Community Health and Development

Isabelita M. Samaniego MD June 25 2008

First Shifting

Objectives 1. Define and explain terms 2. List and discuss the perspectives in approaching health care delivery influencing a community health development 3. Discuss how communities address their health concerns 4. Discuss community organization and health promotion planning Health - A state of complete physical, mental, and social well being and not merely the absence of disease and infirmity.” World Health Organization - 1947 A dynamic state or condition which is multidimensional in nature and results from the adaptation to his/her environment.

Perspectives in Approaching Health Care Delivery 1. Health is a Social Phenomenon 2. All Sides of Reality must be Considered 3. The Community should be Partners in Health, not Just Beneficiaries

Community Group of people who have common characteristics; can be defined geographically or administratively Community Health The health status of a defined group of people and the actions and conditions, both private and public, to promote, protect, and preserve their health. Population Health - The health status of people who are not organized and have no identity as a group or locality and the actions and conditions to promote, protect and preserve their health Public Health - Health status of a defined group of people and governmental actions and conditions to promote, protect, and preserve the people’s health Community Health vs Personal Health Personal o Individual actions and decision making that affect the health of an individual or their immediate family Community o Activities aimed at protecting or improving the health of a population or community Development growth in one or more sectors of society plus associated changes in attitudes, social institutions and knowledge, resulting in desired changes in people’s standard of living Community Health Development (CHD) Process of putting in the hands of community members the power to make effective health decisions and to influence the management of available health resources so that they can start to address their own health concerns - Active players: community leaders, barangay health workers, community volunteer health workers,and people in the community
Elyu, masayahin ako

Factors Affecting Community Health Physical: industrial development, community size, environment, geography Social/Cultural o beliefs, traditions and prejudices o economy, politics, religion o socioeconomic status o social norms Political o local and external decision making process o policy-making policies (?) Individual Behaviour: takes the concerted effort of many, if not, most to make a community volunteer program work All Sides of Reality Must Be Considered Strengths: internal capacities, positive traits and values, experiences, physical and human resources Weaknesses: internal to the community (problems, issues), acts as barriers Opponents: possibilities, generate strength, help realize health goals Threats: external conditions/situations affect health or effort to improve health Community Should Be Partners in Health, not Just Beneficiaries Putting health in the hands of the people Encouraging comunities to assume responsibility for their health and become partners Paradigm shift for health professionals Actions that Help Community Address Health Problems: Community organizing Community mobilization Education and Training Establishing effective linkages for the future Mobilization of financial, technical or other resources Community Organizing A process through which communities are helped to identify common problems or goals, mobilize resources, and in other ways develop and implement strategies for reaching their goals they have collectively set.” Community Mobilization Helping the community to recognize that health is a community concern, and not just the concern of the medical profession or the government, and motivating community 1 of 2


Community Health and Development members to take sustained action to address health concerns in their own barangay Helping communities have a voice in health issues which cannot be resolved at the community level o Participation of representatives of the community in decision-making o Advocacy/lobbying for change in health care delivery by either community members or by a body established to give the community a voice

Assumptions of Community Organizing 1. Can develop the capacity to deal with their own problems 2. People want to change and can change 3. People can participate in making, adjusting or controlling major changes 4. Changes in community living, which are self-imposed or self-developed have a meaning and permanence 5. A “holistic approach” can deal successfully with problems 6. Democracy requires cooperative participation and action in the affairs of the community and people must learn the skills 7. Frequently, community of people need help in organizing to deal with their needs, not as many individuals requiring help with individual problems

Stakeholders in the Process Community Initiating agency o may be from community, LGU, NGO, external funding agency Facilitating agency o may be the initiating agency or some other agency Supporting agencies o agencies that can help with lobbying or advocacy

Education and Training Disseminating knowledge and/or information needed to enable people to act together for barangay health development o Up-to-date knowledge on health issues o Information on leadership o Community diagnosis techniques o Strategies for community-based health promotion Establishing Effective Linkages for the Future Ensuring that the community has access to information that can enable them to make informed choices

Process for Organizing a Community (presented in a flowchart form) 1. Recognize the problem 2. Making entry in the community 3. Organize the people 4. Assessing the Community 5. Determine priorities and setting goals 6. Selecting a solution to the Problem The Final 4 Steps



Actions to address Health Concerns in Policies Training in basic advocacy skills and in how health system works o Ex: Policies affecting availability of drugs at the Barangay Health station o Ensuring representation on appropriate special bodies o Ex: people’s organization to have a seat on District Health Boards Formation of alliances o Alliances with agencies to support certain causes Formation of a municipal or provincial body o a special body with representatives from communities, NGOs and government agencies, can be nominated or established to have direct responsibility for tapping the concerns of local communities

Looping Back


Student Activity

•Community A : felt need is the high prevalence of hypertension
in their barangay: Describe how you will organize the community to develop a health project focusing on hypertension.

System for Putting Health in the Hands of the People Helping communities address their health problems where these can be addressed o Facilitating a paradigm change on the part of the health workers o Community organization, diagnosis, training and establishing linkages as part of CHD intervention o Community-based health promotion
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•Community B : High prevalence of PTB. •Community C : High Incidence of Dengue •Community D : High Prevalence of DM

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