NCM 113 LEC- MIDTERM, MODULE 5

FORMULATING GOALS AND OBJECTIVES

Goals- are statements of long-term future situations, conditions, or status.

Objectives - are statements of what is to be achieved through the program activities or services.
- provide the road map for where the program is headed.

Complete objectives are written in behavioral terms using action verbs to describe terminal behaviors.
Objectives need to contain qualifying phrases about who will perform the behaviors under what
conditions. Quantity and quality of performance, as well as how the behavior will be measured, adds to
the completeness of objectives.

DECIDING ON COMMUNITY INTERVENTIONS/ ACTION PLAN

Community action plan- is a road map for implementing community change by identifying and
specifying WHAT will be done, WHO will do it and HOW it will be done.

Action plan describes what the community wants to accomplish, what activities are required during a
specified timeline and what resources (money, people and materials) are needed to be successful. The
community action plan shall become a framework for implementing sustainable sanitation and water
management activities that are decided by the community itself. It is important to emphasize that the
community members should be the main actors in preparing their own community action plan regarding
sanitation and water management.

IMPLEMENTING COMMUNITY HEALTH INTERVENTIONS

Importance of Partnership and Collaboration

Effective partnerships are essential for community-based solutions for advancing health equity by
making it a shared vision and value, increasing the community's capacity to shape outcomes, and
fostering multi-sector collaboration.

Partnerships are important because they enable action on the determinants of health, which is vital in
order to address health inequalities. Learning from research on building better partnerships to develop
more effective and sustainable partnerships is also explored.

The quality collaboration that brings together healthcare stakeholders to achieve common and
improved objectives is key for healthcare improvement. Collaboration may result in optimizing the
development of resources, enhancing communication, coordination, and consequently a better
healthcare performance

Activities Involved in Collaboration and Advocacy

Advocacy- any action that speaks in favor of, recommends, argues for a cause, supports or defends, or
pleads on behalf of others.

Health advocacy aims to bridge the gaps within our healthcare systems to ensure that people can access
affordable, effective, and high-quality healthcare. 

Community Organizing And Social Mobilization

Community Organizing Definition

Maglaya
Process whereby community members develop the capability
-To assess their health needs and problems
- Plan and implement actions to solve these problems
- Put up and sustain organizational structures
- Support and monitor implementation of health initiatives by the people

Human Resource Development Program (HRDP)

-A continuous and sustained process
-It is working with the people collectively and efficiently, discover their immediate and long-term
problems and mobilizing the people to develop their capabilities and readiness to respond and take
action on their immediate needs toward the solution of their long- term problems.

Objectives of Community Organizing

1.To make people aware of social realities
2.To form structures that hold the people’s basic interests
3.To initiate responsible actions

Elements of Community Organizing

1.Power- ability to make something happen
-getting people understand the source of problem, devise solutions, strategies, take on
leadership and move to action thru campaigns that win concrete changes

2.Relationship building- people are accountable to one another for their activities on behalf of the group
2 kinds of relationship
a.one on one
b. public relationships

3. Leadership development-must build a base of members for them to see the root of the problem and
get them involved to develop them as leaders

4.Political education- form of training whether formally or informally about issues, social movements
and history of the organization

5. Strategy- over-all approach to achieving objectives

- way that a community is using its power to win what it wants by:
a. campaigns
b. research
c. collaboration and alliances

6.Mobilization- essential process of moving people to action

7. Action- a public showing of an organization’s power

- takes place during campaigns

8.Winning-organizing focuses on winning

- unless the organization wins concrete, measurable benefits for those who participate, it will
not last long

9. Movement building- groups engage in broader social justice activities that are not solely connected to
winnable campaigns or self-interest of community

10. Evaluation-monitors and improves performance (action-reflection-action)

- continuous process of assessing actions whether the goals are met or not

Principles of Community Organizing

1.People are motivated by self-interest

2. It is a dynamic process
3.Learns to deal with conflicts and confrontations
4. Takes into account the fundamental definition of an issue
5. Tactics should be within the experience of the people and outside the experience of the target
6. Man learns effectively from his own actual experiences
7.Man needs to deepen and widen his horizon
8.People must make their own decisions
Phases of Community Organizing (Maglaya)

A. Preparatory Phase
1. Area selection
2. Community Profiling
3. Entry in the community and integration with the people
Guidelines:
Recognize the role and position of local authorities
Adopt a lifestyle in keeping with that of the community
Choose a modest dwelling
Avoid raising expectations of the people
Participate directly in production process and social activities
Make house calls
Seek out people where they usually gather

B. Organizational Phase
1. Social preparation
2. Spotting and developing potential leaders
3. Core group formation- represented by different sectors of the community
The core group serves as the training ground for developing potential leaders in:
>Democratic and collective leadership
>Planning and assuming task for the formation of a community-wide organization
>Handling and resolving group conflicts
>Critical thinking and decision- making process
4.Setting up the community organization

C. Education and Training Phase

1. Conducting community diagnosis
2. Training of community health workers
3. Health services and mobilization
4. Leadership formation activities

D. Intersectoral Collaboration Phase

As the organization grows, its needs also grow
Assistance and support can be achieved through collaboration with other organizations and
communities

E. Phase Out
Turn-over of work
Monitoring and subsequent follow-up of activities until the community is ready for full
disengagement
Basic Community Organizing Process (Jimenez)

I. ENTRY TO THE COMMUNITY - establishes a helping/working relationship

The following should be considered:

A. Clarity of purpose of the relationship between the agency/community organizer and the people
B. Existence of social problems and needs
C. Community’s desire and willingness to work for change 

II. INTEGRATION WITH THE PEOPLE - establishing rapport with the people in a continuing effort to
imbibe in their community life
- Immerses himself/herself in the community to know and
respect the culture, history, economy, leaders, and lifestyle of
people
- Facilitates social investigation and vice versa

III. SOCIAL INVESTIGATION/COMMUNITY STUDY - Is the process of systematically learning and

analyzing the various structures and force in the community study –
economic, political and socio-cultural
- Comes at the beginning and as a process. It is continuous. “no
community study is ever complete”

Objectives:
1. To gather data
2. To identify the classes and sectors present
3. To determine the correct approach and method of organizing
4. To provide a basis of planning and programming of organizing activities

General Methodology In Social Investigation

A. Interview
B. Observation
C. Examination/ Review of Secondary Data
- Assumes that much of the initial information needed is already available
- Major data to be gathered:
a. Geographic and demographic data
b. Economy system/ type of economic production
c. Political system/ decision-making structure/s
d. Socio-political system

IV. PARTICIPATORY APPROACH IN SOCIAL INVESTIGATION- people’s participation should be

observed
Participatory Data Gathering- the process of involving the community residents in the collection and
consolidation of data or information

Knowing the answers to the ff.:

1. Why data are gathered
2. What data to gather
3. How data are to be gathered (tools to be used)
4. Where data are to be gathered (sources)

It is important in Community Organizing because it provides:

1. Demographic profile
2. Inventory of community resources
3. Identification of community trends and issues
4. Picture of network of service and organization in the area
5. Opportunity for raising the level of consciousness

Aids in the community organizer in:

1. Identifying the situation/s he/she is entering
2. Initial view of the social problem
3. Specifying his role face to face with the people
4. Setting relevant objectives and effective programs
5. Evaluating the community’s progress

V. PROBLEMS/ISSUES IDENTIFICATION AND ANALYSIS

Problem identification- process of defining, analyzing and ranking community problems and needs
- Helping communities perceive and analyze their situation from a more comprehensive
and analytical viewpoint

Guide in Problem Identification:

1. Scope/ degree of the problem
2. Past change efforts
3. Origin of the problem
4. Factors that maintain/ increase or eliminate the problems
5. Consequence analysis
6. Problem on organization

Community health as defined by the World Health Organization: environmental, social, and economic
resources to sustain emotional and physical well- being among people in ways that advance their
aspirations and satisfy their needs in their unique environment.
Examples of Community Problems: 
1. Adolescent pregnancy
2. Access to clean drinking water
3. Child abuse and neglect
4. Domestic violence
5. Drug use
6. Pollution
7. Mismanagement of resources
8. Lack of funding for schools and services
9. Ethnic conflict
10. Health disparities
11. HIV/ AIDS
12. Hunger/Poverty
13. Inadequate emergency services

VI. PLANNING AND STRATEGIZING

Planning- process of translating goals/ objectives into specific activities to meet needs or community
problems

Planning process involves:

A. Identification of perceived problems and needs
B. Identification of existing resources
C. Study on the block to the utilization of their resources
D. Formulation of the possible solutions
E. Setting plans of actions
Plans are further broken down into strategies and tactics
Strategy- general/ over-all direction that organizing process will take course (long range goal)
Tactics- a specific action/ goal within a strategy

Guidelines For Forming Strategies:

A. Principal issue/ problem
B. Solution to the problem
C. Strengths and weaknesses
D. Other secondary issues
E. Larger outside issues

VII.CORE GROUP FORMATION- the identification of potential leaders

Criteria:
 >Belongs to poor sectors and classes- engaged in production
>Well-respected and has relatively wide influence
>Willing to work for change
>Can find time, conscientious and resourceful
>Must be able to communicate effectively

Functions Of A Core Group:

>Training ground for democratic and collective leadership

>Builds people’s potential and self-confidence
>Helps gather data, spotting other potential leaders and members for a community-wide
organization
>Helps in laying out plans and tasks for the formation and maintenance of the organization

VIII. ORGANIZATION DEVELOPMENT- forming a community-wide organization after formation of

the core group
-gives a sense of collective power and confidence
-creation of committees and tasks

Techniques to recruit members:

A. Ground Work – to go around and motivate people on a one-on-one basis (agitation)

B. The Meeting – the people collectively ratify what they already have decided individually
-Gives a sense of collective power and confidence - creation of working
committees and tasks

C. Organizational structure – formal setting up of the community organization where

constitution and organizational plans are ratified and approved
- Organizing process results in consolidating a viable people’s organization

D. Leadership Training and development – revolves on indigenous leaders who will

eventually take over the role of community organizer
- Promotes collective or shared leadership
- May be done formally or informally

Principles and Concepts of Leadership training

1. Leadership as service
2. Corporate/collective leadership
3. Delegation of Authority
4. Eliciting Participation
5. Problem Solving Activities

Activities in Informal Leadership Training:

 >Groundwork
>Continuous exposure to and active participation to mobilization activities
>Action-reflection and self-criticism

Activities in Formal Leadership Training:

>Seminars
>Workshops

IX. MOBILIZATION-- refers to the activities undertaken by the community to solve problems
- Builds and strengthens people’s self-confidence and collective spirit
- Actual experience of the people confronting the powerful and the actual exercise of
people power

Steps and guidelines in preparing Conflict Mobilization:

A. Issue(s) spotting and analysis
B. Target Analysis
C. Planning
D. Role playing

X. REFLECTION AND EVALUATION

Reflection – analyzing the finished mass action, its good and weak points identified.
- Relates practice to theory and creates an awareness of global issues

Continual Self-analysis- necessary to maintain and consolidate a cooperative and participatory spirit to
ensure that no oppressor-oppressed relationship emerge within the group

Evaluation - Process of discovering the way it has been accomplished, what has been left out and
what remains to be done
- People’s participation in evaluation is as important Guidelines for evaluating a
community

PART I. QUANTITATIVE ANALYSIS

A. General Description
B. Listing of activities
1. People’s issues handled, completed, on-going and potential
2. Mobilization/Negotiation taken
3. Meeting/Reflection sessions held
4. Seminars and Conventions

PART II. QUALITATIVE ANALYSIS

A. Area Description
B. Issues
C. Organization/Groups
1. Knowledge gained
2. Involvement and outlook of people
3. Attitudinal changes

XI. TURN OVER AND PHASE OUT - after some time, community organizers become dispensable
and the people’s organization takes over.

Turn-over of the organizing process is done if the ff. are satisfactory achieved:
1. High level of sociopolitical
2. Sustained membership participation
3. Trained pool of leaders
4. Well set up community structures and linkages
5. Delineated goals, directions, plans of actions are clear

- Organizers may assume a supportive role monitoring, consultant, and evaluator

Five Stages of Organizing

STAGE 1: COMMUNITY ANALYSIS

Five Components:
1.Demographic, social and economic profile from secondary data
2. Health risk profile
3. Health/Wellness outcomes profile
4. Survey of current health promotion programs
5. Studies in certain target groups

Steps:
1. Define the community
2. Collect data
3. Assess community capacity
4. Assess community barriers
5. Assess readiness for change
6. Synthesis data and set priorities 

STAGE 2: DESIGN AND INITIATION

a. Establish a core planning group and local organizer
b. Choose an Organizational structure
c. Identify, select and recruit organizational members
d. Define the organization mission and goals
e. Clarify roles and responsibilities of the people
f. Provide training and recognition 

STAGE 3: IMPLEMENTATION
a. Generate broad citizen participation
b. Develop a sequential work plan
c. Use comprehensive, integrated strategies
d. Integrate community values into the programs, materials and messages

STAGE 4: PROGRAM MAINTENANCE

CONSOLIDATION
a. Integrate intervention activities into community networks
b. Establish a positive organizational culture
c. Establish an ongoing recruitment plan
d. Disseminate results

STAGE 5: DISSEMINATION

REASSESSMENT
a. Update the community analysis
b. Assess effectiveness of interventions/programs
c. Chart future directories and modifications
d. Summarize and disseminate results

COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH (COPAR)

PARTICIPATORY ACTION RESEARCH (Jimenez)- an investigation on problems and issues

concerning life and environment of the underprivileged by way of research collaboration with
the underprivileged whose representatives participate in the actual research as researchers
themselves, doing research of their own problem

-a community-directed process of gathering and analyzing information or an issue for the

process of taking actions and making changes

PARTICIPATION – main element

The beneficiaries of the research are the main actors of the research process
 Involves research, education and actions to empower people to determine the cause of their
problems, analyze these problems and act by themselves in responding to their own problem

CHARACTERISTICS OF TRADITIONAL AND PARTICIPATORY ACTION RESEARCH

TRADITIONAL PAR
Purpose: To identify and meet individual needs Social Transformation
within existing social systems
Community problems or needs are defined by Research problems are defined by the community
experts
Research problems is studied by the researchers The community undertakes the research process.
External researchers work alongside
Recommendations are based on the researcher’s Community formulates recommendations and an
findings and analysis action plan based on research outcome

COPAR - is a social development approach that aims to transform the apathetic, individualistic and
voiceless poor into a dynamic, participatory and politically responsive community

It is a continuous and a sustained process of:

1. Educating the people - to understand and develop their critical consciousness

2. Working with people - to work collectively and effectively on their immediate and long term
problems
3. Mobilizing with people - develop their capability and readiness to respond, take action on their
immediate needs towards solving the long- term problems

It is a process and a structure through which the members of the community are tapped to become
organized for participation in health care and community development activities

A strategy used by the HRDP III in implementing the Primary Health Care delivery in depressed and
underserved communities to become self-reliant

Process- the sequence of steps whereby members of the community come together to critically
assess to evaluate community conditions and work together to improve those conditions

Structure- refers to a particular group of community members that work together for a common
health and health related goals

Emphasis of COPAR

1. Community working to solve its own problem

2. Direction is established internally and externally
3. Development and implementation of a specific project less important than the development of the
capacity of the community to establish the project
4. Consciousness raising involves perceiving health and medical care within the total structure of
society

Importance of COPAR

1. COPAR is an important tool for community development and people empowerment

2. COPAR prepares people/clients to eventually take over the management of a development
programs in the future.
3. COPAR maximizes community participation and involvement; community resources are mobilized
for community services.

PRINCIPLES OF COPAR

1. People especially the most oppressed, exploited and deprived sectors are open to change, have the
capacity to change and are able to bring about change.
2. COPAR should be based on the interest of the poorest sector of the community
3. COPAR should lead to a self-reliant community and society.

Process/Methods Used in COPAR

1. A Progressive Cycle of Action Reflection Action – begins with small, local and concrete issue identified
by the people and the evaluation and reflection of and on the action taken by them
2. Consciousness – Raising – through experiential learning is central to the COPAR process because it
places emphasis on learning that emerges from concrete action and which encircles
succeeding action
3. COPAR is Participatory and Mass-Based – because it is primarily directed towards and biased in
favor of the poor, the powerless and the oppressed COPAR is Group Centered- not leader centered.
Leaders are identified, emerged and are tested through action rather than appointed or selected by
some force or entity

CRITICAL STEPS (ACTIVITIES) IN COPAR

1. Integration – the health worker becomes one with the people in order to:
a) Immerse in the community
b) Understand deeply the culture, economy, leaders, history, rhythms and lifestyle in the
community

2. Social Investigation (Community Study) - Systematic process of collecting, collating, analyzing data to
draw a clear picture of the community

Must remember the following:

a) Use of survey questionnaires is discouraged
b) Community leaders can be trained to initially assist in the social investigation
c) Secondary data should be thoroughly examined
d) Social investigation is facilitated if the health worker is properly integrated and has acquired the trust
of the people
e) Confirmation and validation of community should be regularly done

3. Tentative Program Planning – CO to choose one issue to work on in order to begin organizing people

4. Groundwork – going around and motivating the people on a one on one basis to do something on the
issue that has been chosen

5. The meeting – people collectively ratify what they have decided individually - Gives collective power
and confidence
- Problems and issues are discussed

6. Role Play – acting out the meeting that will take place between the leaders of the people and the
government representatives
- way of training people to anticipate what will happen and prepare them for such eventually

7. Mobilization or action – actual experience of the people in confronting the powerful and the actual
exercise of people power.

8. Evaluation – the people reviewing the steps 1-7 so as to determine they were successful or not in
their objectives

9. Reflection – dealing with deeper, ongoing concerns to look at the positive values CO is trying to build
in the organization
- Gives people time to reflect on the stark reality of life compared to the ideal

10. Organization –is the result of many successive and similar actions of the people
- a final organizational structure is set up with elected officers and supporting
members

COPAR Process
1. Pre-entry Phase- organizers look for communities to serve/help. It is considered the simplest phase in
terms of actual outputs, activities and strategies and time spent for it

Preparation of the Institution

o Train faculty and students in COPAR.
o Formulate plans for institutionalizing COPAR.
o Revise/enrich curriculum and immersion program.
o Coordinate participants of other departments

Site Selection
o Initial networking with local government.
o Conduct preliminary investigation.

Criteria for Initial Site Selection:

1. Economically depressed
2. Health services are inaccessible/ inadequate
3. Poor community health status
4. Acceptance of the program by community
5. No serious peace and order problem.
6. No similar group or organization holding the same program

o Do final networking and consultation with local government and NGOs

o Generate secondary data.
o Make long/short list of potential communities.
o Do ocular survey of listed communities

Choosing Final Barangay/Site

o Conduct interviews with barangay officials and key informants to choose project site.
o Discuss suitability of project site
o Coordinate with local government and NGOs for assistance of the program’s implementation in the
future.
o Develop community profiles from secondary data.
o Develop survey tools

After site selection

o Pay courtesy call to community leaders
o Conduct Community Assembly
o Create a working committee
o Conduct baseline study
o Conduct Staff planning, strategizing for entry phase

2. Entry Phase (social preparation phase)- crucial in determining which strategies for organizing would
suit the chosen community. Success of the activities depend on how much the community
organizers has integrated with the community

Guidelines for Entry

o Recognize the role of local authorities by paying them visits to inform their presence and activities
o Her appearance, speech, behavior and lifestyle should be in keeping with those of the community
residents without disregard of their being role model.
o Avoid raising the consciousness of the community residents; adopt a low-key profile

Activities in the Entry Phase

1. Integration - establishing rapport with the people in continuing effort to imbibe community life
a. living with the community
b. seeking out to converse with people where they usually congregate
c. lending a hand in household chores
d. avoid gambling and drinking

2. Deepening social investigation/community study - verification and enrichment of data collected from
initial survey. A previous investigation was done but this time it is needed to better view how the
community and its people perform in general. Conduct baseline survey by students results relayed
through community assembly
 Core Group Formation- Leader spotting through sociogram

1.  Key persons - approached by most people

2. Opinion leader - approach by key persons
3. Isolates - never or hardly consulted
-define roles and functions of the core group
- prepare community for health and development work
-organize research team
-set-up community health organization

The staff can assist the community leaders and core group in creating a project:
>Management of health programs and to ensure the collective participation of the residents
>Establish networks and linkages
>Generate resources
> Raising consciousness of the community in health and other issues
>Mobilize residents to act
>Identification of possible community worker
>Scrutinize and mobilize residents
>Conduct team building activities and informal education of the group
>Train community researchers

3. Community Study/ Diagnosis Phase (Research Phase) -is a comprehensive documentation of the data
about the community gathered through social investigation

Components of the study:

1. Physical and geographical data
2. Demographic data
3. Economic Condition
4. Mortality and morbidity data
5. Food Supply and Nutrition
6. Cultural Patterns
7. Health Services and Facilities
8. Education
9. Community Leadership and organization
10. Development agencies
11. Community Problems and Needs

Activities
1. clustering of household and spot mapping
2. selection of the research team
3. training on data collection methods and techniques/ Capability building (data collection tools)
4. Planning for the actual gathering of data
5. data gathering
 6. Training on data validation (tabulation and preliminary analysis of data
7. Community Validation
8. Presentation of the community study/ diagnosis and recommendations
9. Prioritization of community needs/ problems for action
4. Community Organization and Capability Building Phase

Activities
1. Draw up guidelines for the organization of Community Health organization
2. Election and induction of officers
3. Development of management systems and procedures
4. Team building activities
5. Action-reflection-action session (ARAS)
6. Working out legal requirements of CHO
7. Organization of the working committees
8. Training of CHO officers and members

5. Community Action Phase

Activities
1. Organization and Training of Community Health Workers:
a. development of selection criteria of CHWs
b. selection of CHWs – each zone of group of families will select from their members
c. training of CHWs
2. setting up linkages, network and referral systems
3. Project implementation, monitoring and evaluation (PIME) of health services, intervention schemes
and community development projects
4. Initial identification and implementation of resource mobilization schemes

6. Sustenance and strengthening Phase

1. Develop financial and management systems

2. Identification and development of secondary leaders
3. Formulation and ratification of the constitution and by-laws of the CHO
4. Work for the registration of CHD with the securities and exchange Commission
5. Formalize and institutionalize linkages, networks and referral systems
6. Development and implementation of viable management systems and procedures, committees,
continuing education/training of leaders, CHWs, community residents
7. Continuing Education and upgrading of community leaders, CHWs and CHO members
8. Development of medium and long- term community health and development plans

REFERENCES: Community Organizing Participatory Action Research (CO-PAR) for Community Health
Development: Helping People Grow and Glow, Carmen E. Jimenez, C & E Publishing,
Inc. First Edition, Copyright 2008

Nursing Practice In The Community, Araceli Maglaya, Fifth Edition