COPAR

Community Organizing Participatory Action Research (COPAR)

COPAR
▪ is a CONTINUOUS AND DYNAMIC PROCESS of encouraging people to UNDERSTAND/DEVELOP THEIR
AWARENESSof their existing conditions by providing the skills, capability training, and working with the people
collectively and efficiently on their problems. – (CBQ)
▪ A social development approach that aims TO TRANSFORM the Apathetic, individualistic, voiceless poor
INTODYNAMIC, PARTICIPATORY and politically responsive community. (Turning a passive to ACTIVE community)

TAKE NOTE: The COMMUNITY is NOT considered as subjects of research they are considered as participants or
CO–RESEARCHERS – (CBQ)

IMPORTANCE OF COPAR
S – self reliance by preparing people to manage a development program in the future.
A – active community participation and involvement is maximized
M – mobilized community resources for community services.
E – empowerment of the people and community development

PRINCIPLES OF COPAR
P – people’s participation should always be present (CBQ)
O – oppressed and exploited sectors are most open to change.
W – with COPAR it should lead to self – reliant community and society. (CBQ)
E – empowerment – Power must reside in the people
R – remember, COPAR should be for the interest of the poorest sectors of the society.

Saul Alinsky – Father of Community Organizing

PHASES OF COPAR

I. Pre-entry Phase (1-2 months)

▪ Initial phase of the organizing process

▪ Looking for communities to serve or help. (Area selection)(CBQ)

▪ Simplest phase

F – formulation of objectives and targets for the program

I – institutional goals
R – revision of curriculum
S – seek and coordinate participation of other departments within the institution.
T – training of faculty in CO-PAR

A – at the community level: encourage dialogues with the people

C – criteria for site selection development
T – the ACTUAL SITE SECTION (CBQ)
I – initial or preliminary social investigation (PSI)
O – ocular survey noting accessibility, geography, terrain, and available resources. (CBQ)
N – networking with LGUs and NGOs and other department

5 activities of the pre entry phase.

A – area selection
C – courtesy call to the mayor
T – train students on baseline survey
I – interview
O – ocular survey
N – networking with other departments
Criteria for site selection(CBQ)
D – depressed and exploited rural community
E – ensure acceptance (No strong resistance from the people)
P – poor
R – residents - 100-200 families
E – economically depressed
S – safe ( No serious peace and order problem)
S – shows high morbidity and infant mortality cases.
E – ensure NO similar agency holding same program
D – DO NOT have BHS or nearby hospital

II. Entry Phase

P – phase for “Social Preparation” (CBQ)
A – actual entry of the nurse or community organizer into the community. (CBQ)
S – sensitization of the people on the critical events in their life
O – organizer motivates the people to share their dreams and ideas.
K – known also as the MOST CRUCIAL phase. (CBQ)

GUIDELINES FOR ENTRY INTO THE COMMUNITY

P – pay courtesy call upon entry to the community to the local authorities (Barangay Officials) (CBQ)
L – let them know your projects objectives
E – ensure to be a ROLE MODEL
A – avoid raising expectations/consciousness of the community residents
S – speech, behavior and lifestyle should be in keeping with those of the community residents
E – ensure to adopt a low key profile

1-Immersion/integration/sensitization with the community

▪ Establish rapport(CBQ)

▪ Converse with people in their usual gatherings/area of congregation

▪ Living with the community

▪ Information Campaign on health programs

▪ Participate in livelihood activities.

▪ Support and lend hand in household chores

▪ Ensure to be a role model, AVOID gambling and drinking alcohol

2. Deepening social investigation

3. Potential leader spotting
Leader spotting through sociogram.
A. Key Persons - approached by most people
B. Opinion Leader - approached by key persons
C. Isolates - Never or hardly consulted
Criteria for a potential leader
L – low profile
E – education: at least basic primary education
A – approachable /respected by both formal & informal sectors
D – develops a good communication skill
S – serve willfully. (CBQ)
4. Core group (CG) formation
5. Self Awareness and Leadership Training (SALT)

III. Community Study/ Diagnosis Phase (Research Phase)

Selection of the research team
 Training of researchers on data collection(CBQ)
Planning for the actual gathering of data
Data gathering
Training on data validation
Community validation
Presentation of the community study/ diagnosis and recommendations
Prioritization of community needs/ problems for action

Methods of data selection

S urvey - most practical ( using questionnaires)
I nterview - face to face ( using interview guide)
R ecord review ( checklist)

C ensus – MOST IDEAL ( provides BIGGEST BULK of data)

O bservation - occular surveys

CENSUS
▪ De facto - ACTUAL place ( individuals are recorded to the geological area where they were present at
a specific time.)
▪ De jure - RESIDENCY (individuals are recorded by their place of residence-"usual residence"-the
place where a person lives and sleeps most of the time)

IV. Community Organization and Capability Building Phase

E lection of officers and delineation of roles and task
L eaders or groups are being given trainings (formal, informal, OJT)
E ntails the formation of more formal structures
C ommunity meetings to draw up guidelines for the organization
T eam building Exercises

TAKE NOTE: A-R-A-S (Action- Reflection- Action-Session)

V. Community Action Phase

Organization and training of (BHWs)
PIME of health services(Project Implementation Monitoring and Evaluation)
Resource mobilization
Setting up of linkages/ network/ referral systems

VI. Sustenance and Strengthening Phase(7-8 months)

▪ Occurs when the community organization has already been established and the community members already
actively participating in community wide undertaking. (CBQ)

Formulation and ratification of constitution and by-laws

Identification and development of " secondary" leaders. (CBQ)
Setting up of a financing scheme an implementation of livelihood projects
Training and continuing education of BHW (CBQ)

TAKE NOTE: Formalize linkages, networks and referral systems then register organization to S.E.C.(Security and
Exchange Commission)

7. Phase Out phase

▪ Gradual turn over of works

▪ Transfer of Community Organizing roles and responsibilities and documents to the organization

▪ Follow up

FAMILY
 ▪ The UNIT OF SERVICE in the community (CBQ)

▪ is a small social system (2) or more people living together who are related by blood, marriage, adoption, or by
arrangement over a period of time.

BEST definition of family: A group of people who live together.(CBQ)

Genogram
▪ displays pertinent family information in a family tree format, the family can see the family structure, its members
and their RELATIONSHIPS. (CBQ)
▪ diagram of family relationships

Ecomap
▪ Used to identify family relationships between members of the community. (CBQ)

Pedigree chart
▪ Chart/diagram of the GENETIC HISTORY of a family over several generations(CBQ)

CLASSIFICATION OF FAMILIES

1. Nuclear family – TRADITIONAL type, consists of husband and wife (and perhaps one or more children).
2. Extended family – includes relatives (aunts, uncles, grandparents, and cousins)
3. Single-parent family – consist of one parent and children
4. Blended family- married couple, their children and their children from previous marriages
5. Alternative family – Relationships include multiadult households, "skip-generation" families (grandparents caring for
grandchildren), communal groups with children, "nonfamilies" (adults living alone), cohabitating partners, and homosexual
couples.
6. Beanpole - Family comprised of 4 or more generations
7. Same Sex/Homosexual – Family comprised of Gay/Lesbian partner w/ adopted/biological child
8. Communal – Unrelated individual/family in one roof

AUTHORITY:
▪ Patrifocal/Patriarchal – Father has main authority

▪ Matrifocal/Matriarchal – Mother has main authority

▪ Egalitarian – Equal authority of both parents

▪ Matricentric - Prolonged absence of father (OFW), Mother gets the dominant power

LOCALITY:
▪ Patrilocal – Newly wed living nearby father's side

▪ Matrilocal – Newly wed living near mother's side

▪ Bilocal – Newly wed living near both side

FAMILY CARE PLAN

▪ blueprint of the care to the family

First Level Assessment

1. Health Deficits – FAILURE in health maintenance ( disease, disorders and disability)

Score: 3
 Disease/ illness – hypertension, DM, heart diseases, URTI, marasmus, scabies (CBQ)
Disabilities – deaf, mute, blind, polio, stroked patient with paralysis.
Disorders – problems like mental retardation, down syndrome (CBQ)

2. Health Threat – conditions conducive to disease, accidents or failure to realize one’s health potential. (Score:2)
B roken glasses and scattered sharp objects
A bsence or lack of prenatal visits or clinic visits(CBQ)
S afety hazards: fires, falls and accident
U nhealthy lifestyle – faulty eating, sedentary
R odents and insects
A bsence or lack of immunization
S anitation issues and family history of diseases.

3. Stress Points/ Foreseeable Crisis(CBQ)

▪ anticipated periods of UNUSUAL DEMAND on individual or family in terms of adjustment or family resources
(SCORE: 1)

Pregnancy
Abortion
Parenthood
Additional family member (Newborn) (CBQ)

Income loss (loss of job) (CBQ)

Separation or break ups and courtship

Divorce and annulment

Entrance in school(CBQ)
Adolescence (circumcision, menarche, puberty.)
Death of love ones.

PRIORITIZING HEALTH PROBLEMS

NATURE OF THE PROBLEM – health deficit, health threat and foreseeable crisis
▪ Health deficit 3

▪ Health threat 2

▪ Foreseeable crisis 1

MODIFIABILITY OF THE PROBLEM –the PROBABILITY OF SUCCESS of success in minimizing, alleviating or

totally eradicating the problem through intervention (CBQ)
▪ Easily modifiable 2

▪ Partially modifiable 1

▪ Not modifiable 0
PREVENTIVE POTENTIAL –refers to the nature and MAGNITUDE of future problems that can be minimized or totally
prevented if intervention is done on the problem under consideration
▪ High 3

▪ Moderate 2

▪ Low 1

SALIENCE – refers to the family’s PERCEPTION and evaluation of the problem in terms of
seriousness and urgency of attention needed (CBQ)
▪ A serious problem, immediate attention needed – 2

▪ A problem, not needing immediate attention – 1

▪ NOT seen as a problem – 0

CHN PROCEDURES

CLINIC VISIT steps - patient or family visits the health center

I. Admission/Registration – initial and FIRST ACTION in clinic visit.(CBQ)
▪ Greet and welcome clients (CBQ)

▪ Prepare the individual or family treatment record

II. Waiting time – 1st come, 1st serve basis

III. Triaging
IV. Clinical evaluation
V. Laboratory test and other Diagnostic examinations
VI. Referral-2-way referral system
VII. Prescription and Dispensing
VIII. Health education – LAST step of clinic visit (CBQ)

HOME VISIT
▪ a nurse –family contact which allows the health worker to assess the home and family situations in
order to provide the necessary nursing care and health related activities

ADVANTAGE OF HOME VISIT: provides opportunity to do FIRST HAND APPRAISAL of the home situation(CBQ)

PURPOSES OF A HOME VISIT:

H – health care provider gives nursing care to the sick, postpartum and her newborn.
O – observation and assessment of living condition and family health practices.
M – may establish relationship between agencies and the public for heath promotion.
E – educate the family regarding health promotion and disease prevention.

PRINCIPLES OF A HOME VISIT

M – must “HAVE”a purpose or objective
U – use all available information about the patient and his family
S – set and give priority TO the essential needs of the FAMILY
T – the planning and deliveryMUST INVOLVEthe individual and his family.

TAKE NOTE: Home visit must be FLEXIBLE

STEPS IN CONDUCTING HOME VISIT

1. Greet client and introduce self and ESTABLISH RAPPORT (FIRST STEP) (CBQ)
2. State the purpose and objective of the visit
 3. Assess health needs
4. Perform bag technique (Bag placement)
5. Physical examination and nursing care
6. Impart Health teaching
7. Record all data and observations
8. Appointment

PHN BAG- essential and indispensable equipment of a PHN

IMPORTANT POINTS TO REMEMBER: 4 C’s + H

COMPLETE – contains all the necessary articles, supplies and equipment.
CLEAN – Cleaned very often, supplies replaced and ready for use anytime.
CONTAMINATION – bag contents are clean and sterile, while articles belonging to
the patient as dirty and contaminated. (CBQ)
CONVENIENCE - collection of article should be convenient to the user.
▪ Solutions like 70% alcohol, hydrogen peroxide and betadine are placed at the BACK of the bag (CBQ)

▪ Oral and rectal thermometers, syringes and needles should be placed at the FRONT of the bag
(Thermometers should be facing DOWN.)

Handwashing is done as frequently as situation for, helps minimizing and

avoiding contamination of the bag and its contents. (CBQ)

BAG TECHNIQUE
▪ A “TOOL” making use of a public health bag through which the nurse, during his/her visit, can perform nursing
procedures with ease and deftness, saving time and effort with the end in view of rendering effective nursing care

PRINCIPLES OF BAG TECHNIQUE:

1. MINIMIZE, if NOT prevent the spread of any infections. (Most important) (CBQ)
2. Saves time and effort in the performance of nursing procedure.
3. Show the effectiveness of total care of the individual and the family.
4. Variety of ways should be performed depending on the agency’s policy.

COMMON BOARD QUESTIONS:

▪ Upon arriving at the clients home, place the bag on the table or any flat surface lined with paper lining, clean side
out (folded part touching the table).
▪ Place the linen/plastic lining spread over work field or area CLEAN SIDE OUT

▪ LAST item place back in bag is the PLASTIC/PAPER LINING (CBQ)

▪ Sphygmomanometer (BP cuff) and stethoscope is NOT included inside the bag(CBQ)

▪ DO NOT USE NEWSPAPERS only clean papers as linings.

▪ FIRST thing you get from the CHN bag – soap in a soap dish and hand towel

▪ AVOID frequent opening of the bag. (CBQ)

▪ Avoid shaking or swaying the bag when carrying it.

▪ Bag technique shouldn't overshadow but rather show the effectiveness of the total care given to the individual
and family.
ISOLATION TECHNIQUE IN THE HOME CONSIDERATIONS:
1. Articles used by the patient should NOT be mixed with the articles used by
other family members.
2. Frequent hand washing and disinfection of the room are imperative and room exposure to sunlight.
3. Health provider should use PPE (gown and mask) and should be used ONLY within the room.
4. Properly discard all used tissue paper with nasal and throat discharges
5. Soiled articles with discharges should be boiled for 30 minutes before washing.

Demography is concerned with the study of population.

Demographic profile:
▪ Size, distribution, composition, and change in population. (CBQ)

Philippine census is done every 5 years(CBQ)

Based on the 2017 demography report (JULY 2016 estimate), the Philippine population has reached: 102 Million (CBQ)
Demographic variables in population growth includes: FERTILITY, MORTALITY and MIGRATION
TAKE NOTE: MORBIDITY is NOT included as demographic variable. (CBQ)

Median age:2018 estimate: 23.7 years2020: 25. 7 years

Life expectancy: 2018 estimate: 69.6 years

Population structure is a diagram of population typically presented in a pyramid-like style format

based on AGE AND SEX (CBQ)

Aging population
▪ refers to a phenomenon in which the median age of the population in a country rises significantly compared to the
total population in a country rises significantly compared to the total population. This is caused by any or
combination of the following: (CBQ)
▪ A declining birth rate.

▪ Rising life expectancy. .

▪ Decreased fertility.

Situation – The public health nurse must have an understanding of demography which should support health care plan.

1. Demography is concerned with the study of population. Which of the following are included in demographic profile?
A. Size, composition, health status, and environment.
B. Change in population, distribution, and health status.
C. Size, distribution, composition, and change in population.
D. Size, distribution, and composition.

2. Based on the 2017 demography report (July 2016 estimate), the Philippine population has reached:
A. 140 million B. 120 million C. 102 million D. 85 million

3. There are three demographic variables in population growth. Which one is NOT included?
A. Fertility B. Migration C. Morbidity D. Mortality

4. Population structure is a diagram of population typically presented in a pyramid-like style format based on ___________.
A. Sex and educational attainment C. Age and civil status
B. Age and fertility D. Age and sex

5. An aging population refers to a phenomenon in which the median age of the population in a country rises significantly
compared to the total population in a country rises significantly compared to the total population. This is caused by any or
combination of the following:
1. A declining birth rate. 4. Increased child survival.
2. Rising life expectancy. 5. Better health.
3. Decreased fertility.
A. 1, 2, 3 and 4. B. 1, 2, 4 and 5. C. 1, 2 and 3 D. 1, 2, 3, 4 and 5.