Session 8:

Promoting Partnership with

Community
Prof. Flora Kessy
CMT 05105 Health Promotion
26th January 2018

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 Learning Objectives
• By the end of this session, students are expected to be
able to:
– Define partnership
– Describe the importance of partnership with the community
in health promotion
– Determine areas of partnership between the community and
health care providers
– Identify elements of effective networking with the community
– Identify obstacles to partnership with the community
– Describe strategies for partnership with community for health
promotion coordination.

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 Definitions
Partnership:
• A mutual search for information and solutions.
• A voluntary joint action or decision-making in a harmonious
and supportive way, for a common goal and outcome:
– It involves all players or stakeholders at community level who,
through their actions, will influence health services delivery in the
community.
Organization:
• A collection of people joined together in some formal
association in order to achieve group or individual
objectives.

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 Types of Partnership
• Partnership can be initiated between
organizations providing:
– Health and health-related care in a
community (partnership between health
care providers)
– Health and health-related care and the
community.

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 Importance of Partnership (1/2)
• Isolated efforts have limited impact because
experiences, expertise and lessons learnt are
neither shared nor concentrated.
– Umoja ni nguvu!!
• With effective collaboration, each organization can
focus on its strongest areas.
• By cooperating with interested parties, Council
Health Management Teams (CHMT) may be able to
provide broad-based and high quality health
services to those who need them.
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 Importance of Partnership (2/2)
• The importance of developing partnership with
the community in health promotion include:
– Improved community perception about health care
and health indicators
– Full community participation leading to program
acceptability, ownership and sustainability
– Increase financial and programmatic resources
(taping synergies)
– Assists in individual and organizational networking.

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 Advantages of Partnership in Health Care (1/3)

• When resources are scarce there is an obvious need to

share the limited resources.
• Partnership makes the most efficient and effective use of
resources while avoiding duplication.
• Significant health problems always have environmental,
social, economic, political and legal determinants.
– These multiple determinants of health problems may only be
addressed through combined efforts by various sectors.
• Collaboration brings greater influence:
– When all service-providers speak with one strong voice, they
are much more likely to be heard, respected and answered.

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 Advantages of Partnership in Health Care (2/3)

• Through collaboration, organizations may identify

common areas of interest and they may pursue
activities in similar standards.
– Eventually they may develop common policies and thus
increase a common sense of direction.
• Monitoring of progress is easier when efforts and
technology are harmonized.
• Combined health interventions or programs may be
more responsive to specific health needs of a
particular area or community than multiple isolated
efforts.
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Advantages of Partnership in Health Care (3/3)

• Exchange of data, information and networking may

make an organization avoid mistakes, learn from the
problems and successes of others, and avoid wasteful
and unnecessary activities.
– It may also benefit the design, implementation and
evaluation of programs in all kinds of fields including
health, education, and home-based care.
• When organizations coordinate, they can assign
activities to those organizations that are best qualified
to carry out those activities, thus putting an end to
duplication of services.
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 Identification of Areas of Partnership between Organizations (1/6)

Overview
• In order to provide clients with the best and
most accessible health services possible, the
CHMT needs to work collaboratively with
other organizations in both the public and
private sectors available in the community.
– It is very important for the CHMT to coordinate all
elements of health programs in the community.

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 Identification of Areas of Partnership between Organizations (2/6)

Characteristics of an Organization
• Before entering into partnership you would like to
know your partner better.
• Organizations are characterized by:
– The purpose of its establishment
– The people, who are associated with the organization, their
attitudes and values, their aspirations, their experience of
different types of work
– The policies and strategies - relate to services provided,
intended target group and area, finances and personnel
– The technology or equipment they have

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Identification of Areas of Partnership between Organizations (3/6)

– The environment in which the organization is

operating
– The structure of roles and relationships e.g. control
systems and administrative structure.
– The culture of the organization, which consists of its
shared values and beliefs.
• This culture creates special patterns of thinking and feeling
within each organization.
• Large government and donor organizations may have a
bureaucratic culture very different from the organizational
culture of a local NGO.

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 Identification of Areas of Partnership between Organizations (4/6)

Building Partnerships
• Partnerships are formed by groups of individuals that
join together aiming to accomplish a common purpose
• Key questions to ask yourself before approaching
potential partners:
• Who should constitute the partnership?
• Who should lead the partnership?
• How will resources be accounted for?
• How big should the partnership be? - Should it be limited to
the community other levels should be involved as well e.g.
religious organizations, other levels of government?

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 Identification of Areas of Partnership
between Organizations (5/6)
Determine characteristics of organization and
patterns of collaboration
• Identify organizations to meet with in the area
• Write to the organization requesting them to
attend a joint meeting (a senior staff to attend)
• During the meeting identify:
– Organization’s interests, similarities and differences
– Identify existing or potential areas of
cooperation/partnership.
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 Identification of Areas of Partnership
between Organizations (6/6)
• Development of organizational networking:
– Devote time and attention to all aspects, do not only
concentrate on activities within the structure of the
organization e.g. inter-personal relationship may influence a
link within organizations.
• Communication
– Convey messages with a shared meaning in a two-way
manner between the parties involved.
– Conflicts may arise because of barriers to communication
e.g. difference in perception, lack of knowledge, prejudice
or bias, among others.

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 Effective Partnership Networking with the Community (1/4)

Factors Facilitating Partnership:

• It is good to know what factors encourage partnership:
– Knowing those factors may help you to create the right
climate for partnership and to recognize opportunities for
collaboration when they arise.
• Examples of such factors:
– Political will - clear purpose and commitment to inter-
organizational partnership by all partners.
– Partnership at all levels - partnership is easier to achieve if
there is a national framework for facilitating a similar process
at regional, district and community levels.

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Effective Partnership Networking with the
Community (2/4)
– Decentralization provides community managers with
decision-making authority over resources that facilitate
partnership.
– Joint planning - join efforts to identify and agree on
problems, setting objectives, identification of resources,
budgets, timetables and procedures.
– Sometimes formal rules, regulations and procedures
indicate where different agencies can make common
use of resources such as finance, personnel and
transport – review of policies may be necessary in
facilitating partinership.
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Effective Partnership Networking with the
Community (3/4)
Requirement for effective networking with the community
• Identification of community resource persons e.g. village
elders, traditional healers, Traditional Birth Attendants
(TBAs) etc.
• Consolidation of existing resources
• Formation and maintenance of the network and defining
the purpose for the network
• Commitment building; need for commitment by both
parties, health personnel and the community
• Maintenance of the network

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Effective Partnership Networking with the
Community (4/4)
• Having a community representative in the health
facility committee as part of the network
• Meetings and documentations
• Plan of action for any activity which need to be done
for promotion of health
• Collaborative implementation, that is, communities
are part of the implementation
• Building alliances with other interested groups;
incorporating other groups who have similar interest .

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 Obstacles to Partnership with the Community (1/8)

Constraints to partnership
• If you intend to work together, it is important to
foresee and identify possible problems of
collaboration and seek ways of solving them.
• Problems in collaboration are related to differences in
organizational:
– Structures
– Cultures,
– Procedures (e.g. financial, administrative), and
– Professional ideologies and values.
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 Obstacles to Partnership with the
Community (2/8)
Problems related to organizational purpose and structure
• Different policy priorities held by different organizations.
• Establishing relationships with local partners is difficult when
partners are still under central control and are lacking autonomy.
• Partnership is further made difficult when agency boundaries are
different
– E.g. Ifakara Town CHMT may want to work with health facilities in Ifakara
Town while the Diocese has facilities in other districts
• Some organizations may view partnership as a threat to their
established role or responsibility, or causing a loss of autonomy
or their leadership role
– These fears are most pronounced among weak or young organizations.

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 Obstacles to Partnership with the Community (3/8)

Problems related to differences in procedures

• Organizations operate according to their own
management and planning systems and
procedures that may be incompatible with
those of other organizations. E.g:
– Planning horizons/limits and cycles
– Budgetary cycles and procedures.

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 Obstacles to Partnership with the
Community (4/8)
Problems related to finances
• Insufficient resources to be used in joint programs
and the considerable costs involved in establishing
and maintaining collaboration.
• Even those who have enough resources to commit
may find it difficult to share them with others
because of differences in funding sources, funding
mechanisms and flow of finances.
– This is due to the regulations which give guidance on how
the funds should be used.

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 Obstacles to Partnership with the Community (5/8)

Problems related to professional differences

• Professional differences that may come in the
way of collaboration include:
– Differences in ideologies and values
– Professional self-interest and concern for threats
to autonomy.
• Conflicting views about the roles and views of
health service users.

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 Obstacles to Partnership with the
Community (6/8)
Problems related to status and organizational culture
• Organizational members may hesitate to collaborate
because they may fear loss of autonomy and
bureaucratic control.
• Mistrust and conflict may further be based on
differences in organizational culture (e.g. the
difference in attitude toward family planning between
the government and religious organizations).
• Donors and NGOs often compete for access to
national policy-makers and specific community.

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 Obstacles to Partnership with the Community (7/8)

• Fear of revealing secrets or weaknesses:

– Organizations may feel that they have to share innovative
ideas and methods, which they believe give them
advantage over the competitors.
– May fear that their weaknesses will be exposed.
– Issues of competition and pride.
• Fear of being used:
– Managers of some organizations may worry that another
organization will use them for its own benefit:
• Making effort to open communication channels and to understand
the interest of other organizations can minimize these fears.

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 Obstacles to Partnership with the Community (8/8)

Common obstacles within the health care system

• Too much central control which hinders decision making and
flexibility required to collaborate with communities at local level:
– For example planning a health intervention in the community without
involving them.
• Wrong perceptions of health workers towards the communities
and vice-versa:
– E.g. health workers believing that they know everything about health and
community does not know anything.
• Community believing that the health workers have been given
money to provide services but they have used the money for their
own benefits.

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 Strategies to Promote Partnership within
the Community (1/5)
Developing coordination among organizations in the
community
• Mapping collaborators and collaborative activities
– Sort out who is doing what and prepare function chart.
– The function allocation chart will help the CHMT and partners to
visualize the entire range of health services that are available in the
community and use it to identify gaps and duplication of effort.
– Partner organizations will also see how they fit into the overall
community health system.
– The chart is an effective tool for establishing a common
understanding of the complexities of coordinating health services
among different organizations in the community.

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 Strategies to Promote Partnership within
the Community (2/5)
How to improve partnership among organizations in the
community
• Organize a meeting and proposed agenda:
– Alleviate the fears and highlight the advantages of partnership.
– Establish working procedures of the group, such as frequency of
meetings and sharing of information through reports.
– Conduct a function allocation exercise to see who is currently doing
what and to identify gaps and redundancies.
– Define the key areas for coordination, and specify the desired
changes and expected results.
– Record the discussions and agreements reached.
– Set a date for next meeting.

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 Strategies to Promote Partnership within
the Community (3/5)
Strategies in promoting partnership with the community
• Getting to know the community and the community getting to
know you
• Before you can involve a community in anything, you have to
know the community and vice versa
• Important things you may want to know about a community:
– Work, living standards and seasons
– Family life
– How people in a community relate to each other and their
environment
– Values, beliefs and customs
– Health attitudes, problems and practices.

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Strategies to Promote Partnership within
the Community (4/5)
Some of the questions the community may ask you:
• Who are you as a person? Where do you come from? Whom or
what do you represent?
• Why are you here? And what motivates you to enter this
community?
• Are you to be trusted? Will you be dependable? Do you keep your
promises?
• For how long will you be here?
• What do you know, what money do you bring and how can we
benefit?
• Are you sincerely interested in our situation and us?
• What authority do you have? Can you make decisions?

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Strategies to Promote Partnership within
the Community (5/5)
• To encourage community participation build community
management capacity:
– Ensuring that the community directly benefits and recognizes that the
program is vital for them
– Promoting motivation by ensuring that the ownership of the program is
placed in the hands of the community
– Training community leaders in the skills of organization and program
development.
– Community involvement can be useful input in health services delivery.
• Given the right conditions, communities posses the potential for
being active participants to identifying their own needs and
priorities.

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 Strategies in Promoting Partnership
• Read Handout 8.1 on Strategies in Promoting
Partnership
• It provides elaboration on:
– Approaches to partnership
– Organizational-Bureaucratic Approach
– Mutual agreement
– Development of network
– Communication, and
– Strategies to promote partnership with communities.

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Methods of Working with Community

• The establishment of any relationship requires

time. Most important is to be in touch
regularly, be truthful and dependable.
– Make only such promises that you can respect.
• The appropriate method to work with the
community is known as ‘Participatory Rural
Appraisal (PRA)’.
– Community members act as researchers and
analysts together with health workers.
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 Getting to Know Your Community
• Read Handout 8.2 - Getting to Know Your
Community
• It provides details on:
– Important things you may want to know about a
community
– Important things the community may want
to know about you

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 Relationships between People and their Environment (1/2)

• What is the predominant system of social organization

in this area? E.g. modern with political parties,
traditional with chieftaincy or exclusively under a
religious order?
• Who are the community leaders and how do they
come to power?
• How are decisions made in this society?
• Is the political structure democratic or authoritarian?
• Do they have places where people can meet to make
decisions?
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 Relationships between People and their Environment (2/2)

• Values, beliefs, customs and attitudes:

– What beliefs are most common about the five top
health problems of the area?
– Which customs (traditional practices) do people
feel are harmful to human health?
– Are there any social practices or beliefs, which
hinder cooperation with certain groups in the
area?

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SIDANGANYIKIIII!!!

Thanks
www.ttchih.org
fkessy@ttcih.ac.tz
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