31/08/2021

COMMUNITY ORGANIZING:
A Method for Community Development and
Community-Oriented Primary Care (COPC)

MA. ROSARIO “Cherry” BERNARDO-LAZARO, MD, MBAH, FPAFP

Family & Community Medicine Physician

MRC BERNARDO-LAZARO 2021

LEARNING OUTCOMES:
• Review the definitions of community and community-
oriented primary care (COPC)

• Explain the interrelation of community engagement,

community development and community organizing

• Analyze the steps and principles of community

organizing and their alignment with the process of
COPC

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REFERENCES
• Castro-Palaganas, E. Health Care Practice in the
Community. 1st ed. Manila: Education Publishing
House, 2003: 185 – 2000
• Lecture slides of Dr. Josefina Isidro-Lapena on How
to Teach COPC (2020)
ACKNOWLEDGEMENTS
• Pictures from St. Jude Hospital & Medical Center DFCM Residents
• Images from the internet
• Lecture notes of Dr. Geohari Hamoy on Community Organizing
• Lecture notes of Dr. Louricha Opina-Tan on Making Community Engagement
Meaningful

MRC BERNARDO-LAZARO 2021

COMMUNITY - DEFINITIONS

HISTORY, EVENTS & HEALTH CARE COVERAGE or

CIRCUMSTANCES PRACTICE POPULATION
GEOGRAPHICAL
( ethnicity, gender, socio- (Hypertensive patients, elderly
(location or geo-political area)
economic status, religion…) patients, families with terminally
ill member)
Definitions Adopted from Lecture slides of Dr. Josefina Isidro-Lapena on How to Teach COPC (2020);
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COMMUNITY ORIENTED PRIMARY CARE

(COPC)
• Patient/family • Population group
• Patient centered/ Family • Community oriented
focused • Narrative stories and
• Clinical History socio demographic
• Physical examination Clinical Public profile
• • Relevant biostatistics
Clinical diagnosis
Practice Health • Community diagnosis
• Management
• Follow up and • Interventions
evaluation • Follow up and
evaluation
A systematic approach to improving primary health care services through
integration of clinical science with public health at the community level.
Both the INDIVIDUAL patient and the COMMUNITY are the foci of
diagnosis, treatment and ongoing surveillance
MRC BERNARDO-LAZARO 2021

Source: Lecture slides of Dr. Josefina Isidro-Lapena on How to Teach COPC (2020)

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BENEFITS OF COMMUNITY ENAGEMENT

• Informed decision making

• Increased sense of
involvement and
responsibility
• Build capacity
• More ideas and options
for improvements in
health

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Community engagement is “a process by which people

are enabled to become actively and genuinely involved in
defining the issues of concern to them, in making decisions
about factors that affect their lives, in formulating and
implementing policies, in planning, developing and delivering
services and in taking action to achieve change” (World Health
Organization, 1992)
Image source: https://www.careinternational.org.uk/fighting-poverty/care-know-how/tackling-child-malnutrition-empowering-women
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A PROCESS
RATHER THAN AN ENPOINT

COMMUNITY COMMUNITY
ENGAGEMENT DEVELOPMENT

• An ongoing relationship between citizens, health care

providers and other community members and organizations
to improve health through dialogues or discussions.
• It involves creating trust, building capacity and working
together.
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NOT
COMMUNITY DEVELOPMENT

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The community development perspective places

the responsibility for the development of
community on the PEOPLE.
• The people, working through their own organizations, have the
vision, know-how, capabilities and experience to confront and
solve the problems of underdevelopment.
• EXTERNAL SUPPORT is needed only as a COMPLEMENT to their
resources and efforts.
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METHODS IN
COMMUNITY DEVELOPMENT
• Community Research

• Community Organizing
• Community Education

• Community Resource Management

• Community Planning

• Community Mobilization and Advocacy

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Community Organizing
DEFINITIONS
• Minkler, 1990: Evolved into a “broad process that stresses
working with people as they define their own goals,
mobilize resources, and develop actions for addressing
problems they collectively have identified”
• Ross, 1955: a process by which a community identifies its
needs or objectives; orders or ranks these needs or
objectives; develops the confidence and will to work at these
needs and objectives; finds the resources (internal/external) to
deal with these needs or objectives; takes action concerning
their needs; develops cooperative and collaborative attitudes
and practices in the community.
MRC BERNARDO-LAZARO 2021

COMMUNITY ORGANIZING
(CPHC, 1985; PCF, 1990)

• “a continuous and sustained process of educating

the people to understand and develop a critical
awareness of their existing conditions
• working with the people collectively and efficiently on
their immediate and long-term problems
• and mobilizing the people to develop capability and
readiness to respond and take action on their immediate
needs towards solving their long-term problems”
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Image of Residents and Trainers

of St. Jude Hospital & Medical
Center Department of Family &
Community Medicine together
with members of community
partner

The responsibility to direct change, lies with the

people, and not with the COMMUNITY
ORGANIZER who is just playing a FACILITATIVE
role.
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• Raise peoples awareness about

OBJECTIVES their situation to effect social
of Community change
Organizing • To form structures and
mechanisms that uphold basic
rights and interests
• To help people become aware of
their potentials – to improve their
quality of life
• To initiate actions that will bring
change
Adopted from Lecture Slides of Dr. Geohari
Hamoy on Community Organizing

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STEPS & PRINCIPLES

IN COMMUNITY ORGANIZING (CO)

MRC BERNARDO-LAZARO 2021

STEPS & PRINCIPLES

IN COMMUNITY ORGANIZING (CO)
STEPS (A Manalili ,1985) PRINCIPLES (Quesada, 1972)
1. Entry in the community • Principle of Felt Needs
2. Integrating with the people • Principle of Leadership
3. Community study or situation
analysis
• Principle of Structure
4. Identifying and developing • Principle of Participation
potential community leaders • Principle of Communication
5. Core group formation • Principle of Evaluation
6. Setting up the organization
7. Strengthening the organization

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Step 1: Entry in the Community

• Gather some basic information
about the people and the place
(i.e. Culture, practices and lifestyle)

• You should not be regarded as

superior or different from the
people.

MRC BERNARDO-LAZARO 2021

Step 2: Integrating with the People

• Start working
with the
community

• Realize the
hardships and
problems that
the people face.

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Step 3: Community Study or Situation Analysis

• Facilitate the people’s participation
in analyzing their situation by
letting them examine their
situation themselves.

• Do not limit their participation to

mere answering survey
questionnaires.

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Principle of Felt Need

• Felt needs are problems / issues the
people recognize.

• They are conditions which disturb people

and are causing general discontent.

• These are differentiated from needs

which health providers and do-gooder
groups or agencies have determined
based on their perceptions.

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ISSUE SELECTION

It is important to identify and differentiate the

problems or the things that are troubling the
people from the issues or the problems that the
community feel strongly about. (Miller, 1985; Minkler, 1990)
If the people feel strongly about issues, it facilitates concerted
or collective, meaningful resolutions and actions.
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Step 4: Identifying and Developing

Potential Community Leaders
• Observe who seem to have a
deep understanding and
concern for the people of the
community.
• Slowly educate and convince
the community that their
leaders must come from their
ranks and not from outside.
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Principle of LEADERSHIP
It is important that the LEADER is:
• accepted
• well respected
• has influence to a number of people
• democratic
• has a track record of working for the
common good
• demonstrated capability of making
things work.

MRC BERNARDO-LAZARO 2021

Step 5: Core Group Formation

• Form a core group

consisting of the identified
potential leaders

• Each member must

represent a sector of the
community

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Step 6: Setting-up the Organization

(Developing Organizational Structure)

• Election of leader with participation of all the members.

• Educate the members to trust their organization so they
must all participate in choosing their leaders in a
democratic way.
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Principle of STRUCTURE
• Community organizing
should develop an
organizational structure
that is simple and
functional based on the
needs of the organization.

It need not follow the

structure of formal
organizations.
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Step 7: Strengthening the Organization

• Give the organization the chance to move and work

together on their own.
• Strengthen the organization until the people are truly
convinced about their collective strength.
MRC BERNARDO-LAZARO 2021

Principle of Participation
• People affected by the problems must be actively
involved in all phases of the organizing process: needs
identification, capability building, resource identification
and utilization, other decisive actions to solve the
problems, and evaluation.

• Genuine CO aims to enable people to be in control in

management of projects or programs designed to
address their problems, in which they were involved in
the decision-making process.
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EIGHT (8)
LEVELS OF
COMMUNITY
PARTICIPATION
Community organizers must veer away from
token participation such as information giving,
consultation and placation efforts.

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Principle of Communication

Open lines of communication must be established and

maintained among community organizers, local leaders
and community members.
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INFORM CONSULT INVOLVE COLLABORATE EMPOWER

To provide the To obtain To work directly To partner with To place final
community community with the the community in decision-
with balanced feedback on community each aspect of the making in the
and objective analysis, throughout the decision, including hands of the
information to alternatives or entire process to the development community
assist them in decisions ensure that of alternatives and
understanding community and the identification
the problem, organizational of the preferred
alternatives or concerns are solution
solutions consistently
understood and
considered

Continuum of Communication Strategies

Source: Lecture slides of Dr. Louricha Opina-Tan on Making Community Engagement Meaningful
MRC BERNARDO-LAZARO 2021

Principle of Evaluation
• Assessment is an on-going
process in community organizing

• Efforts should be made to assess

the gains of any mobilization or
social action, its strengths and
weaknesses and to sum-up the
lesson learned.

• This process is also referred to as

ARA, or Action, Reflection,
Action.

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STEPS & PRINCIPLES

IN COMMUNITY ORGANIZING (CO)
PRINCIPLES (Quesada, 1972)
STEPS (A Manalili ,1985)
• Principle of Felt Needs
1. Entry in the community
• Principle of Leadership
2. Integrating with the people
3. Community study or situation • Principle of Structure
analysis • Principle of Participation
4. Identifying and developing • Principle of Communication
potential community leaders
5. Core group formation • Principle of Evaluation
6. Setting up the organization
7. Strengthening the organization

MRC BERNARDO-LAZARO 2021

Principle of
COMMUNICATION Step 3: Community study
or Situation Analysis
Step 1: Entry in the
community Principle of
Step 2: Integrating with FELT NEED
the people
Step 4: Identifying
and developing
Principle of potential community
EVALUATION leaders
Step 5: Core group
formation
Step 7: Strengthening Step 6: Setting up the
the organization organization

Principle of Principles of LEADERSHIP,

PARTICIPATION & STRUCTURE

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COPC & COMMUNITY ORGANIZING

COMMUNITY ORGANIZING
STEPS IN COMMUNITY PRINCIPLES
STEPS IN COPC ORGANIZING (may apply throughout the
process)

1. Entry in the community

Community Definition Principle of Communication*
2. Integrating with the people
Community
Characterization 3. Community Study or Principle of Felt Need
Prioritization situational analysis
4. Identifying and developing
potential community leaders Principle of Leadership
Detailed Assessment of the 5. Core group formation
Selected Problem 6. Setting up the organization Principle of Structure

Planning and Intervention 7. Strengthening the Principle of Participation*

Evaluation organization Principle of Evaluation
MRC BERNARDO-LAZARO 2021

COMMUNITY ORIENTED PRIMARY CARE

(COPC)
• Patient/family • Population group
• Patient centered/ Family • Community oriented
focused • Narrative stories and
• Clinical History socio demographic
• Physical examination Clinical Public profile
• • Relevant biostatistics
Clinical diagnosis
Practice Health • Community diagnosis
• Management
• Follow up and • Interventions
evaluation • Follow up and
evaluation
A systematic approach to improving primary health care services through
integration of clinical science with public health at the community level.
Both the INDIVIDUAL patient and the COMMUNITY are the foci of
diagnosis, treatment and ongoing surveillance
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Principle of
COMMUNICATION Step 3: Community study
or Situation Analysis
Step 1: Entry in the
community Principle of
Step 2: Integrating with FELT NEED
the people
Step 4: Identifying
and developing
Principle of potential community
EVALUATION leaders
Step 5: Core group
formation
Step 7: Strengthening Step 6: Setting up the
the organization organization

Principle of Principles of LEADERSHIP,

PARTICIPATION & STRUCTURE

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FAMILY COMMUNITY

Minimal emphasis on Family OPD in the community

L Medical missions
E Ongoing medical information and Public health lectures, Mother’s
advice
classes [sole purpose is to educate ]
V
Feelings and Support Community projects intended to
E
make the community beneficiary of
L support
S Systematic assessment and Community diagnosis as the start of
planned intervention
an on going relationship towards
O community development
F Family therapy Community development activities
where doctor is a PART of the
community stakeholder
Source: Adopted from Lecture slides of Dr. Josefina Isidro-Lapena on How to Teach COPC (2020)

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PROBLEM

ORGANIZED
COMMUNITY

Never do for others what they

can do for themselves
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