COPAR Reviewer Midterm PDF

STAGES OF COPAR (Community Organizing and Participatory Action Research) I. Pre-entry Phase CRITICAL ACTIVITIES: 1. Selection or validation 2. Personal visit (Preliminary Social Investigation) >A secondary data gathering through review of records. Common sources are Barangay H...

STAGES OF COPAR (Community Organizing and Participatory Action Research) I. Pre-entry Phase CRITICAL ACTIVITIES: 1. Selection or validation 2. Personal visit (Preliminary Social Investigation) >A secondary data gathering through review of records. Common sources are Barangay Health Center, Barangay Hall, and Family Records. >Rationale: 1. Redundancy: to avoid repetitive questions 2. Irritation: to avoid rejection from the community 3. To identify common issues > Consolidation and identification of priorities are other ways to accomplish PSI 3. Formal Communication >The group communicates to the barangay about their purpose. 4. Courtesy Call to the municipal leader or a personal visit to the leaders like mayor or municipal health workers > Rationale: 1. Show respect to the leaders 2 Leaders of the community know what are or is the need of their area. 3. T o get their initial support on the health activities are going to do by the group 5. Agencies orientation >Content: 1. Policies, Philosophy of Community Health Nursing, principles, goals and objectives. 2. Initial data that has been gathered by college of nursing on the area. 3. Initial activities. 4. COPAR approach, strategies, principles and processes involved II. Entry Phase Description: > Actual entry and immersion of community health workers in the community > Also known as the Social Preparation Phase > Considered as the most crucial phase because * It determines acceptance of the community *Sensitization of people on critical events in their lives , e.g. dreams and aspiration CRITICAL ACTIVITIES 1. Courtesy call at the barangay level - conducting a personal visit to the leaders Purposes: a. To (sensitize) make them aware of your presence in their community b. To make them feel that you have recognized their important roles in this health partnership. c. To establish rapport or initiate a trusting relationship with them. d. To discuss initial but immediate plans, such as; *settling down in the staff house *terms or conditions related to the staff house immersion *Immersion *Ocular survey >Reasons : 1. To determine the house of the contact persons, or leaders of the community. 2. to be familiar on the landmarks 3. To be aware on the physical and political boundaries of the area 4. To determine the entry and exit points of the area. *kind of approach to be use - concept of partnership - " Umay kami mak- ili...", insted of saying ,"umay kami tumulong " 2. Community integration - basic continuing activity by which the community especially the poor through immersing self in the community. Purposes of integration : a. To get to know the people's culture, economy, leaders, history, rhythm, and lifestyles as bases for own adjustments --better acceptance to the community. b. To understand and respect the people and recognize the positive aspect of their culture that give them the strength to struggle. c. To understand how the people analyze their own situation d. To have basis for modifying own values and lifestyle in keeping with that of the community. Guidelines in integration: a. Appearance, speech, behavior and lifestyles be in keeping with the community residents, without disregard to being a role model in health beliefs and practices. Appearance--not appearing like a tourist Speech--not talking slang Behavior--not being too close with the opposite sex Lifestyle--simple food yet nutritious b. Be humble and adopt a low key profile or approach. Go down to their level. Encourage you to call you simply. Refrain from  being messianic in approach. Do not promise anything you are not very sure of giving. c. Visit as many people as possible in the community by conducting house to house visits and answering house calls. Rationale: to avoid creating jealousies and factions. Cautions: insinuating remarks of personal interest d. Live with the poorer people in the community if you really want to be of service to humanity. e. Participate in direct production, household and social activities of the people. f. Seek out and converse with people where they usually congregate - stores, washing streams, church, etc. Caution: Distinguish between small talks and discussion from tsismis. g. Avoid too much drinking. h. definitely no smoking or gambling in the community. i. avoid flirting with male and female community members. j. Share the people's housing, food, entertainment, and meetings. 3. Leader spotting and initial core group formation/ identifying existing leaders or groups a. Laying the foundation of a strong people's organization by identifying original or indegenous members of a community with leadership qualities and bringing them together to exchange knowledge and insights about their community b. Core goup- a group of people who are initially identified as leaders (key persons and opinion leaders) with the following characteristics: * has a high level of interest and needs and is open / willing to shareneeds and interest with others on a collective basis * Manifest attitudes / values of integrity and credibility in words and actions. * Open to learn more and gain skills. * Committed to share own time and resources for the community * expresses willingness to act on something or solve problems with others on a collective basis * Shares similar vision, goals and values with that of the people. Functions of the core group: *serves as the initial contact group of the health worker * performs initial actions or mobilization of the community members * Later on be elected as officers of the people's organization or become chairs of different committees that the community may probably form.  * Helps the health workers conduct a deepening social investigation, spot additional potential leaders from different sectors of the community * Helps in laying out plans and tasks for the formation and maintenance of a community-wide organization. c. Sociogramming - a systematic process of identifying indigenous leaders in the community who can facilitate the change process, especially in mobilizing people. Sociogram - a tool that can be used to analyze a leadership or communication pattern between and among groups of people. Purpose of a leadership sociogram: a. Helps the health worker identify key persons, opinions leaders and deviants or isolates in a certain community Key person: * the star in the sociogram because she or he is the most commonly approached by many people regarding their own problems * an obvious leader, persons with whom the health worker has to win support and train as the local community organizer and health worker. Alter ego of the health worker. Opinion Leader: * the person who is approached by the key person and is therefore, the one behind the key person's ideas. Adviser of the key person. Deviants or isolates * persons in the community who are not or are never approached by any or few community members when faced with problems. b. Also helps the health worker to get the identified leaders to express their support to the COPAR approach, its phases and activities c. It is wiser that the detailed results of the sociogram will not be known by the community in order to avoid raising negative feelings or rejection or denial among community members. 4. Groundworking of identified leaders (key persons and opinion leaders) and community members Definition: this is a basic tactic used in community organizing where the organizer goes around and motivate them on a one-on -one basis to: a. critically study and come up with one stand point about a particular issue at hand b. prepare own contributions prior to a meeting c. think of a suggestion on what to do about something that needs to be acted upon d. motivate them to participate / attend Main purpose of groundworking: to mind set people 5. Tentative program planning and implementation- an activity that can be done simultaneously by the community health development workers alongside with the leader spotting, groundworking, and DSI. a. CHD Workers will choose a major health issue or priority concern identified during the PSI and they will work on it with the general population Rationale: To make organizing and health activities more concrete or visible b. Close coordination of these activities with existing local health workers and RHU personnel. Examples: Health service delivery though home visit Health education Maximizing capabilities of BHWs Enhancing capabilities of BHWs 6. Deepening social investigation(DSI) - a continuous systematic process of collection, collation and analysis of primary and secondary data not reflected in the PSI Other terms used for DSI: community study or participatory action research Purpose of DSI: a. Provides a clearer picture about the community b. Basis for planning and organizing activities c. Helps in determining the appropriate approach and method of organizing  Community diagnosis - output of community study that is described as both a profile and a process: a. As a profile, it is a description of the community's state of health as determined by its social, political, economic, cultural and environmental / ecological / physical / geographical factors. b. as a process, it is continuing learning experience for both the agency and the community. * for the agency, it learns to alter its initially drafted plans and programs in order to adapt to the results of the community analysis. * for the community, it allows them the opportunity to gradually understand their own situation and the potential advantages that change can bring about. Guidelines / pointers in conducting deepening social investigation: a. More successful if the health worker has well integrated with the community members. b. Community leaders should be trained to assist the health workers in doing DSI so that it will be truly participatory c. The use of the survey questionnaire is discouraged as much as possible due to the following disadvantages: *Dishonesty of data if the health worker has not yet fully integrated with the community *Difficulty of community folks and leaders in reading and answering a long questionnaire. *Previous negative experiences of community with traditional researchers that leave them a feeling of being subjects of study, instead of being active participants of the study. d. Data can be more accurately and honestly gathered through informal methods like casual conversations during * house-to-house visits *while riding a jeepney with them *in stores *in washing streams *while attending community gatherings *while working with them in production and household activities Note: it is this forth guideline that makes DSI long and tedious and requires the community health development worker to live or immerse in the community  Rationale for using informal methods of data gathering: To obtain reliable data. e. Validation of data should be done regularly with community folks f. Collation, analysis and writing of the community diagnosis should also be participatory g. for a truly participatory analysis to happen, it should be done in four levels: * at the level of the community health development workers * RHU or directly health related agency personnel * local government units * Per sitio-level analysis Steps in conducting a community diagnosis (1) Preparatory phase: a. Review with the community leaders those data that are not available in the PSI but are importantly needed in health development work. b. Assist the leaders to decide to gather these missing data. c. If they decided to gather the data, assist the m to formulate very simple objective / s of the community diagnosis d. Research training of core group on designing very simple tools and methods of data collection: E.g. Training on how to conduct an interview how to make flash cards to augment their data collection through interview e. Mapping and zoning to avoid overlapping of households being interviewed. (2) Participatory data collection based on a set schedule (3) Conduct of first ARAS with the core group. (4) Participatory collation, validation and analysis a. Training of core group on collation of data b. Actual collation of data c. Analysis of data - community development workers and core group analysis, the first to act as facilitators d. Dry run of core group in facilitating sitio level analysis e. Simultaneous with the dry run of core group, data presentation and validation with RHU and other health agency workers will be conducted by the development workers. f. validation and analysis of data by the local government unit, municipal level, facilitated by community development workers. g. Compile all the results of validation and analysis of the different groups. h. identification of a member of the planning team from each of the group. i. Conduct of second ARAS activity (5) Participatory planning a. Brief training of representatives, from the different groups who analyzed  the data, on planning. b. formulate the COMMUNITY DEVELOPMENTAL PLAN. c. planning consultation to the different groups who analyzed the data plus committee formation. The committees that will be formed will be based on problems that were identified in the analysis d. Compilation of plans e. Conduct of third ARAS activity. (6) Participatory action a. mobilization of the different committees formed b. ARAS by each committee (7) Participatory evaluation a. Quarterly b. Annually 7. Community meeting or assemblies - series of community gatherings where all community members or household representatives are enjoined to attend Purpose of community meetings: a. To collectively discuss, agree, plan or act on something that the individual or family have already decided or thought about during a groundworking activity. b. To provide an opportunity for the community folks to exercise their collective power and confidence to act on their concerns COMMUNITY CONSULTATION Definition: this is the first of the series of meetings where the household representatives and the agency will meet together in order to formally know each other and to share their own vision, mission and objectives in relation to health development. Objectives of this consultation: a. To get the people's collective ideas and feelings about the entry of the agency to their community in terms of acceptability or unacceptability. b. if their are no evidences of unacceptability, the agency representatives will now formally introduce their philosophy, principle of work, approach to be utilized, program components and objectives and organizational structure. Note: during this meeting their will be no mention yet of the possible activities stipulated in the plan prepared by the agency representatives upon entry since this will be first evoked from the people. c. to present the results of the PSI in order to provide them an opportunity (1) to validate data (2) for initial analysis and identification of common community problems or concerns. (3) for the community to initially decide about priority problems or needs that concern them at that moment  (4) to identify their own strengths. d. to evoke from the community residents their vision of a happy family and a developed community in the light of the situation that they have just analyzed e. The community to: (1) Identify possible obstacles that block them from achieving their vision (2) formulate their own goals and objectives in relation to the obstacles and problems they have already identified (3) Collectively decide on the next activity they are going to do - any of the following: *do an initial community plan for the identified problems (problems, why, how, when, etc) * formulate specific committees intended to frontline resolution of the problems or obstacles identified Example >Research committee 9if they think they need more data aside from the results of PSI) > Planning committee - to draft the initial community plan > other committees Note: the agency facilitator or development worker should be very conscious to guide the people, but not to suggest, so that they will decide for the second option - to formulate specific committees and give names to the committees they have formed the agency facilitator can help the people decide by exploring with them the advantages of each of the two options. f. to evoke from the community their own ideas about the characteristics and qualifications of a good leader. g. the community will select from among them, people who posses the characteristics and qualifications of a leader that they have identified. Note: there are possibilities that the initial key person or core group identified earlier will now be integrated into the different committees, as chairs or members. Role of the agency representative during this community consultation: Main Facilitator 8. Action-reflection -action session (ARAS) Definition: Regular cycle of evaluation that follows every after an activity, which largely focuses on self-reflection about one's own contribution to the success and failure of that activity and what one can do to enhance or improve future performance or similar future activities. Specific objectives of ARAS for each individual or group : a. Identify and celebrate own strengths related to the success of the activity. Example , Community consultation b. Critically analyze the cause of mistakes and failures in that particular activity so that consequent suggestions can be given to improve performance in the next activity and to prevent recurrence of such mistakes  or failures c. relieve the pains experience due to errors or mistakes or due to the behaviors of others in the group or community. d. reconcile hurt feelings within individuals in the group e. re-affirm commitment to the organizational vision, mission and goals f. becomes closer or develop further cohesion Methods of conducting ARAS: a. small round table discussion b. group singing c. song or story analysis d. question and answer technique then relating responses to actual situations or activities conducted. Suggested steps in conducting ARAS: a. Preparation: * The nature of this activity should be always a part of every orientation Rationale: this is to mind set members to anticipate and therefore prepare for this activity * Members to agree on things to prepare ( e.g., tapes of a song, story) venue for the ARAS, comfortable attire and time. b. Actual ARAS * Formation will be very informal and no physical barriers should be blocking the vision of one participant to the other. * Facilitators to start with gimmicks to decrease anxiety of the members * Present objectives in relation to the recently concluded activity * Facilitator discusses the flow of ARAS and get suggestions and approval from the body. * Group singing, song or story analysis (whatever method is appropriate) * Possible questions for self reflection: > What have you realized from the song or story in relation to yourself - attitudes, knowledge and skills? > How will you relate the realization to the activity we have just concluded? > What have you learned from the story or song? From the activity? > Other questions as necessary * Respect members expression of emotions and feelings by not being judgmental * Sharing and synthesizing learning insights from the activity and from each other. * Deriving implication of insights in relation to self, others and to organizational vision, mission, and goals. Who facilitates the ARAS a. Leader of the agency or a designate - if the ARAS will be conducted within the agency or among the agency workers  b. Community level * The agency workers will facilitate in the first experience of ARAS to be conducted with community folks. * Community leaders will become the facilitators if ARAS will be conducted within the different committees after sufficient skills have been developed III. Organizational Building Phase Description: 1. This is the phase which entails the formation of more formal structures and inclusion of more formal procedures of planning, implementing and evaluating community wide activities. 2. It is in this phase where the organizational leaders, groups or communities are given formal and informal trainings to further develop their attitudes, knowledge, and skills that they need in managing their own activities or programs. 3. This is also considered as the MOST CRUCIAL phase of COPAR because: a. The focus of COPAR is building and strengthening human behavior b. The challenges and struggles of the agency health development worker occur during this stage Note : Community organizing is more of experiencing, instead of inputting. In spite of the struggles and challenges faced by the community organizer or development worker, he or she should not be bombarded with concepts or inputs instead; he or she should be allowed to grow as the organization grows or to learn by experiencing what the organization or community experiences. CRITIAL ACTIVITIES: 1. Formalization of a genuine people's organization Definition of terms: a. Formalize - to give shape, form or structure with a clearly articulated vision, mission, goals, objectives, functions or tasks and personnel b. Genuine people's organization (1) A living organism in a social ecosystem not just a structure. A living organism in a social ecosystem means that it is a group of conscienticized individuals who decided on their own, to unite efforts so that they can collectively generate more resources and collectively act on their own common problems and concerns. (2) An organization that the people, themselves, decided to form for their own interest and not for the interest of external individuals or groups. (3) This organization becomes the source of power for the community Elements of a genuine people's organization: a. Vision - imagination, dream, an ideal or an end result of a standard quality of life, an abstract. It is usually broadly stated and in a noun phrase. Example: self reliance, Empowerment, "health for all", etc. b. Mission - principal; task or assignment, path chosen to be able to reach the vision. Characteristics of a mission statement: (1) Starts with "To..." (2) Must flow from the vision statement (3) Accomplishment of the mission leads to the realization of the vision (4) Should be attainable c. Goal - general, broad aim or direction, the end toward which all effort is directed at d. Objectives (1) Clarifies in detail what one wants to carry out (2) It specifies for whom the project is being done, by whom. Within what period of time, where and what a group wants to accomplish (3) In short, this is a detailed clarification of what one wants to accomplish e. Development plan - written outline of the goals, objectives, planned activities, resources, monitoring scheme and evaluation plan of the community f. Structure - refers to the skeletal arrangement and composition of the people's organization, including the different committees, the people who man these committees, and the relationship and lines of responsibility and authority of its leaders and members g. Mechanics / strategies - methods or tactics h. Policies - set of principles or rules determining what or how things are done by a person or a group. i. Personnel - includes the leadership or management and program staff. j. Membership - constitute the number of actively participating members which ideally should come from every household comprising the community. k. Resources - supply or support for the organization (1) Land - includes beneath and above (2) Labor - all human beings who extract and process raw materials into finished products, to transport and sell goods or products or provide services (3) Capital - materials, money, logistic or support services which the people use to extract and process the raw materials (4) Entrepreneur or manager (5) Exchange value In short, resources would refer to the 6 Ms - manpower, machinery, methods, minute (time), money, materials. l. Participation - considered to be the MOST IMPORTANT ELEMENT of the organization because without this, the organization cannot be considered as a living organism Levels of organic growth of an organization a. Birth to infancy Description: this starts from the identification of potential leaders to core group  formation until the formalization of the people's organization. Characteristics: (1) Structure: very simple, loose and temporary. Example : Mother' s group (2) Leaders and members of the organization : only those who are active and are directly affected by the problem (3) Relationship between and among leaders and members: usually collegial (small group basis) and familial (similar to family relationship) (4) Goal : Resolution of a specific issue or a particular problem (5) Programs and services: Usually sporadic and short-term (6) Focus of action: Usually curative in nature b. Adolescent Characteristics: (1) Structure - well-defined with formal elected officers having defined task and responsibilities (2) Leaders - Either elected indigenous or relational (3) Relationship of leaders and members - Functional or is based on position or authority, with creation of certain cliques or factions. (4) Goal - To effect specific changes in the community, not only on a particular issue (5) Programs - Well-defined, with clear sources of funds, with paid staff, and has a legal personality c. Adult / maturity - Viable, functional Characteristics: (1) Structure - Formal with networks and alliances (2) Leadership - mass based with leaders who are able to form operational alliances and networks and have developed certain culture or value systems such as "we attitude", open and humble, objective, etc. (3) Relationship - Close intra and inter- organizational (4) Goal - Social and value transformation that starts from a smaller community to a wider or bigger society. (5) Programs - Directed at strengthening the organization, self-reliant task groups in the community are available to provide health services, resources are now generated within the community. Sub- activities under formalization of the people's organization a. Community making - means giving opportunities for the community folks and the different committees formed during the community consultation to develop / strengthen trust with each other, to share significant events in their lives, increase their level of participation, enhance their team building capabilities and to clarify their own value system. Activities that can be done (7) Trust walk of trust all (11) Value clarification (8) Banig ng Buhay (9) participation activity  (10) Team building activity b. Formalization of the vision, mission, goals (VMG) and objectives formulated during the community consultation How can this be done? (1) The community leaders and every household representative meet to review their articulated values transformed into the vision of a happy family and a develop community (2) They will now refine the vision and mission, with the assistance of the community health development worker (3) They will agree to present this vision and mission for approval to the general membership c. Formulation of the structure, policies or constitution and by-laws of the organization Some types of organizational structure: (1) Centralized otherwise termed as totalitarian - power comes from the leader , staff, and key informants Example: BOD Pres. (2) Centralized-decentralized. There are different committees on top of the BOD. However, these different committees obviously exist as separate or individual bodies BOD (3) Decentralized. This structure requires the general membership as the main decision makers. It has different committees below the general assembly who are responsible in front lining community activities according to concern. But the over-all decision maker is the general membership or assembly. GA Com 1 Com 2 Com 3 Etc. (4) Autonomous. In this type of structure, different small committees or groups in the community network and link with each other. Note : In community health development where genuine collective voice and action is needed, the best structure to be developed is the autonomous. It this is not yet possible, the next best alternative is the decentralized type. ( again, it is very important for the community health development worker to facilitate the people to decide to adopt this structure, instead of dictating them to adopt this structure). How can we help the organization formulate its own policies or constitution or by-laws? (1) Evoked from the different committees formed the following: a. how will they name of organization? b. do they like to establish a specific office for such? c. How will they man the office, if ever they will have to establish one? d. How will they sustain the organization? e. What will be the requirements in terms of :  *Membership * Leadership tenure of office and etc. (2) Assist them to formulate or present this into a write up. d. Assist the leaders to prepare and conduct a community wide meeting for the ratification or approval of the formalized vision, mission, organizational structure and by-laws or policies. e. Registration of the people's organization to Securities and Exchange Commission (SEC). Purpose of SEC registration: to maximize formal use of the organization in obtaining assistance from other government and non-government support groups. Steps in SEC registration: (1) The community leaders or chairs of the different committees prepare the following requirements for SEC registration: a. Accomplished application for registration obtained from SEC b. Ratified name of the organization. It is important for the leaders to check at SEC first if there is no other organization registered with SEC using the same name that they have selected. c. Registration fee d. Constitution and by-laws, with complete names and signatures of all the officers- reproduced in four copies (2) One representative, preferably the over-all chair, will bring the documents or requirements personally to SEC. 2. Common training of the different committees on the following: a. Self-awareness and teambuilding activities b. leadership training (1)Decision-making (2) Problem solving (3) Facilitating skills (4) Planning skills (5) Evaluating skills (6) Others. As necessary c. Basic health orientation (BHO) 3. Specific training to be given to each formed committee b. Basic health skills training for the Primary Health Committee and community Health Workers c. COPAR training for the local Community Organizers' Committee 4. Dry run or scenario - an opportunity for each of the chairs of the committees to practice or act out as facilitators before they will actually conduct an anticipated community activity. Purpose of dry run: a. Serves as a training for the community leaders since they will be critiqued and guided by the community health development workers b. It helps the future leaders anticipate possible questions or problems that may arise, hence, they can anticipate possible answers already.  c. It prepares the leaders to attain feeling of success that they are able to do it by themselves. 5. Community assemblies. The two most important community assemblies that will be conducted during this phase will be the following: a. Research consultation. This refers to the presentation of the results of collated data in the deepening social investigation or community diagnosis to four different groups: (1) Researchers' group which includes the community core group and the development workers. (2) Health agencies already existing in the community - e.g. Rural Health Unit staff and personnel, health-related NGO's (3) Barangay officials with the presence of the municipal development officer and SB committee on Health. (4) Sitio or barangay residents Purposes of this research consultation: to provide a venue for the community. (1) To collectively validate the data gathered by the core group members and the development workers. (2) To actively and collectively analyzed their own situation then identify their own needs and problems. (3) And health development workers arrive at a common frame of reference in terms of health concerns and problems. (4) To prioritize their own needs and problems (5) To initially articulate their objectives, activities, programs or projects intended to resolve problems identified. Roles to be played by specific individuals or group during this research consultation: (6) Core group or community leaders - data presenters and main facilitators (7) Community health development health workers (outside change agents) - process- observers and co-facilitators, as necessary (8) Barangay officials present in the barangay or sitio-level presentation and analysis-co-facilitators b. Formulation of the community development plan (CDP) Purposes. This is a small group meeting held by the core group or community leaders facilitated by the community health development workers, for the following purposes: (1) To refine initial plans articulated during the assembly on validation and analysis (2) To set their own objectives or desired outcomes per committee (3) To identify activities, program or projects intended to attain their objectives and resolve the problems (4) To prepare their evaluation plan (5) To draft a project proposal, if there are some that were identified c. Planning consultation. This is the presentation of the refined and additional plans to the same group who analyzed the data. Purpose of the planning consultation: To provide a venue for the community members to: (1) Validate community development or committee plans and any project proposed by the planning committee.  (2) To decide to organize themselves into specific task groups or committee members who will be responsible in implementing planned actions or projects. (3) To explore all resources needed to implement the different activities, identify those available to them and those that are not available. (4) To identify possible resources of support or assistance for resources not available from agencies. Roles to be played by stakeholders: (1) Community leaders, particularly to one designated to take charge of the planning committee - main presenter and facilitator of the drafted plan (2) Community health development workers/s - Process observer and co-facilitator, as necessary (3) GO or NGO representatives who were invited - reactors to the plan, project or proposals made and committers of support 6. Mobilization or action Definition: this refers to the actual implementation of the plan or "putting the plan into action" by the different committee chairs and members Expected benefits that will be derived from this ethical activity: (1) Each household representative in the different committees will be actively involved as early as the identification of needs until implementation (2) The people will now realize or experience their strength and capability to confront their problems and to address their own issues. 7. Action-reflection-action session (ARAS) This is now the second ARAS that will be conducted but the first ARAS to be facilitated by the community leader. The community health development worker will act as a process observer and a co- facilitator, when needed. IV. Consolidation, Strengthening and Sustenance Phase Definition: >stage where the people's organization has been fully established and that the community members are already actively participating in community-wide undertakings.(V/A: Amstein's ladder of people's participation) > the different committees in the organizational structure are already and are expected to do their functions of assessing, planning, implementing and evaluating (A-P-I-M-E) > the community is more united or one in terms of vision, mission, goals and programs. INDICATORS OF A CONSOLIDATED, SELF-GOVERNING PEOPLE'S ORGANIZATION: 1. Internal indication: a. Realization of the goal of social transformation is evident in the changes of the value system / lifestyle: (1.) More focus on preventive habits rather than curatives (2. )ARAS is already institutionalized →more open, objective way of addressing conflicts and issues b. the structure of the organization is decentralized, more formal, has operational committees, and with established networks and alliances. c. Mass based group building (1) leaders work with the people and they are already capable of utilizing or doing the following: * Situational type of leadership - means that they are flexible in utilizing the different styles of leadership * preparing project proposals * Handling ARAS * Negotiating for conflicts ( conflict management) * Building alliances and networks * develop certain sets of value systems (2) Membership. At least 15-20% of the total population are actively involved, committed and have developed trust with each other and with the organization as a whole. d. Resources (financial and material) and goods and services are generated within the community before these are sourced from outside of the community. Example: An IGP is already functional and generates support for the health worker's activities. e. Capabilities related to services, programs and projects are now evident, such as: (1) With reasonable and affordable fees for the services and projects provided Example: prices of medicines sold at the Botika Binhi or Barangay Botika are reasonable enough. (2) Organization is now well-defined and self reliant. (3) Programs are directed toward strengthening organizational activities. f. There is a dynamic relationship between and among leaders and members. Intra and inter-organizational networking is evident g. Learning insights derived from the processes and programs put into actual practice in daily living. Examples: No practice of graft and corruption h. the leaders and members are capable of doing advocacy work. i. the quality of life of the community has improved 2. External indicators a. Linkages (1) The Po maintains and strengthens linkages with others  (2) The agency only serves to be the consultant of the people's organization. As a consultant, it functions to provide assistance only as necessary. b. It has established networks ( composed of several linkages) c. Able to source from outside for programs of projects that require additional resources not within the community's ability to produce. CRITICAL ACTIVITIES THAT KEEP THE ORGANIZATION ALIVE 1. Organizational diagnosis - review and analysis of the elements of the peoples organization or components in order to identify strength, weaknesses newneeds or problems in terms of (signs and symptoms of aging peoples' organization) a. indicators of a self governing organization b. leadership c. commitment and trust of members and leaders Possible methods to be used in conducting the organizational diagnosis: a. parabola model b. SWOT analysis c. Fish bone analysis d. historical mapping 2. Re-planning can be done after identification of new needs or problems 3. Strengthening mechanisms. Which may include the following strategies: a. Continued education and training of leaders and members to enhance / strengthen their attitudes, knowledge and skills (AKS) *Training on : Management skills monitoring and evaluation networking and linkaging others, depending on what the PO identified * On -the job training (OJT) * Exposures to other communities, as necessary * One-on one coaching b. Continued motivation and mobilization of the different committees * Psychological pay check * Certificates of recognition * Increasing responsibilities c. Value clarification in relation to: * Commitment to the VMG or cause of the organizational existence * Resources - time, money, material and effort 4. Sustaining mechanisms a. developing second liners  b. Identification of a good project, preparation and submission of a project proposal to appropriate funding agencies Elements of a good project: (1) Resources required to a good project are locally available (2) Benefits from the project can be shared by the majority (3) There is presence of local skills or experience in managing and in the operations of the project itself. (4) There is a history of success of the community in handling projects and in technology. (5) It is environmentally friendly. (6) Specific conditions of men and women are considered even as early as the project identification, instead of being gender-biased. (7) Returns of the project are circulated within the community Format of a project proposal: (a) Proposal summary (b) Background and rationale of the project (c) Goals and objectives (d.) Program plan (e) Program implementation, management and evaluation (f) Annexes > organizational structure > Job description and responsibilities > details and summary of budget c. Implementation of livelihood projects and other self managed projects. Examples: *Botika sa Barangay or Botika Binhi *Nursing Promotive and Preventive Health Clinic * non-formal education projects *private laboratory clinic V. Phase Out and Expansion Definition: Stage whereby the community development workers or change agent leaves the self-sustaining people's organization and looks for other areas to work with. CRITICAL ACTIVITIES: 1. Endorsement to different levels guidance and assistance, as needed a. municipal level b. Provincial level c. National, as necessary 2. Monitoring (closely watching or keeping track of their functionality) through regular area visits 3. Disengagement - release from attachment or connection or freedom from obligation 4. Impact evaluation to assess the degree or extent of the following after a specific period of time: a. People's participation and commitment to the organization b. functionality of the people's organization c. Performance of health activities d. attainment of goals and objectives Prepared by: Jayza Mharie D. Llandado BSN 2-16 A Courtesy of: Mrs. Bolinto hand-out