CHN Chap 3-4
CHN Chap 3-4
CHN Chap 3-4
➢ INTRODUCTION
The improvement in health quality of the population is a
continuing challenge for societies and governments. In spite of
the many advances in medical practice and health sciences in
past years, the vast majority of the population still barely meet
the minimum standards for health care and human develop-
ment.
Faced with the inadequacies in health services, the emer-
gence of lifestyle diseases, new and uncontrolled communicable
diseases, maldistribution of health resources, and the worsening
social and economic status of the marginalized, some societies
and governments are not able to cope adequately to meet the
needs of the population.
Cont.
➢ In the age of globalization, health and health problems
too become global.
➢ Health care is not just a problem of poor developing
countries; even the wealthiest countries are facing
health care concerns.
➢ An overall approach in the delivery of health services is
necessary – a strategy that engages both the health
workers and the people themselves as partners, and a
strategy that is affordable to the government yet still
effective and acceptable to the communities, a strategy
that ensures access to the health care regardless of
economic class.
Cont.
➢ The World Health Organization (WHO) has long champ-
ioned a strategy that it believes is the key to most of
the health problems.
➢ The WHO has not wavered in its promotion for the
global implementation of primary health care (PHC).
Brief History Of Primary Health Care
❖ Sept. 6-12, 1978, health leaders from around 200 coun-
tries attended the International Conference for Primary
Health Care held at Alma Ata, USSR initiated by the WHO
and United Nations Children’s Fund (International
Conference on Primary Health Care, Alma-Ata, 1978).
❖ INTRODUCTION:
Public Health services in the Philippines are
planned and implemented by applying the primary health
care approach. With the goal of developing self-reliance,
premium is placed on community participation. This
requires the development of organized communities that
recognize and analyze their own health concerns, plan
and implement concerted actions to deal with these
health concerns, evaluate the outcomes of their
concerted actions, and sustain their own community organiza-
tion.
Cont. Introduction
❑ 1. Pre-entry
2. Entry into the Community
> Considerations in the entry phase
3. Community integration
> Integration styles
4. Social analysis
5. Identifying potential leaders
6. Core group formation
7. Community organization
8. Action phase
9. Evaluation
10. Exit and expansion phase
Phases of Community Organizing
❑ 1. Pre-entry
> Pre-entry involves preparation on the part of the organizer
and choosing a community for partnership.
> Preparation includes knowing the goals of the community
organizing activity or experience. It may also be necessary
delineate criteria or guidelines for site selection. Making a list
of sources of information and possible facility resources, both
government and private.
> Skills in community organizing is developed on the job or
through an experiential approach. For novice organizers
( Example student), preparation includes a study or review of
the basic concepts of community organizing.
Phases of Community Organizing
❑ 2. Entry into the community.
> Entry into the community formalizes the start of the
organizing process. This is the stage where the organizer gets
to know the community and the community likewise gets to
know the organizer.
> An important to remember during this phase is to make
courtesy calls to local formal leaders (mayor and municipal
council, barangay chairperson, council members, etc.).
> Visit also to informal leaders recognized in the community,
like the elders, local health workers, traditional healers,
church leaders and local neighborhood association leaders.
Considerations in the Entry Phase
❑ Get to know and understand the community we are working with.
❑ The community organizer’s responsibility to clearly introduce
themselves and their institution to the community.
❑ A clear explanation of the vision, mission, goals, programs, and
activities must be given in all initial meetings and contacts with the
community.
❑ The community organizer must have a basic understanding of the
target community.
❑ Preparation for the initial visit includes gathering basic information
on socioeconomic conditions, traditions including religious
practices, overall physical environment, general health and illness
patterns, and available health resources.
Considerations in the Entry Phase
❑ The community organizer must keep in mind that the goal of the
process is to build up the confidence and capacities of people.
❑ Two strategies for gaining entry into a community as describes by
Manalili (1990):
1. Padrino entry – where the organizer gains entry into the
community through a padrino or patron, usually a
barangay or some other local government officials.
2. Bongga entry – seen as the easiest way to catch the
attention and gain the “approval” of the community. This
exploits the people’s weaknesses and usually involves
dole-outs, such as free medicines. This creates unreasonable
expectations and also reinforces a dole-out mentality, which
contradicts the essence of community organizing.
Phases of Community Organizing
❑ 3. Community Integration
> Community integration, termed as pakikipamuhay, is the
phase when the organizer may actually live in the
community in an effort to understand the community better
and imbibe community life. The establishment of rapport
between the organizer and the people indicates a successful
integration.
> If organizers are working for the poor, then they must live
and work with the poor. Integration frequently requires
immersion in community life. This is stage is a gradual
process. The organizer must consciously discard the “visitor”
or “guest” image. It is important to respect for community
culture and traditions. The organizer’s conduct as well as
manner of dressing must be in accordance with the norms of
the community.
Integration styles as to Manalili (1990)