learn; e.g., testing your own assumptions,
understanding the views of others
c. Integrative- to find an integrative solution when both sets of concerns are too
important to be compromised
d. Merging- merge insights from people with different perspectives on a problem
e. Better interpersonal relations- to work through hard feelings which have been
interfering with an interpersonal relationship

5. Compromising is moderate in both assertiveness and cooperativeness. The objective is to

find some expedient, mutually acceptable solution that partially satisfies both parties. It
falls intermediate between competing and accommodating. Compromising gives up more
than competing but less than accommodating. Likewise, it addresses an issue more directly
than avoiding, but does not explore it in as much depth as collaborating. In some situations,
compromising might mean splitting the difference between the two positions, exchanging
concessions, or seeking a quick middle-ground solution. This is best use:
a. Temporary- to achieve temporary settlements to complex issues.
b. Expediency- to arrive at expedient solutions under time pressure
c. Alternative/backup mode when collaboration or competition fails to be successful
d. Moderate importance- when goals are moderately important, but not worth the
effort or potential disruption of more assertive modes. 
e. Strong commitment- when two opponents with equal power are strongly
committed to mutually exclusive goals

Each of us is capable of using all five conflict-handling modes. None of us can be characterized as
having a single style of dealing with conflict. But certain people use some modes better than others
and, therefore, tend to rely on those modes more heavily than others—whether because of
temperament or practice.

Your conflict behavior in the workplace is therefore a result of both your personal predispositions
and the requirements of the situation in which you find yourself.

KEY MESSAGES IN CONFLICT MANAGEMENT:

1. Trust and Reciprocity: The law of reciprocity is the foundation of cooperation and
collaboration. What you give out is likely to be what you get back. Mutual exchange and
internal adaptation allows two individuals to become attuned and empathetic to each
other’s inner states. Hence a powerful technique to master in any kind of dispute is to
empathize with the feelings and views of the other individual by managing what we express
– both verbally and non-verbally. This builds trust which sustains the process of resolving
conflict.

2. Relationship and Bond: The key to defusing conflict is to form a bond, or to re-bond, with
the other party. We do not have to like someone to form a bond with him or her. We only
need a common goal. Treat the person as a friend, not an enemy, and base the relationship
on mutual respect, positive regard and co-operation. Once a bond has been established, we
must nurture the relationship as well as pursue our goals. We need to balance reason and

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF

 emotion, because emotions such as fear, anger, frustration and even love may disrupt
otherwise thoughtful actions. We need to understand each other’s point of view, regardless
of whether we agree with it or not. The more effectively we communicate our differences
and our areas of agreement, the better we will understand each other’s concerns and
improve our chances of reaching a mutually acceptable agreement.

3. Understanding interests, needs, values (cause of conflict)

To be able to create a dialogue aimed at resolving the conflict, we need to understand the
root of the disagreement. Among the common causes of disagreement are differences over
goals, interests or values. It is crucial to determine whether a conflict relates to interests or
needs. Interests are more transitory and superficial, such as land, money, or a job; needs are
more basic and are difficult for bargaining, such as identity, security and respect.

4. Engaging in dialogue/conversations
At all times it’s important to keep the conversation relevant, stay focused on a positive
outcome and remain aware of the common goal. It is imperative to avoid being hostile or
aggressive. The next stage is negotiation, in which we add bargaining to the dialogue.
Talking, dialogue and negotiation create genuine, engaging and productive two- way
transactions. We need to use energy from the body, emotions, intellect and the spirit.

PRIMARY HEALTH CARE 2 HAND OUTS-JOBAS DMSF