1. COMMUNITY ENTRY AND ORGANISATION DATE: 13th Oct, 2014 LECTURE ONE MARK K. ANANGA Population and Behavioural Sciences School of Public Health UHAS

2.  It is expected that everyone will attend class and show up on time.  It is expected that everyone will check their public health email (…………… ) accounts regularly for course updates, new materials and announcements.  Mobile device (e.g., smart phones) ringers will be turned off or placed on vibrate prior to class. Lecture Hall Etiquette

3. Remove the battery if it is a “China Phone”  If you set a gospel song as your ringtone and then it rings in town and police officers arrest you for holding crusade without permit.  If the only map in your phone is Beijing City  If the only game in your phone is Beijing Olympics 2008 hey that’s china thing.  When you recharge with 10Ghc and 5Ghc is deducted for maintenance.  Finally if the vibration is even louder than your ringtone, my friend your officially china hooked Lecture Hall Etiquette Above all ….. Mutual Respect is the key!

4. Name of Course: Community Entry and Organization Course Code : UHAS 104 Credit Hours : 3 Lecture Hours : Mondays 13 – 16hrs &Tuesday 8.30am – 11.30am. Lecturer : Mark Kwame Ananga Contact : kananga@uhas.edu.gh Course Description In order for community entry and organization to be successful, it is essential that all people and identifiable stakeholders involved in every stage of planning and implementing the activity. This course is designed to introduce students to approaches of working with communities and to help them develop community entry and organization skills. The course will rely heavily on class discussions approach to teaching.

5. Course Objectives By the end of the course, the student will be able to:  Understand concepts and principles of community entry and organization  Learn various models and theories of communication  Identify the main community mobilization approaches  Understand the uses of community mobilization to achieve communication objectives  Develop a community entry and organization plan

6. Course Content Week 1: Introduction to the course Week 1: Composition of community structure and governance. Week 2: Identification of community resources. Week 2: Introduction to concepts and principles of community entry and organization. Week 4: Community mobilization skill. Week 8: Models and theories of communication. Week 8: The advantages and disadvantages using various communication channels Week 10: Health education/ promotion approaches for community participation Week 10: Gender roles in community organization communities for participation Week 12– 14 : Models of community organization including Social action Mass mobilization Grass roots empowerments Leadership developments, and Advocacy. Reading materials will be provided by lecturer

7. Activities for the Semester Summative Assessment Attendance/Participation5% Class Test/Assignments/Mid Sem30% Group Work/Project5% Final Exams60% TOTAL100%  At least 7 class test and/or Assignments  Group Work/Project  Field Trip – Date TBD later  Mid Sem Exams – Date TBD later  Final Exams

8. Class Activity 1 Group Work What is a community? List its properties Describe its structure and governance Hints: There are 3 types  Traditional  Solidarity  Neighborhood 15mins

9. A place or geographical area where a group of people lives and shares a common interest and aspirations and have social network of relationships at the local level A group of people with well-defined demographic characteristics and power structure also form a community. E.g. Villages Towns Other residential areas On the other hand, people who do not live in the same neighbourhood but share common characteristics in terms of goals, etc could be described as communities. E.g., youths Ethnic minorities Drug addicts Handicapped person What is a community

10. Types Traditional Community  Old and establish settlements of people with certain common identifiable traits.  Ethnic grouping such as Clans families,  divisions in terms of religion,  employment etc could be found  Important natural bonds such as Leadership Language traditions and customs What is a community

11. Solidarity Community  People living in a common territory because of common heritage such as  Nationality Ghanaian Community in USA  Ethnicity Ewe Community in K’si- Anloga Dagomba Community in Nima  Religion Yordan nu near Vakpo  Language. Hausa speaking Communities - Zongo What is a community

12. Neighborhood Community  This develops as people live in areas together for a period of time and in the process develop familiarity out of which strong loyalty may grow. Workers estates Civil Servants Bungalows SSNIT Flats Nurses Quarter etc What is a community

13. Community Leadership /Hierarchy Paramount Chief Town/village chiefs Clan/lineage heads Family heads

14. The Community Profile What is a community Profile?

15. The Community Profile  Community Profile is a write up which summarizes the main characteristics of a community its main features resources and needs.  It is a document that informs the health worker of What the community is What is has What it hasn’t,  In terms of health and other social structures for health for health promotion in a community. What are some of the features that should be recorded in a community profile?

16. The Community Profile The main Features described in a typical Community profile  Name of Community  Name of District in which Community is located  Name of sub-district  Names of villages/settlements making up the community  Brief definition of landscape and vegetation  Population of community/member villages  Main customs and beliefs of the people  Predominant religious groupings

17. The Community Profile The main Features described in a typical Community profile  Economic activities Sources of income  Economic facilities markets, shops, etc  Forms of transportation  Forms of communications  Water facilities  Sanitation facilities

18. The Community Profile The main Features described in a typical Community profile  Housing nature and pattern of housing  Schools and other educational facilities  Health facilities hospitals Clinic health post chemist shops traditional healers TBA’s home

19. The Community Profile The main Features described in a typical Community profile  Diseases patterns most common causes of diseases most frequently diagnosed diseases most and unusual health problem  Sickness and health behaviour who people see for health when sick what people do to prevent illness what role traditional healers and TBAs play in health delivery

20. Key assumptions underlying this definition  It is a process  It is aimed at achieving a developmental goals  It is planned with the people  Communities can initiate and promote their own mobilizations; and  People from outside the community could carry out mobilisation with community members Community Mobilization Community mobilization is a process through which action is stimulated by a community itself or by others that is planed, carried out and evaluated by a community’s individuals, groups, and organizations on a participatory and sustained basis to achieve development goals.

21. Group Discussion: 1.Discuss how you have experienced the mobilization process in your community generally and in health service delivery activities in particular 2.Attempt a definition of a community mobilisation for health. 15 mins Class activity

22. Community Mobilization for Health  Health is now considered more than merely absence of diseases  Biomedical being replaced new paradigm which recognises multiple influences on health: social and environmental factors.  It is now understood that individual behaviours occurs in a certain cultural, societal and /or institutional context.  When CM is successful, individuals and communities become more self reliant and behavioural, social and /or structural changes are more likely to be sustained.

23. JHU/CCP Composite report on Community Entry Skills Training for DHMTs (2001) Community Mobilization for Health Community mobilisation for health is a process by which the people of a community, families and individuals, health workers and policy makers are motivated to organise their own, the community’s own and other resources for the purpose of achieving and sustaining improved health Is a process through which a community analyses its health situations with support of health workers and plans for effective organisation and evaluation of health programs. Is a process of involving and motivating people in a community, health workers and policy makers in organising themselves to promote health activities.

24.  Brings together contributions of materials and human resources from all sectors of the community  Builds social support system, particularly for disadvantaged families and groups  Creates ownership and involvement through shared decision making and communal action  Generates empowerment  Encourages sustainability of effort Benefits of Community Mobilisation

25.  The CMF provides a focus for the health workers to analyse the various factors that create the drive for CM.  It also leads to the identification of the intended behaviour change that results from CM and the capacity to carry out the process in future to support the development of other programs. Key Elements:  Readiness does that community perceive a problem and a need for change?  Catalysts Is there an event and or person(s) that sparks the desire for change now?  Environmental Support Does the existing system support the desired change?  E.g when community leaders build a house and ask for health service provider as a result of deaths from preventable diseases. Community Mobilisation Framework

26. Readiness Catalyst Environmental Support Community Mobilisation Process Intended Behaviour Change Increased capacity for community to mobilise again on another issue Conceptual CMF

27. Volunteerism versus Paid work  As members participates in working for the community voluntarily for a period of time, the desire for formal remunerations develops When volunteers feel they are being cheated by other members of the community who benefit from the service while contributing little or no efforts to its development. Community burn out  Continual dependence on mobilising communities for work that does not yield any improvements in their health delivery system my create frustrations among the people and cause them to give up. Maturations and Maintenance  There is a limit to how far community members can go without losing the enthusiasm and energy to support the system if their ownership of the process is not appreciated. Formations of Community health Committees to help organise and maintain the CM process Limitations of Community Mobilisations

28.  Crisis situations such as outbreaks of diseases such as measles, cholera etc  Localised issues such as inability of health workers to reach hard to reach and localised communities When Does CM work best

29. PARKING LOT Difference between community mobilisation and community involvement? Community involvement is the process of engaging in dialogue and collaboration with community members Community mobilization is an attempt to bring both human and non-human resources together to undertake developmental activities in order to achieve sustainable development. To make mobilise will certainly involve engaging in dialogue and collaboration

30.  Community mobilisation also means mobilising available resources to fulfill a felt or real need. These resources are:  Human resources  Natural resources  Man made resources  Organisational resources Mobilising Resources Activity 3 List some of the common examples of these resources above and discuss how their presence or absence aid or jeopardise community mobilisations

31.  People constitute an important resource for the success of any development activity  They are often regarded as the reasons for a certain need.  Important to realise that most of the people in the community are potential contributors whose skills, knowledge and ideas are important resources, which must be tapped and fully explored.  In mobilising human resources one must be conscious of the norms, culture and traditions of the people Their positive elements may enhance program implementations whilst the negative ones may tend to interfere with the program process Certain challenges that arise when working with people with different perspectives. Some of these barriers are: Self-centredness jealousy and petty quarrels among community members lack of co-operations etc Human Resources

32. Some natural resources include: Land Water Forest etc  Constructive and innovative use of these resources would be helpful in supporting program development. For example, a community farm to generate funds for the constructions and maintenance of a Community Health Compound/Home would require fertile piece of land, and adequate rainfall.  Its is important to encourage community members to understand that : Natural resources are definite and must be used responsibly; Development projects should not lead to abuse of natural resources; and Development can not be sustained if its activities harm the environment. Natural Resources

33.  These include: Roads communication networks Shops Markets Factories Schools Hospitals houses and money  It is important for a community mobiliser to understand the availability of these resources and use the informations gathered on these to plan for project implementation.  Money is one of the important man made resources. The level of income of a people in a community may impact on the health of the people in various ways. Man made Resources

34. Sources of raising funds Charges/tarrifs Communal labour Contributions from community and non residen citizens Appeal for funds Fund raising harvest Appeal for external funding from NGOs etc  It may also affect the way community members respond to the development of various facilities to support project activities.  The implementation of programs should be structured in such a way the community would be prepared to contribute money to it because they think its worthwhile. Man made Resources

35. Individuals and groups, who may help to mobilize resources include Chief Town/village Development Committees District Assemblies Area Councils Unit Committees Local Associations Man made Resources

36. Organisational Resources  The provision of most social services including health often involves partnerships with various sector organisations all of which have their own types and levels of resources they would wish to contribute.  These may include technical expertise/personel Money Vehicles service equipments etc  Efficient co-ordination in mobilising these resources is required to avoid duplication and waste fighting over ownership of program marginalisation of community effort.