HTDP III Philippine Center for Population and Development, Inc.

1. COMMUNITY HEALTH
DEVELOPMENT
With
COMMUNITY ORGANIZING-
PARTICIPATORY ACTION
RESEARCH
By: Rommel Luis C. Israel III
Health Services Coordinator
SPU-HRDP III CO-PAR

2. HEALTH RESOURCE
DEVELOPMENT PROGRAM III
• Developed and sponsored by
Philippine Center for Population
and Development, Inc. (PCPD,
Inc)
• Purpose:
- to make health services
available and accessible to
depressed and underserved
communities in the Philippines

3. PCPD, Inc.
• It is a non-stock, non-profit private institution
• Serves as a resource center assisting
institution and agencies through programs and
projects geared toward the social human
development of rural and urban communities
• Formerly Population Center Foundation

4. HRDP
3 cycles

5. HRDP I
• Trained the faculty members, medical/nursing
students to provide health care services to the
far-flung barrios because of lack of manpower
for health services
- simultaneously, there was the
fulfillment of the curricular requirements
of students for public health

6. HRDP I
• PCPD provides seed money for the income-
generating projects
• The Community Organizer uses his/her own
strategy or method in developing the
community
• Considered to be a short-term service

7. HRDP II
•Uses the same strategy but the
program could not be sustained
by the schools or hospitals
•The income-generating
projects eventually became a
hindrance to the goal of
achieving the health program

8. HRDP II
Why income-generating projects
became a hindrance to the goal
of achieving the health program?
- Because the people tended to
be more interested in the
income generated by the
projects

9. EFFECTS OF HRDP I AND II TO
THE COMMUNITY
•Established basic health
infrastructures
•Increased basic health services
•There were trained health
workers and organized health
groups to take care of the
health needs of the people

10. HRDP III: Unique Features
• Comprehensive training of the staff and
faculty members of the participating agency in
which the community work was initiated
• Periodic training program and regular
assistance to the participating agency were
provided to strengthen the health outreach
program to become community oriented.

11. HRDP III: Unique Features
• PHC as the approach with which
all nursing/medical students,
their Clinical Instructors and
indigenous health workers are to
be trained for community health
work and around which all other
project inputs will revolve

12. HRDP III: Unique Features
• Community organizing as the
main strategy to be employed in
preparing the communities to
develop their community health
care system and the
establishment of community
health organization to manage
the community health programs

13. HRDP III: Unique Features
• Organizing work in the communities
was done in three phases. The
participating agency worked only in
one community on the first year. A
thorough assessment and summing
up of field of experience in the first
community done before the entry to
three communities on the 7th
month.

14. HRDP III: Unique Features
The experiences on these 3
communities are assessed
before entering the last 3
communities on the 14th
month.

15. HRDP III: Unique Features
• Participatory Action Research
(PAR) as facilitating strategy for
maximum community
involvement, through collective
identification and analysis of
community health problems and
collective health action

16. HRDP III: Unique Features
• Available funds to finance
community initiated projects;
thereby enabling the communities
to gain hands-on experience in
managing community health
projects.
(PCPD 1992)

17. HRDP III
• It aimed to develop an effective
primary health care system in
underserved communities through
the improvement of the
capabilities of health training
institutions:
a. to provide community
outreach services

18. HRDP III
b. To train and to
organize community
residents in the
management of their
health concerns

19. HRDP III: GOAL
It is the delivery of health care to
the far-flung communities which
can not be reached by the health
care agencies. Through the
development of available health
care givers and the local
residents, the primary health care
can be delivered to the
community members.

20. HRDP III: STRATEGY
The strategy:
COMMMUNITY ORGANIZING and
PARTICIPATORY ACTION
RESEARCH
- to activate the
involvement of community
members

21. HRDP III: PARTICIPATING INSTITUTIONS
DURING ITS IMPLEMENTATION
1. De La Salle University,
College of Medicine,
Dasmarinas, Cavite
2. Liceo de Cagayan,
College of Nursing,
Cagayan de Oro City
3. Saint Paul University,
College of Nursing,
Tuguegarao City
4. Sacred Heart College of
Nursing, Lucena City

22. PHC
PHC IN THE PHILIPPINES
• Practiced even before 1978 when
the WHO declared PHC in Alma
Ata
• What is PHC in the Philippines
now? How is it? Where are the
accomplishments?

23. PHC: Definition
• It is the key in achieving an acceptable level
of health through-out the world in the
foreseeable future as part of social
development and in the spirit of social
justice
- PHC Report of the International
Conferences on PHC, Alma Ata, USSR,
Geneva (WHO: September 1978)

24. WHO (1978) ON PHC
• PHC is people-oriented
• Its success rests on people
• It identified 4 pillars (where actions
for health for all must be based):
1. Political and societal commitment
and determination to move towards
health for all as the main social
target for the coming decades.

25. WHO (1978) ON PHC
2. Community participation – the active
involvement of people and the mobilization
of social forces for health development
3. Intersectional cooperation between the
health section and other development
sectors such as education, communication,
industry, public works, transportation, and
housing

26. WHO (1978) ON PHC
4. System support to ensure
that essential health care and
scientifically sound
affordable health technology
are available to all people.

27. WHO (1978): OBJECTIVES OF
PHC
1. To enable the people to seek
better health at home, in
school, in fields, and in
factories;
2. To enable the people to prevent
injury and diseases, instead of
relying on doctors to repair
damages that can be avoided;

28. WHO (1978): OBJECTIVES OF
PHC
3. To enable the people to exercise
the right and responsibility in
shaping the environment and
bringing about conditions that
make it possible and easier to live
a healthy life
4. To enable the people and exercise
control in managing health and
related systems and to ensure
that

29. WHO (1978): OBJECTIVES OF
PHC
… the basic pre-requirements for
health and access to health
care are available to all people.
LET US EVALUATE OUR OWN
ADOPTED COMMUNITIES:
“As members of the health
team, were we able to meet
these objectives?”

30. PRINCIPLES OF PHC
1. Accessibility, availability, and
acceptability of health
services;
2. Provision of quality basic and
essential health services;
3. Community Participation
4. Self-Reliance

31. PRINCIPLES OF PHC
5. Recognition of
interrelationship between
health and development
6. Social Mobilization
7. Decentralization

32. ACCESSIBILITY, AVAILABILITY,
ACCEPTABILITY OF HEALTH SERVICES
• Health services must be delivered where the
people are
• Use of indigenous/resident volunteer workers as
health care providers with a ratio of one
community health worker per 10-20 household
• Use of traditional (herbal) medicine together
with the essential drugs

33. PROVISION OF QUALITY BASIC AND
ESSENTIAL HEALTH SERVICES
• Training design and curriculum based on
community needs and priorities, task analysis
of CHWs are competency based
• AKS developed are on promotive, preventive,
curative, and rehabilitative health care
• Regular monitoring and periodic evaluation of
CHW performances by the community and
health staff

34. COMMUNITY PARTICIPATION
• Awareness building and consciousness raising
on health and health-related issues
• Planning, implementation, monitoring and
evaluation done through small group meetings
(10-12 household cluster)
• Selection of CHWs by the community
• Community building and community organizing

35. COMMUNITY PARTICIPATION
• Formation of health committees
• Establishment of a community Health Worker
Organization at the parish municipality level
• Mass health campaign and mobilization to
combat health problems.

36. SELF-RELIANCE
• Community generates support (Cash, Kind,
Labor) for the health program
• Use of local resources (human, financial,
material)
• Training of community in leadership and
management skills
• Incorporation of income-generating projects,
cooperatives, small scale industries

37. RECOGNITION OF INTERRELATIONSHIP
BETWEEN HEALTH AND DEVELOPMENT
• Convergence of health, food,
nutrition/water, sanitation, and population
services
• Integration of PHC into national, regional,
provincial, municipal, barangay
development plans
• Coordination of activities with economic
planning, education, agriculture, industry,
housing, public works, communication, and
social services

38. SOCIAL MOBILIZATION
• Establishment of an effective health referral
• Multisectoral and interdisciplinary linkages
• Information, education, and communication
support using multi-media
• Collaboration between GOs and NGOs

39. DECENTRALIZATION
• Re-allocation of budgetary
resources
• Re-orientation of health
professionals on PHC
• Advocacy for political will and
support from the national
leadership down to the barangay
level

40. ESSENTIAL ELEMENTS OF PHC
1. Education on the prevailing
health problems and the
methods of preventing and
controlling diseases;
2. Prevention and control of local
endemic diseases;
3. Promotion of food supply and
proper nutrition;

41. ESSENTIAL ELEMENTS OF PHC
4. Adequate and safe supply of
water and basic sanitation;
5. Maternal-child health
including family planning;
6. Immunization against
infectious diseases

42. ESSENTIAL ELEMENTS OF PHC
7. Appropriate treatment of
common diseases and
injuries;
8. Provisions of essential drugs
and herbal medicines

43. Community organizing and participatory
action research

44. CO-PAR
•It has been the strategy used
by the HRDP III in
implementing the PHC delivery
in depressed and underserved
communities to become self-
reliant

45. COMMUNITY ORGANIZING
Accdg. To HRDP III DESCRIPTION:
• Continuous and sustained process
of educating the people to let
them understand and develop
their critical awareness of the
existing conditions;

46. COMMUNITY ORGANIZING
Accdg. To HRDP III DESCRIPTION:
• It is working with the people collectively and
efficiently, discover their immediate and long
term problems;
• Mobilizing the people to develop their
capabilities and readiness to respond and
take action on their immediate needs towards
the solution of their long-term problems

47. OBJECTIVES OF COMMUNITY
ORGANIZING (PCPD)
• To make people aware of social realities
toward the development of local initiative,
optimal use of human, technical and material
resources, and strengthening of people’s
capacities
• To form structures that hold the people’s basic
interests as oppressed and deprived sectors of
the community and as people bound by the
interest to serve the people

48. OBJECTIVES OF COMMUNITY
ORGANIZING (PCPD)
•To initiate the responsible
actions intended to address
holistically the various
community health and social
problems.

49. COMMUNITY ORGANIZING AS APPLIED
TO PHC
• It is defined as the process and
structures to which members of the
community are tapped to become
organized for participation in health
care and community development
activities
• The community members organized
themselves to get better health
care...

50. COMMUNITY ORGANIZING AS APPLIED
TO PHC
… and improve their health as
part of larger effort, to
increase their power and
achieve greater social and
economic equality within a
larger social system

51. COMMUNITY ORGANIZING AS A
PROCESS
•It is the sequence of step
whereby the members of the
community work together to
critically assess and evaluate
community conditions to
improve these conditions

52. COMMUNITY ORGANIZING AS A
STRUCTURE
•It refers to the particular
group of community members
that work together for
common health and health-
related problems

53. EMPHASES OF COMMUNITY
ORGANIZING TO PHC
1. The community works to solve
their own problem
2. The direction is internal rather
than external.
3. The development of the
capacity to establish a
project is more important than
the project.

54. EMPHASES OF COMMUNITY
ORGANIZING TO PHC
4. There is a consciousness-
raising to perceive health
and medical care within the
total structure of society.

55. PARTICIPATORY ACTION
RESEARCH (PCPD 1990)
• It is an investigation on problems and
issues concerning life and environment
of the underprivileged by way of
research collaboration with the
underprivileged whose representatives
participate in the actual research as
researchers themselves, doing
research of their own problem.

56. PARTICIPATORY ACTION
RESEARCH (PCPD 1990)
OBJECTIVE:
• To encourage consciousness of the
suffering and develop
competence for changing their
own situation, and helping in the
organization-building by
harnessing both human and
natural resources in responding
to community needs.

57. PAR (accdg. to Partners in
Action Research 1997)
•PAR is a community-directed
process of gathering and
analyzing information or an
issue for the process of taking
actions and making changes

58. PAR
ESSENTIAL ELEMENT:
• Participation
BENEFICIARIES OF THE RESEARCH:
• The main actors in the research process.
- it enables the community to experience
a collective consciousness of their own
situations

59. PAR
• It involves:
- research
- education
- actions
> to empower people to determine the
cause of their problems, analyze
these problems, and act by
themselves in responding to their
own problems

60. PAR
•In PAR, there is an outside
researcher, a professional one
who through immersion and
integration on the community
becomes a committed
participant and learner in the
community

61. CHARACTERISTICS: Traditional vs
PAR
TRADITIONAL
• Research for the
purpose of
identifying and
meeting individual
needs within existing
social system.
PAR
• Research seek social
transformation.

62. CHARACTERISTICS: Traditional vs
PAR
TRADITIONAL
• Cmty. problems or
needs are defined
by experts or the
external
researchers to
cmty. groups and
considered neutral
or non-biased.
PAR
• The research
problems are
defined by the
community
members
themselves who
are viewed as
“experts of their
own reality”

63. CHARACTERISTICS: Traditional vs
PAR
TRADITIONAL
• The research
problem is studied
by the researchers
who control the
research process
PAR
• The cmty. group
undertakes the
investigation or
research process
from data
collection to
analysis. External
researchers work
alongside the cmty.
group.

64. CHARACTERISTICS: Traditional vs
PAR
TRADITIONAL
• Recommendation
s for the
community are
based on the
researcher’s
findings and
analysis
PAR
• The community
formulates
recommendation
and an action
plan based on
research
outcome,

65. References:
Jimenez, Carmen E. (2008). Community
Organizing Participatory Action Research (CO-
PAR) For Community Health Development.
Quezon City: C & E Publishing, Inc..
International Conference on Primary Health
Care, Alma-Ata, USSR, 6-12 September 1978.
(1978). Retrieved February 17, 2020, from
https://www.who.int/publications/almaata_dec
laration_en.pdf.

66. Reference
Population Center Foundation (1990).
Community Organizing: A Manual On HRDP
EXPERIENCE. Makati: PCPD, Inc..