COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH

 A middle ground where the healthcare worker and the people need to attain community
organization.
 A liberal freedom of the community where the people are allowed to participate in the overall
health care status of their community.
 A transformation force, that enables the individual, families and communities to be responsible
for their own health

OBJECTIVES OF COPAR

Patterns to be followed:

1. Organize people

2. Mobilize people

3. Work with people

4. Educate people

• Knowledge

• Attitude

• Skills

PHASES OF COPAR

1. PREPARATORY
A. Area of Selection
It should be DOPE Community: Depressed, Oppressed, Poor & Exploited, a new criteria for
community organization
“Old Criteria”→ it must be a virgin community=meaning no agency has gone there.

B. Entry: the 1st thing to do upon entering the community is to have a courtesy call with the
Barangay

C. Integration/Immersion
• Immersion is imbibing the life situation/ condition of the community by living, eating & sleeping
with the family to be able to understand their situation
• It requires 2 Qualities of PHN:
 Empathy
 Sympathy (Integration)

D. Community Study: Diagnosis of Community-COPAR
• Makes use of the Nursing Process/Problem Solving Approach
• Prioritized which among the problems identified is to be attended 1 st like in nature, magnitude,
modifiability, preventive potential, salience
 NATURE

Health Status (HS) 3

Health Resources 2
Health Related 1

PRIORITIZATION OF COMMUNITY PROBLEM

Indicators of Health Status/Condition:

Fertility: ↑ CBR=community is overpopulated=HS

Morbidity: IR (new cases) & PR (old cases)=HS
Mortality: Deaths of children dying with pneumonia=HS

Health resources

5 M’s-Manpower/Man, money, machinery, material & methods

(+) available facilities-Hospital/Clinic, mode of transportation, market, school & movie houses for
recreation

Health Related: Categories according to 5 Aspects of Man=PEMSS

P hysiological

P sychological

E motional

M ental

S ocial

S piritual

MAGNITUDE OF THE PROBLEM: % of the population affected by the

identified problem

75-100% 4
50-74% 3
25-49% 2
<25% of the population 1
MODIFIABILITY

Easily 3
Intermediate 2
Low 1
 Not modifiable 0
PREVENTIVE POTENTIAL
Highly 3
Moderate 2
Low 1
SALIENCE

2. ORGANIZING 

Choosing Potential Community Leaders

• Core Group Formation

• Community Assembly: Community Organizing Participatory Action Research (COPAR)

 Attend the assembly of the family/families

  Families in the community should be represented, any family members can represent
his/her family as long as he/ she is a RESPONSIBLE (one who also can comprehend)
member of that family.

 Barangay Captain/Chairman need not necessary be the leader. He can recommend

3. MOBILIZING 
Mobilization -let the members of the community do the work. PHN should only SUPERVISE

4. EDUCATING
 Adjust on the level of understanding of the community
 Return demonstration is the best way of teaching
 Focus on the KSA
 Respect of the custom and tradition

5. PHASE OUT

The phase when the healthcare workers leave the community to stand alone. This phase should
be stated during the entry phase so that the people will be ready for this phase.

EPIDEMIOLOGY
It is the pattern of occurrences and distribution of diseases, defects and deaths

Terms used:

Susceptible: at risk to develop, acquire or experience the disease

Immune: those that did not experience the disease, usually individuals develop resistance against the
disease

EPIDEMIC

Greater than 50% of populations are susceptible or less immune individuals.

Greater percent of the population is affected by the occurring disease
Example: Health workers reports that the community has an epidemic of measles affecting children less
than 7 years old.

Total susceptible population: 3000

Children affected by measles: 1,750

SPORADIC

The pattern of occurrence is on and off where:

ON: available causative agent
OFF: no available causative agent
It is intermittent in occurrence

ENDEMIC

The disease occurs regularly, habitually, constantly, affecting the population group
Causative agents are available to those places
 Schistosomisasis: Samar, Leyte, Mindoro, Davao
 Malaria: Palawan and Mindanao

PANDEMIC

Worldwide, international, universal, global in occurrence like in AIDS, PTB, Measles, Mumps, Pneumonia

STRATEGIES/ PROGRAMS TO PROMOTE HEALTH OF THE VULNERABLE SECTORS OF THE

POPULATION

DOH ENDEMIC DISEASE CONTROL PROGRAM

I. SCHISTOSOMIASIS CONTROL PROGRAM

POLICIES FOR SCHISTOSOMIASIS CONTROL PROGRAM

C ase Finding
H ealth Education
E nvironmental Sanitation
S nail Eradication
CASE FINDING:

6 Aspects or Thing to Know

1. Disease: Schistosomiasis

2. Other name: Bilhariasis or Snail Fever

3. Causative agent: Schistosoma-a blood fluke (parasite)

3 Types of Species: Schistosoma japonicum-endemic in the Philippines & affecting Indonesia, China,
Japan, Korea Vector:
• Oncomelania quadrasi
• Schistosoma mansoni
• Schistosoma haematobium

4. Laboratory Procedures to rule out Schistosomiasis:

• Blood Examination: ↑ eosinophil level indicates parasitism

• Fecalysis: Kato Katz (plain stool exam that uses a special apparatus resembling a feeding bottle
sterilizer)
Procedure:
• Collect specimen
• Have the test tube undergo centrifugation for 20 minutes
• Get specimen from precipitate & swab it on glass slide  
• Observe it on microscope

5. Signs & Symptoms

• CNS: High grade fever → cerebral convulsion
• GIT: Nausea & vomiting, Diarrhea → Chronic dysentery (prolonged diarrhea of more than 2
weeks & consistency is mucoid & bloody (with streaks of blood)
• Liver: Presence of infection manifested by jaundice &  hepatomegaly
• Spleen: Infection of spleen → inflammation→ enlargement
• organ (Splenomegaly)→ abdominal distension→ abdominal pain on the right upper quadrant
• Blood: Anemia & weakness

6. Treatment: Drug of Choice-Praziquantel (Biltricide) 60mg/KBW/day

• Example: If patient is 50 kg, 50 kg x 60 mg/KBW/day=3000 mg/day
• Initial treatment: 1st 2 weeks=3000 mg/day, then do stool exam after 2 weeks→ if still (+),
extend treatment for another 2 weeks. Repeat stool exam, if still (+) after the extended week,
continue treatment for 2 weeks again. No adverse effect or over dosage even if extended for a
year.
• Length of Treatment: takes months to a year

Health Education: It affects mostly farmers so educate them to wear rubber boots
Environmental Sanitation:

• Snail is the 1st concern

• Water where snail thrives is the 2nd concern
• Toilet=3rd concern
• Food
• Garbage
• Snail Eradication: Use molluscicides treat the entire suspected soil with chemical solution that
kills snails

II. MALARIA CONTROL PROGRAM

CASE FINDING:

1. Disease: Malaria

2. Other name: Ague

3. Causative Agent: Plasmodium-a protozoa

4 Types of Species:
• Plasmodium falciparum-more fatal that affects the Philippine
• Plasmodium malariae
• Plasmodium vivax
• Plasmodium ovale
Vector: Female Anopheles Mosquito

4. Laboratory Procedure: Malarial smear-extract blood at the height of fever because plasmodium is
very active & ruptures at this period.

5. Signs & Symptoms of Malaria:

1st Stage=Cold: Chilling sensation for 1-2 hours
2nd Stage=Hot: High grade fever lasting for 3-4 hours
3rd Stage=Wet: Diaphoresis (excessive sweating/perspiration)

 6. Treatment: Drug of Choice-Quinine

2 Forms:
Chloroquine (Aralen)
Primaquine
If Quinine is not available, may use Sulfadoxime-an antibacterial drug paired with pyrinthamine
PERSONAL PROTECTION:
• Sleep under a mosquito net
•  Sleep in a screened room
• Sleep with long sleeve attire
• Use repellents that contains DET (diethyl toluamide or toluene which has a pungent odor that
drives away mosquitoes & an irritant to mucous membrane of respiratory tract when inhaled
• Plant a Neem Tree using the leaves
• CLEAN:
• Chemical Method=insecticide spraying at night
• Larvae eating fish=Tilapia
• Environmental Sanitation & Health Education=insect, water, trash
• Anti-mosquito soap=basil citronelli Neem tree=banana, banaba, gabi, eucalyptus provide
repellent effect