OUR LADY OF FATIMA UNIVERSITY COLLEGE OF NURSING NCM 101 COMMUNITY HEALTH NURSING Organizing for Health Promotion

I. Community Organizing y It is a process whereby the 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 which will support and monitor implementation of health initiatives by the people. y It has a goal of motivating, enhancing and seeking wider community participation in decision-making in activities that have the potential to impact positively on community health. y The emphasis is more on strengthening the members capability in problem-solving and decision making skills necessary for self-reliant development initiatives. II. Phases of Community Organizing

A. Preparatory Phase The activities in the preparatory phase include area selection, community profiling, entry in the community and integration with the people. 1. Area selection To guide the nurse in choosing and prioritizing areas for community health development, the following questions must be answered: y Is the community in need of assistance? y Do the community members feel the need to work together to overcome a specific health problem? y Are there concerned groups and organizations that the nurse can possibly work with? y What will be the counterpart of the community in terms of community support, commitment and human resources? 2. Community Profiling y A community member who is known and accepted by the people will be chosen to act as the contact person and identify other persons who can be depended upon to initiate activities in the community. y A community profile provides an overview of demographic characteristics, community and health related services and facilities. y The community profile will serve as an initial database of the community and provide the basis for planning and programming of organizing activities. 3. Entry in the Community and Integration with the People y Before actual entry into the community, basic information about the area in relation to the cultural practices and lifestyle of the people must be known. y Establishing rapport and integrating with them will be much easier if one is able to understand, accept or imbibe their community life. Guidelines in Conducting Integration Work: y Recognize the role and position of local authorities. y Adapt a lifestyle in keeping with that of the community. y Choose a modest dwelling which the people, especially the economically disadvantaged will not hesitate to enter. y Avoid raising expectations of the people. Be clear your objectives and limitations. y Participate directly in production process. y Make house calls and seek out people where they usually gather.

Participate in some social activities.

B. Organizational Phase The organizational phase consists of activities leading to the formation of a peoples organization. 1. Social Preparation y The integration work paves the way for the nurse to be introduced into the community and signals the beginning of the social preparation phase. y While continuously learning more about the conditions of the community, the nurse deepens and strengthens her ties with the people. 2. Spotting and Developing Potential Leaders y As a result of living and being with the people, the nurse comes to know who among them have deep concern and understanding of the conditions of the community. y It is necessary that they should also be able to gain trust and respect of the community members. y Providing opportunities that will demonstrate their potential as leaders can test their commitment to the communitys well-being. y It is not necessary that the potential leader is highly educated or one belonging to affluent family in the community, what is important is for that person to be able to identify with, understand and articulate effectively the problems that beset the community. 3. Core Group Formation y The core group consists of the identified potential leaders who will task with laying down the foundation of strong peoples organization. y The core group represents the different sectors of the community women, youth, farmers or workers depending on the type of community. y The nurse facilitates in skills development of core group members related to the tasks they will assume in the organization. y The core group serves as training ground for developing the potential leaders in: - Democratic and collective leadership - Planning and assuming tasks 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 y The formation of community-wide organization facilitates wider participation and collective action on community problems. y The nurse makes sure that there is maximum participation of and control by the members in all its activities. y The organizational structure must be simple to facilitate consultation and decision-making among its members. y Part of the organizational structure will be working committees specifically created to look into the different concerns of the organization community. y One such committee is the health committee. C. Education and Training Phase The purpose of the education and training phase is to strengthen the organization and develop its capability to attend to the communitys basic health-care need. This can be done through: 1. Conducting Community Diagnosis y It is done to come up with a profile of local health situation that will serve as basis of health programs and services to be delivered to the community. y The nurse assists the people in developing a plan and in the actual conduct of community diagnosis.

The nurse also helps the community to identify, analyze and understand the implications of the data that they have collected.

2. Training of Community Health Workers y The community decides on the roles the community health workers are expected to perform and the competencies and personal qualities they should possess. y The people will decide who will be trained as community health workers based on the expected roles of the CHWs. y The nurse facilitates the conduct of a training needs assessment (TNA) to determine the level of health skills and knowledge the trainees possess. y The results of this assessment will serve as the basis for the health skills training curriculum which will focus on the required competencies. 3. Health Services and Mobilization y The organization takes the lead in undertaking activities that will solve the problems the community is confronted with. y Engaging them in collective work gives the people opportunities to test and strengthen collective spirit and at the same time, build and enhance their confidence. 4. Leadership-formation activities y The process of developing community leaders is a continuous and sustained process. y Leaders learn a lot by engaging in actual activities such as conduct of meetings, assessment, planning, implementation, monitoring and evaluation activities. y They can utilize these opportunities in mastering organizing skills, human relations development or supervisory skills. y As the nurse works with the organization and the community, she will be able to assess the specific training and other practical needs of the leaders and plan for a continuing education program for them. D. Intersectoral Collaboration Phase y As an organization grows, its needs will also grow. y The need for resources-material, human, financial will have to be sourced externally. y Assistance and support in any form can be funneled into the organization through collaboration with other organizations and communities. y The nurse is in the best position to facilitate and coordinate with institutions, agencies and other key people to articulate the communitys need for support and assistance. E. Phase-Out y As the organization and the community assume greater responsibility in managing their healthcare needs, the nurse gradually prepares for turn-over of work and develops a plan for monitoring and subsequent follow-up of the organizations activities until the community is ready for fulldisengagement and phase-out. Partnership and Collaboration y The aim of partnership and collaboration is to get people to work together in order to address problems or concerns that affect them. y It gives people the opportunity to learn skills in group relationship, interpersonal relations, critical analysis and most important of all, decision-making process in the context of democratic leadership. Ways to Commit and Work Together: A. Networking y It consists of exchanging information about each others goal and objectives, services or facilities. B. Coordination

It is the relationship where organizations modify their activities in order to provide better services to the target beneficiary.

C. Cooperation y It is the relationship where organizations share information and resources and make adjustments in ones own agenda to accommodate the other organizations agenda. D. Collaboration y It is the level of organizational relationship where organizations help each other enhance their capacities in performing their tasks as well as in the provision of services. E. Coalition or Multi-sectoral Collaboration y It is the level of relationship where organizations and citizens form a partnership. Advocacy y Advocacy work is one way the nurse can promote active community participation. y The nurse is responsible for providing mechanisms for people to participate in activities that aim to improve the conditions of the community. y The nurse as an advocate helps empower the people to make decisions and carry out actions that have the potential to better their lives. Advocacy Involves: A. Informing the people about the rightness of the cause B. Thorough discussing with the people the nature of the alternatives, their content and possible consequences. C. Supporting peoples right to make a choice and to act on their choice. D. Influencing public opinions Supervision y It is a developmental and enabling process whereby the nurse supervisor ensures the work is done effectively and efficiently by the person being supervised and at the same time, keeps the person satisfied and motivated with his work. y In community health nursing, supervision is seen more as a coaching rather than a function of control. y In community, most of the supervisory functions of the nurse are directed towards lower level health workers, thus, they will require closer supervision than do professional health workers. y The nurse as a coach to health workers uses persuasion, exhortation and judicious mixture of reward and punishment to motivate the players toward higher levels of performance. Objectives of Supervision 1. Identify the supervisory needs of the worker 2. Determine ways of meeting the needs of the worker 3. Develop the capability of the worker to solve own problems and meet own needs by providing continuing personal guidance and professional development 4. Evaluating the performance of the worker as it becomes the basis for providing help or guidance.