Community Involvement Some Lessons from Southern India
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Community InvolvementSome Lessons from Southern India
Hari and Prem John Deenabandu &
People’s Health Movement India
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Community Health
Community involvement in health or development is not value neutral. It is not a mere methodology to implement a project.
It is an intensely political involvement where one identifies victims and oppressors, takes sides, goes behind the barricades with the people against ruling structures that oppress them.
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“Health is politics on a social scale- Halfdan Mahler
“The Sole purpose of life is to serve humanity”
- Leo Tolstoy
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“and those who were seen dancing were thought to be insane by those who could not hear the music" (Nietzche)
The medical professionals look down upon other medical professionals working at the community level. Call them quacks.
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The Analysis
The very basis of community involvement in health lies in socio-political analysisa Class Analysis and Approach
(Marx). Clearly defined class enemies,
therefore entirely pro-poor
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The Blocks
Ignorance Class, Caste, Ethnicity, Gender, Religion Cultural factors such as dress, food habits Preconceived notions Rigidity Arrogance Haste/Impatience Long history of insensitivity/oppression
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Therefore, the Need
Humility Open mind Ability to transcend class, caste,
education factors Willingness to deschool Willingness to learn Ability to go beyond the boundaries Capacity in integrate into the community
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That would lead to
Participation as an internalised value
Participation as a methodologyWhere the community
participates from the stage of conception to data collection, to collation, analysis, planning, implementation, monitoring, evaluation, course correction
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Community Organisation
Communities divided along any lines (caste, class, ethnicity, religion) cannot work together
Therefore, the necessity for ‘organising’ the community, to build unity (Ivan Illich)
The biggest investment is in terms of time – to bring the community under the same tree for discussions and agreement on joint action
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Methods Used
Participatory Strategic Planning (PSP)
Participatory Action Research (PAR) Participatory Vulnerability Analysis
(PVA) Participatory Training Methodologies
(PTM)
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PSP PSP is a derivative of Strategic Planning. It
comes from the military and corporate sectors and has been specially adapted for communities
The Process affirms the belief that any one, even illiterate, down trodden communities have the capacity to look back, take stock of their present situation and state what they aspire for
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PSP Simply stated, it means:
* What we want to be
* Where we want to be
* What is the path to take
* How do we want to reach there on a specific time frame
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PSP Communities and the organisations
that work with them learn to look at it under three circlesThe Context Circle (Community and
Organisation)The Vision CircleThe Organisation Strengths Circle
(Community and Organisation)
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The Context Circle
The Critical IssuesThe ChallengesOpportunities and ThreatsKey Players
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The Vision Circle
* Vision
* Mission
* Objectives
* Strategies
* Program
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The Third Circle
Strengths Weaknesses Capabalities Potential Resources
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The Three Circles
VisionMission
StrategiesObjectivesPrograms
Role Models
StrengthsWeaknesses Capabilities
Potential Resources
ContextCritical Issues
ChallengesOpportunities
ThreatsKey Players
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The “F I T”
FIT
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The Fit The three circles converge and the area
of convergence is called as the “FIT” The more they converge, the larger is the
fit When the “FIT” keeps getting larger, over
time, then the aspirations and capabilities of the community and the organisation and the goals and objectives of the organisation are congruent
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The Methods The Community uses many
participatory techniques. One of them is Village Mapping The Older people map the village as it
was 10 years ago using available materials
The younger people map it as it is today
The community looks at it and sees what changes have taken place over time
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Then Our role is only facilitatory The community then looks at the
reasons for change We help them to reason out why
these changes have taken place and what can be done about these changes eg water, deforestation
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Changes
The Community looks at: the reasons for change the trends
If trends remain the same what would be the scenario 5 years from now,
if trends become better what would be the scenario and
if the trends worsen, what would be the scenario
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The Probable Scenario
Then they pick from each of the scenarios and come up with a probable scenario, look at what problems would be faced and how the scenario can be improved
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Joint Action The Community then gets to know
what needs to be done, what resources they have, what outside resources are needed, how they can go about it, what the blocks are, who the obstacles are and at what level –
local, national and international, and finally how to overcome those obstacles
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PAR
It is a methodology where the community participates fully in getting to know their situationStrengths and weaknessesResourcesProblemsOpportunitiesThreats
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PAR
Regenerate and build upon existing knowledge
Regenerate and build upon existing skills
Regenerate, refine and build upon existing practices
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From Day One
The community participates fully in: InvestigationAnalysisPlanning Appropriate and Joint Action Implementing the ProgramMonitoring and EvaluationMid-course Corrections
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Goals of PAR
To release To restore To renew To empower and finally Transform
PAR empowers, achieves collective power,
Makes them realize their collective worth and
Builds Self Reliance
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PAR Is committed to the Marginalised and
the Poor. Is biased in favour of the poor.
Believes that everyone has intelligence, create knowledge, the right to make history.
Develops critical understanding Insists on democratic interactions
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PAR Is an Action-Reflection-Action Process and
therefore is basic to community organisation Build inter-personal and intra-community
relationships, bonds Re-energises and fosters social capital such as
trust, confidence, sharing, care of the poor etc., Helps breakdown barriers
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Participatory Vulnerability Analysis (PVA)
PVA is a systematic process that involves communities and other stakeholders in an in-depth examination of their vulnerability, and at the same time empowers or motivates them to take appropriate actions.
The overall aim of PVA is to link disaster preparedness (droughts, floods, state oppression on a large scale) and responses to long-term development.
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PVA-Community Level
PVA enables communities to play a dual role, as informants, but also analysts, by breaking down vulnerability to a point where they can begin to take action to reduce their ownvulnerability. The analysis itself has no value unless it is followed by action: people cantake action themselves
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PVA Means
Community meetings Discussion sessions and analysis Training of local facilitators Participatory and reflection approaches Stakeholders and focal group meetings Local level advocacy and lobbying Documentation and liaison Studies on selected issues
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Participatory Training Methods(PTM)
Is an enabling experience Best method for adult learning Learning by doing No one comes as empty vessels and
that even the illiterate have experiential knowledge
Equality between trainer-trainee
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PTM Treats trainees as adults Shared responsibility for learning Is a confidence-building process Mutually enriching Builds on what they know Respects cultures, values and life
experience Translates scientific knowledge to real life Leads to behavioural changes
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Rights-based Approach Participatory Approaches empower communities
to stand up to ruling structures Communities know what their rights are:
Human rights Women’s rights Peasants’ rights Rights of outcastes, indigenous people Children’s rights
And have the knowledge, skills and capacities to fight their own battles