PHC-II LECTURES

Lesson 1: Community Entry

INTRODUCTION
Entering the community is an important task the community health nurse does to
acquaint him/herself to his/her with area of work.

SPECIFIC OBJECTIVES
By the end of the lesson the student should be able to:

 explain community entry

 describe the preparations made before a community is entered
 identify critical actions in community entry
 list the advantages of community entry

DEFINITION OF COMMUNITY ENTRY:

1. Community entry refers to the process of initiating, nurturing and sustaining

a desirable relationship with the purpose of securing and sustaining the
community’s interest in all aspect of a program.
2. Community entry refers to the process, principles and techniques of
community mobilization and participation. This involves recognizing the
community its leadership and people and adopting the most appropriate
process in meeting, interacting and working with them.
What are strategies of community entry?
Five steps in order to gain entry into a community.
These steps involve:
1. Establishing dialogues with the community members
2. Identifying community problems
3. Discussing inter-sectoral issues
4. Mobilizing the community to take action
5. Establishing partnerships within the community

CRITICAL ACTIONS IN COMMUNITY ENTRY

  Identify the community by gathering information through formal and
informal means.
 Reading from available literature
 Talking to knowledgeable people
 Informal sources such as market places, drinking bars, funerals, festive
occasions etc.
 Identify the leadership
It is very important to recognize the position and roles of the community leaders in
order that they will help the community health officer to develop ways in seeking
their co-operation and support for program Implementation. In meeting with chiefs
and their stool/skin elders, it is important to schedule meeting, times to suit the
convenience of the traditional leaders.
Follow Protocol
Meet the paramount chief first and discuss your mission e.g. to know the history of
the community and new health program.

 Meet elders also if possible.

PROCESS

 Knock and enter upon response.

 first greet chief and elders. Introduce yourself to the chief elders and other
local leaders.
 inform them of your work with them.
 ask for their permission and advice and state your mission e.g. getting
information about the village or introduction of new health programme.
  thank them for their co-operation.
Note: The community health officer can get ideas on contact persons/groups in the
community whose support would facilitate your work.
 Identify contact persons
Apart from the chiefs and elders, there are various interest groups and personalities
in every community who must be identified to serve as contact persons in working
with the community.
Various interest groups and personalities in the community who can serve as
contact persons are:

 Prominent head of families.

 Heads of schools/teachers.
 Religious leaders/catechists
 District assembly members.
 Unity committee members
 Youth leaders
 Women group leaders
 Opinion Leaders
 Development committees
 The water and sanitation committee
 Disease surveillance volunteers.
 Traditional birth attendants. (TBA’s)
 Other health workers.

ADVANTAGES USING CONTACT PERSONS

 As a good organizers people will respect your authority.

 Their presence helps people see the issues as important.
 Trust by their people.
 They are credible

DISADVANTAGES

 Sometimes not respected-so people may not come to the meeting.

 Presence at meetings may discourage people from talking.
 They are not credible
COMMUNITY HEALTH NURSE TASKS

 Set up meetings.
 Know community priorities.
 Links with opinion leaders.
 Helpful in chieftaincy disputes.

CHALLENGES WITH CONTCT PERSONS

 Some may have lost credibility.

 Some may embezzle funds.
 Some dominate meetings.
 Some may have conflict with chiefs.
 Some may be too bossy to help

WOMEN AS SPECIAL RESOURCE

As care takers in the family, women are key players in the promotion of primary
Health Care in communities. Women are more familiar with child health problems

CONDUCT MEETING WITH COMMUNITY LEADERS

In traditional Ghana, leadership lies in the hands of a hierarchy of persons ranging
from paramount chiefs through town/village chiefs, clan/family heads to family
heads. At each of these levels of leadership, communities have their own schedules
and plans of carrying out development activities. There is therefore the need to
recognize the position and roles of the community leaders in order that the most
suitable ways could be developed in seeking their co-operation and support for
program implementation.

 In organizing meetings with chiefs and their stool/skin elders. It is important

to schedule meting times to suit the convenience of the traditional leaders.
The following levels of meetings with chiefs should be followed during the
advocacy and consultation for applying the CHPS process:
 Meet the paramount chief first and discuss the new health program with him.
Allow him time to discuss your proposals with his sub-chiefs and elders.
 Meet the chiefs of the selected communities and discuss the program with
them.
  Meet the chiefs and their elders and the community at large and discuss the
program at the sub-district Start-Up Forum and subsequent community
meetings.
 Outline your mission to them
 Brief them on what you are there to do
 Ask them to freely support you.
 Identify the leadership
 Identify contact persons

Conduct meeting with community leaders

 Outline your mission to them

 Brief leaders of the purpose of your visit;
 Seek approval and support for your program.
 Study and be knowledgeable with the custom and tradition of the people
(community study)

SOURCES OF INFORMATION

 Reading from available literature

 Talking to knowledgeable people
 Informal sources such as market places, drinking bar, funerals, festive
occasions etc.

OTHER SOURSES OF INFORMATION:

Apart from using community leaders and contact persons through the application
of (PLA) Participatory Learning and Action techniques to collect data in
community entry, secondary information could be collected from documentary
sources.
These include: Annual reports of DHMT, District Assembly, Dept. of Community
Development, Dept. of Environmental Health; Special project reports such as
Nutrition, Family Planning, Talking to knowledgeable people, informal sources
such as market places, drinking spots, funerals festive occasions etc

SKILLS AND ATTITUDES REQUIRED OF HEALTH WORKERS IN

UNDERTAKING COMMUNITY ENTRY
 SKILLS
  Maintain good eye contact.
 Listen to both sides of and issue
 Paraphrase
 Show interest
 Be empathetic
 Encourage others to listen.
 ATTITUDE
 Patience
 Tolerance
 Respect for other people
 Good listening attitude
 Humility

Note: The health worker should also do the following:

 Ensure that community members understand the message and are

encouraged to ask question when necessary.
 Probe to find out reasons why the community members may not be well
with other leaders through asking relevant questions, encouraging answers
as well as holding discussions with them.
 Ensure that message is clear and avoid unnecessary semantics and jargons.
 Encourage effective dialogue through the use of effective two way
communication skills.
 Create humor (funny) and interacts in a way that helps to build the
environment for effective interpersonal relationships.

ADVANTAGES OF COMMUNITY ENTRY

 Objectives will be achieve

 Gain support
 It ensures the establishment of good working relationship
 It helps one to plan his / her work
 It helps to observe protocols
Assignment
Each group to carry out community entry, report to be ready for discussion in two
weeks

TESTS AND QUIZZES

1. Explain skills and attitudes should the CHW employ during community
entry.
2. Describe the strategies the CHW should employ to win the support of chief,
elders and community members.