COMMUNITY PARTICIPATION

AND
MOBILIZATION

By: Takele G (MPH, Asst. Prof.)

Sept. 2021, A.A Ethiopia

 Learning Objectives
2

At the end of this class, you will be able to:

 Define community and community participation
 Describe the principles of community participation
 Describe the level and process (Spectrum) of community participation
 Describe the benefits of community participation
 Describe approach/application to community for participation
 Concept and Definition of Social mobilization
 Define the concept of community mobilization
 Identify the steps/phases in community mobilization
 Recognize assessment in community mobilization process
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Brainstorming
3

1) What is community?
2) When is community health education needed?
3) What is Community participation?
4) How do you approach to community for participation?
5) What is community/social mobilization?

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Think-pair-share
4

 What is the difference in between;

 Community organization
 Community participation
 Community engagement
 Community mobilization

 What factors need to be considered to apply community

participation in a certain project/program
 Describe the levels/degree of community participation

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Introduction
5

What is community?
 The word community can be understood from two
aspects.
Structurally
 A place or small geographical area; where people
reside or an area of land that belong to community
Functionally
 A group of people who share some common interest, values,
common history, culture, and accept certain forms of behaviors
as normal for all community members.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Introduction …
6

When is community health education

needed?
 When a problem affects many or all people in the

community and when the cooperation of every one

is required to solve the problem.
E.g. Provision of clean water supply.

But, planners and managers cannot agree upon the contribution

of community participation to health improvements.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

Introduction to Community Participation
7

What is Community participation?

 It is the process by which community members

actively take part in the designing and delivering of

programs and activities being conducted in the
community’s interest.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

Introduction to Community Participation
8

 We may say communities are participating when

they are actively involved in:
 The assessment of the situation/needs
 Problem identification
 Priority setting & making decisions
 Sharing responsibility in the PIME of the program
 The role of experts should be limited to helping them. It
Is bottom-up approach not top-down or indoctrination
approach.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

Introduction to Community Participation
9

 In the past, health communication/education follows persuasion

approach to force behavior change among individuals.

 However, contemporary health communication/education

program underscores an informed decision-making approach
emphasizing community participation and empowerment.

 When the idea of PHC was launched, community participation

was one of the important principles identified for its
implementation.
 Although everyone talks about it, real community participation is
rarely practiced.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Introduction to Community Participation

10

 Is a long-term approach where the people affected by

an issue are supported in identifying problems and
taking action to achieve solutions.

 It is essential for capacity building, to create sense of

ownership in the community and to establish program
sustainability.
 Community empowerment is its final aim and goal.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Introduction to Community ...
11

 "A single bracelet does not jingle" ….. African proverb

 ‘Dir biyabr anbessa yasir’ ………….Amharic proverb
 The basic supposition in CP/CO is that communities
want to and will obtain health services and facilities,
but that they may need help to do so.
 The concepts of community participation also
encompass the concept of consumerism.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Continued ...
12

 This concept supports the orientation that recipients as well as

providers of health services should be involved in decision
making at the time of planning and services delivery.
 Power is the purpose of community participation and the issues,
problems, strategies and victories are a means.

 Its level ranges from passive participation at the bottom level to

active involvement in decision making in the upper.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

13

 Community participation is best seen on a continuum,

because this emphasizes the importance of the
participation process, rather than just the outcome.

Definitions of community participation range from people

passively receiving benefits from health/disability programmes to
people actively making decisions about the programme policies
and activities. By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Continued ...
14

 It indicates the extent at which power is shared between

the power holders and the powerless people in
determining the end product of planning, implementation
and resources.
 Community participation does not just happen- it needs a
strategy, resources, commitment, time and a planned
approach.
 It also requires attention to capacity building in partner
agencies as well as communities.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Community Involvement/ Participation
15

 Participation is a rich concept that varies with its

application and definition.
 The way participation is defined also depends on the
context in which it occurs.
For some, it is a matter of principle; for others,
practice; for others, an end in itself.

Def. "Members of a community taking part in shaping, planning,

developing, implementing and evaluating policies and actions
which affect their lives and the life of their community"

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Key Principles
16

 Participation means partnership, which for some will

mean accepting uncertainty and being open to
different ideas.

 Deciding for effective consumer participation means

being open for change.

 Align consumer involvement plans with organizational

capacity.

By Takele 9/5/2021
G. (MPH, Asst. Prof.)
 Key Principles…
17

 Consumer participation must be supported from the

top but it is built from the bottom up.

 Consumer participation needs a partnership

approach; partnerships need dialogue; dialogue
needs trust. So build trust.
 Multiple strategies work better.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Why CP is important?
18

 Achieve a more democratic solution

 Develop a culture of participation
 Empower people
 Mobilize resources and energy
 Result in the development of holistic and integrated
approaches/services
 Ensure the ownership and sustainability of programs
 Result in better decisions and more effective services
 Improve health outcomes
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 At project level CP is important to:
19

1. Sharing project costs

2. Increasing project efficiency
3. Increasing project effectiveness
4. Building beneficiary capacity: participants are actively
involved in project process; People become committed to
activities.
5. Increasing empowerment
People can develop skills, knowledge and experience that
will aid them in their future work.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 CP in the Health Sector
20

 The concept of community participation had long story

in different disciplines (politics, sociology…).
 However, it has been started to notify boldly in the
Global, Regional and National Health Sectors since
after included in the Declaration of PHC at Alma
Ata.1978

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 A framework for CP
21

A framework for community participation assumes:

 Different levels of participation appropriate for
different situations.
 There is not one ‘community’ but many interests or
stakeholders to consider.
 Participation takes time it is not a one time action.
 The organizer role must be clear

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 CP Framework…
22

Dimensions of community Involvement

1) Level of participation
2) The phase or stage of
participation
3) Different interests or
stakeholders involved

By Takele G. (MPH, Asst. Prof.) 9/5/2021

1. Level of participation CP
23

The level of CP ranges from Inform to Empower.

Community engagement can also be seen as a continuum of

community involvement
Level of Community Engagement

9/5/2021 24
Types of CE…

9/5/2021 25
 1. Inform
26

 Informing and creating awareness is a very important

step towards public participation
Goal: to provide stakeholders with balanced and
objective information.
 Is the foundation of all community engagement
processes.
 No channel provided for feedback and no power for
negotiation

Range: from the general public to key stakeholder

groups
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Inform Cont’d
27

 Where appropriate
 No room for maneuver

E.g. where there is a clear legal requirement.

 An authority is reporting a course of action

 At the start of a consultation or other process

 Inappropriate
 Seeking to empower community
 Methods: Newsletters, press release, radio, TV

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 2. Consult
28

 Consultation describes the process of eliciting

feedback on information provided.

Goal: to obtain feedback on analysis, alternatives

or decisions.
 Consultation actively seeks community views and
input into policy, plans and decisions.
 Decisions remains with government or the
organization

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Consult…
29

Where appropriate:
 Organizer want to improve a service
 Limited range of options.
 The initiator of the proposals can handle feedback and
is prepared to use
Inappropriate
Organizers aren’t going to take any notice of what

people say
 Organizers are seeking to empower community
 Organizers don’t have the resources or skills to carry
out option presented (Level 4 & 5 )
Methods: meetings, written …
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 3. Involve
30

 “Working with the community to ensure their concerns

are directly reflected in alternatives and solutions”
 Demands a higher level of participation and inclusion
with stakeholders
Goal: to work directly with the public throughout the
process to ensure that public concerns and
aspirations are consistently understood and
considered.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 3. Involve …
31

 People have greater involvement in this level.

 The rights of local people are recognized and accepted in
practice at local level
 The difference between ‘consult’ and ‘involve’ is
 Consulting: requires to seek feedback at a given point
in time,
 Involving: deliberately putting into place a method to
work directly with stakeholders throughout the
process.
 Final Decisions remains with government or the
organization
By Takele G. (MPH, Asst. Prof.) 9/5/2021
32

Where appropriate
 It is important that other people ‘own’ the solution.
 Fresh ideas needed
 There is enough time
Inappropriate
 Have little room for maneuver (Inform and consult
level may enough)
 If organizer can’t implement decisions by own

By Takele G. (MPH, Asst. Prof.) 9/5/2021

33

Methods:
 Information-giving methods to start the process.

 Stakeholder analysis to identify who should be

involved.

 Cost/Benefit Analysis to make choices

 Action planning to decide what next

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 4. Collaborate
34

 Indicates working together or work in partnership with

other organization, stakeholders …

 It involve short-term collaboration or forming more

permanent partnerships with other interests.

 Partnership involves both deciding together and then

acting together
 Having a common language, a shared vision of what
they want, and the means to carry it out.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 4. Collaborate (Cont.)
35

Goal: to partner with the community in each aspect of

the decision, including the development of
alternatives and the identification of the preferred
position.
 High impact upon the community.
 Ownership is shared between the organization and the
stakeholders.
 There is a greater level of delegated decision-making,
but the organization responsible for the engagement
may have still retain the overall decision-making
power
By Takele G. (MPH, Asst. Prof.) 9/5/2021
36

Where appropriate:
 One party can not achieve what they want on their own.
 The involved all get some extra benefit from acting
together.
 There is commitment to the time and effort needed to
develop a partnership.
Inappropriate
 One party holds all the power and resources and uses
this to impose its own solutions (level 1 and 2 enough)
 The commitment to partnership is superficial
Methods
 Team building exercises, Working parties and steering
committee By Takele G. (MPH, Asst. Prof.) 9/5/2021
 5. Empower
37

 It is the highest and the most ‘empowering’ level of

community participation.
 It is a means that provide people want to do things for

themselves.
Goal: is to place final decision-making in the hands of
the public.

 "Empowered communities share responsibility for

making decisions and accountability for the outcomes
of those decisions"
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 5. Empower…
38

 External organizer will support independent

community-based initiatives to develop and carry out
their own plans.
 Legislative and policy frameworks give power to
communities to make decisions.
 The community may have the power to make a limited
range of decisions (e.g. on a specified issue or for a
limited time)
 Or it may have extensive decision-making powers.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

39

Where appropriate
 Where there is a commitment to empower individuals
or groups within the community.
 Where people are interested in starting and running an
initiative.
Not appropriate
 Community initiatives are seen as ‘a good thing’ in the
abstract and pushed on people from the top down.
(Inform, consult and involve levels may enough).
 Where there is no commitment to training and
support.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
Approaches to engage communities
• Community engagement – empowering the community to
practice and move towards better change
• Social mobilization
• Communication for development

• Behavior change communication

• Health education
• Health promotion
• Outbreak communication
• Crisis communication
• Risk communication
Communication for behavioral impact
• 9/5/2021 40
 Steps of CE Implementation
Step 1 – Determine the Need for Community Engagement
Step 2 – Develop an Advisory Committee

Step 3 – Define the Scope, Goals, and Anticipated Outcomes

Step 4 – Identify and Analyze the Stakeholders/Community Served

Step 5- Consider Engagement Techniques/Methods & Develop

Engagement Strategies

Step 6 – Create and Implement an Operational Plan

Step 7 – Monitor Progress, Evaluate the Plan, and Improve/Modify Plan

9/5/2021 41
 II. The Participation Process
42

 Participation is a process in which people have to

think through what they want, consider some options,
and work through what should happen.
There are four main phases:

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 The Participation Process…
43

 Initiation: The phase at which something triggers the

need to involve people, and you start to think what that
involves.
 Preparation: The period when you think through the
process, make the first contacts, and agree an approach.
 Participation: The phase in which we use
participation methods with the main interests in the
community.
 Continuation: What happens in this phase will depend
very much on the level of participation
9/5/2021
By Takele G. (MPH, Asst. Prof.)
III. People – who is involved?

By Takele G. (MPH, Asst. Prof.) 9/5/2021 44

 Methods for participation
45

 The starting point – problems

1. Techniques:
 Are frequently used short-term interventions
 Ranges from communication materials distribution
and simple workshop sessions through to more
complex methods of decision-making, like
Strategic Choice.
 Participation takes time, and techniques should
usually be part of a long-term program, or related to a
structure
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Methods..
46

2. Structures
 Both interim and longer-term organizational
structures are used in participation processes.
 It range from working parties and advisory
committees to organizations like development trusts,
and community-based cooperatives.

 Local councils and similar organizations often favor

structures because they can be linked to their
committee systems and the procedures which go
with them.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
47

3. Longer-term programs
 These are processes for participation, planned over
a period of time, which may involve staff devoted
partly or completely to the program as well as the
use of techniques and structures.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

Challenges in CE
• Hard to maintain involvement over time

• Overcoming difference between responders, &

influencers

• Working with hard to reach and vulnerable

community

• Risk perception differ among population

• Complexity in social dynamics of community and

changing power relationship
9/5/2021 48
 Community Mobilization
49

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 What is Community Mobilization?
50

Defined as:
 A capacity building process through which community,
individuals, groups, and organizations plan, carry out,
and evaluate activities on a participatory and sustained
basis to achieve an agreed upon goal.

 The goal can be one of their own initiatives or

stimulated by others

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Community Mobilization…
51

Community Mobilization refers to the process or stage

where the community participates in the process of change
or development.
Key Points During This Stage :
1. The people are informed and consulted
2. The people are involved in planning
3. Key leaders are identified
4. Key leaders are oriented and trained
5. Volunteers are then mobilized
6. Teams or working committees are created
7. Teams are motivated andBy trained
Takele G. (MPH, Asst. Prof.) 9/5/2021
 Basic community mobilization
skills
52

 Communication and facilitation skills

 Program design and management skills
 Organizational behavior/group dynamics skills
 Capacity-building skills
 Planning and evaluation skills
 Knowledge of participatory methods

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Community Action Cycle
53

Explore health issue &

Set priorities

Organize the community

Prepare to mobilize Plan together
for action

Prepare to scale up Evaluate together Act together

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 1: Prepare to Mobilize
54

 Discuss various health issues and define the community.

 Put together a community mobilization team.
 Gather information about the health issue and the
community.
 Identify resources and constraints.
 Develop a community mobilization plan.
 Develop your team.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 2: Organize the Community for
Action
55

 Orient the community

 Build relationships, trust, credibility, and a sense of
ownership with the community
 Invite community participation
 Develop a ‘core group’ from the community

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 3: Explore the Health Issue
and Set Priorities
56

 Decide upon the objectives for this phase.

 Explore the health issue with the core group.
 With the core group, explore the health issue in the
broader community
 Analyze the information
 Set priorities for action

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 4: Plan Together
57

 Decide on the objectives of the planning process.

 Determine who will be involved in planning and
their roles and responsibilities.
 Design the planning session.
 Conduct/facilitate the planning session to create a
community action plan.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 5: Act Together
58

 Define your team’s role in accompanying community

action
 Strengthen the community’s capacity to carry out its
action plan
 Monitor community progress.
 Problem-solve, advise, and mediate conflicts

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 6: Evaluate Together
59

 Determine who wants to learn from the evaluation.

 Determine what information is needed to answer the
key questions.
 Map the flow of monitoring information and
feedback in the project.
 Identify who will conduct the participatory
monitoring.
 Use participatory methods and tools to collect
information; use simple language and images.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Evaluate Together, cont’d
60

 Share results inside and outside the community –

with all stakeholders – to determine lessons learned
and plan next steps.

 Encourage affected individuals and groups to use

the information to advocate for further change or to
scale up projects in additional areas.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Phase 7: Prepare to Scale Up
61

BEFORE YOU SCALE UP…

 Have a vision to scale up from the beginning of the

project.
 Determine the effectiveness of the approach.

 Assess the potential to scale up.

 Consolidate, define, and refine the approach.

 Build a consensus to scale up.

 Advocate for supportive policies.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Prepare to Scale Up, cont’d
62

AS YOU SCALE UP…

 Define the roles, relationships, and responsibilities of

implementing partners.
 Secure funding and other resources.

 Develop the partners’ capacity to implement the

program.
 Establish and maintain a monitoring and evaluation

system.
 Support institutional development for scale.

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Community Participation
Assessment
63

Indicators that influence community participation process:

 Need assessment
 Howwere needs identified?
 Who identify them?

 Leadership
 Which groups are represented in the leadership?
 What types of leadership is it?

 How decisions made/ how does the leadership mobilize

support?
By Takele G. (MPH, Asst. Prof.) 9/5/2021
64

 Organization
 Which groups are involved in the organization who makes
up the organization’s staff? Are they paid?
 Who owns the program ?

 Resources mobilization
 What have beneficiaries contributed?
 What resources are being brought into play?

 How are resources mobilized?

 Whose interests are served by resources, mobilized and

allocation?
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Community Participation
assessment …
65

 Management (how does the organization achieve

its goals?)
 What are the roles of the beneficiaries in managing
the program
 On whom the ultimate responsibility lie?

 Who decides on the activities and allocation of

resources

By Takele G. (MPH, Asst. Prof.) 9/5/2021

 Alternative approaches in community
Participation assessment
66

 Community participation
 Community leadership

 Community structures

 External supports

 Resource mobilization

 Skills, knowledge

 Sense of community

 Community power
By Takele G. (MPH, Asst. Prof.) 9/5/2021
 Reference
67

 David Wilcox 1994, The Guide to Effective Participation

 A Ladder of Citizen Participation - Sherry R Arnstein 2006, or
 A Ladder of Citizen Participation," JAIP, Vol. 35, No. 4, July
1969, pp. 216-224
 Community health education, setting, roles, and skills. Donald
J.Berckon, John R.harvery. 1980
 UWS School of Medicine Community Participation Strategy.
February 2006
 IAP2 Public Participation Spectrum http://www.iap2.org/.
 Developing a Good Practice Guide to Community Participation
Inner City Organisations Network/North West Inner City
Network, March 2008.
By Takele G. (MPH, Asst. Prof.) 9/5/2021
68

By Takele G. (MPH, Asst. Prof.) 9/5/2021