THE HEALTH RESOURCE DEVELOPMENT PROGRAM III

The Health Resource Development Program (HRDP) was developed and sponsored by the Philippine Center for Population and Development (PCPD) to make health services available and accessible to depressed and underserved communities in the Philippines. The PCPD is a non-stock, non-profit private institution which serves as a resource center assisting institutions and agencies through programs and projects geared toward the social human development of rural and urban communities. PCPD was formerly the Population Center Foundation.

The PCPD sponsored health training institutions or hospitals to carry out the program as part of the outreach activities of these schools or hospitals. The training institutions developed an effective system of delivery of the primary health care in depressed communities and trained the community residents in the management of their own health concerns. The PCPD provides funds for health programs while the schools or hospitals have a counterpart to contribute in the form of service or in kind.

The HRDP has three cycles. The first cycle (HRDP I) trained the faculty, medical/nursing students to provide health care services to the far-flung barrios because of lack of manpower for health services at the same time that similar activities fulfilled the curricular requirements of students for public health. The PCPD provides seed money for the income-generating projects. On the other hand, the community organizer uses his/her own strategy or method in developing the community. His is considered to be a short-term service.

The second cycle (HRDP II) uses the same strategy but the program could not be sustained by the schools or hospitals and the income generating projects eventually 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.

Both HRDP I and II have brought about some changes in the community life of the people. There was an established basic health infrastructures; basic health services were increased, there were trained health workers and organized health groups to take care of the healthy needs of the community.

The PCPD refined the program and resulted to what is now called HRDP III.

COMMUNITY ORGANIZING AND PARTICIPATORY ACTION RESEARCH (CO-PAR)

Community Organizing-Participatory Action Research has been the strategy used by the HRDP III in implementing the Primary Health Care delivery in depressed and underserved communities to become self-reliant.

The HRDP III describes Community Organizing as a continuous and sustained process of educating the people to let the m understand and develop their critical awareness of the existing conditions; it is working with the people collectively and efficiently discover their immediate and long-term problems and mobilizing the people to develop their immediate needs toward the solution of their long-term projects.

Objectives of Community Organizing:

1. 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.

2. 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.

3. To initiate the responsible actions intended to address holistically the various community health and social problems.

As applied to Primary Health Care, Community Organizing is defined as the process and structures through which members of the community are tapped to become organized for participation in health care and community development activities. They organized themselves to get better health care and improve their health as a part of a larger effort, to increase their power and achieve greater social and economic equality within a larger social system.

As a process, Community Organizing is the sequence of steps whereby the members of the community work together to critically assess and evaluate community conditions to improve thee conditions.

As a structure, it refers to the particular group of community members that work together for common health and health-related problems.

It can be culled from this definition that it is the people who organized themselves into a working team who can effectively solve their own health problems.

EMPHASES OF COMMUNITY ORGANIZING IN PRIMARY HEALTH CARE

1. The community works to solve their own problems.2. The direction is internal rather than external.3. The development of the capacity to establish a project is more

important than the project.4. There is consciousness-raising to perceive health and medical care

within the total structure of society.

PARTICIPATORY ACTION RESEARCH

As a process, Participatory Action Research (PAR) 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.

As a structure, the beneficiaries of the research are the main actors in the research process. It enables the community to experience a collaborative consciousness of their own situations. PAR involves research, education and actions to empower people determine the cause of their problems, analyzed these problems and act by themselves in responding to their own problems. The essential element of PAR is participation.

PAR is a community-directed process of gathering and analyzing information for the process of taking actions and making changes.

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.

The Objectives of PAR:

1. To encourage consciousness of the suffering and develop competence for changing their own situation

2. To help in the organization building by harnessing both human and natural resources in responding to community needs.

3. To enhance the knowledge of the researcher in the community on the social reality before them.

PARTICIPANTS IN PAR

a. Outside Researcher. The outside researcher is a professional researcher, who is committed and a learner; active learner rather than detached. He goes into an immersion and integration in the community. He shares his research knowledge to encourage genuine participation but would never assume a paternalistic authoritarian attitude but leaves the application of that knowledge to the people of the community.

b. Local Researcher. The local researchers are trained in the process of research and are made aware of the needs of their people and committed to do something about them. The local researchers elicit active participation from community members for collective data gathering, data analysis and action. They are the link between the community and the outside resources.

HRDP CO-PAR PROCESS

1. Pre-entry Phase.- initial phase of the organizing process where the community

or organizer looks for community to serve. It is the simplest phase in the community organizing process in terms of expected outputs, activities and strategies. The activities done in this phase are:

o Community consultations/dialogueso Setting of issues/considerations related to site

selectiono Development of criteria for site selectiono Site selectiono Preliminary social investigation (PSI)o Networking with local government units (LGUs),

NGOs and other departments within the HRDP-NGO

2. Entry Phase / Social Preparation Phase- most crucial phase of the COPAR. It allows the community

tube on active participant of the success of the phase depends on how the project implementers have integrated with the community people. This phase includes activities such as:

o Integration with the communityo Identification of leaderso Continuing Social Investigationo Provision of health services

3. Community Study / Diagnosis Phase (Research Phase)- comprehensive documentation of data gathere which focus on

systematically looking for issues around to organize the people. Activities done in this phase includes:

o Selection of the research teamo Planning for the actual data gatheringo Data gatheringo Training of data validationo Presentation of the community study/diagnosis and recommendationso Prioritization of community needs/problems for action

4. Community Organization and Capability-Building Phase- signals the start of the community self-management because

it entails the formation of the formal structure and the inclusion of the formal procedure of planning, implementing, promoting and evaluating of community-wide activities. Activities are:

o Election of officerso Delineation of the roles, functions and tasks of

officers and members of the CHOo Working out legal documentso Training of CHO officers

o Intervention scheme and community development projects

o Setting up linkages/network/referral system

5. Sustenance and Strengthening Phase- when the community can already stand on their own thus the

people can sustain the program even without the help from project implementers. Activities included are:

o Formulation and ratification of constitutions and by-lawso Continuing education and upgrading of community

leaders, CHWs and CHO memberso Formalizing and institutionalization of linkages,

networks and referral systemso Identification and development of secondary

leaders

Different Approaches:

Welfare Approach

– spontaneous response to ameliorate the manifestation of

poverty

– poverty is caused by bad luck, natural disaster, etc.,

– poverty is God-given

Modernization Approach / Project Development Approach

– introduces whatever is lacking in a given society

– poverty is caused by lack of education and resources

Transformatory Approach / Participatory Approach

– poverty is not God-given

– process of empowering and transferring the poor and the

oppressed sectors of the society so they can pursue a more just,

humane society

Records – client’s information and data

Report – periodic summary of services

Purposes of Records and Reports

measure the service / program directed to the client

provide basis for future planning

interpret the work to the public and other agencies and the

community itself

aid in studying the conditions of the community

Steps of Community Organizing

1. Integration – being or becoming with the people

2. Social Investigation – systematic process of collecting and collating data to

draw a clear picture of the community3. Tentative Program Planning

– choosing one issue to work on in order to begin organizing the people

4. Groundwork – going around and motivating the people on one-on-one

basis to do something on the issue that has been chosen5. The Meeting

– people collectively ratifying what they have already decided individually– gives the people the collective power and confidence

6. Role Play– act out the meeting that takes plce between the leader of

the people and the government representatives7. Mobilization

– actual experience of the people in confronting the powerful and the actual exercise of people power

8. Evaluation – the people review their steps or activities so as to

determine whether they were successful or not in their objectives9. Reflection

– dealing with deeper on-going concerns to look at positive values

– gives the people time to reflect on the stark reality of life compared to the ideal

10. Organization– result of many successive and similar action of the

people– final organizational structure is set up with newly

elected officers and supporting members