Republic of the PhilippinesBicol University

Graduate School, Gubat CampusMaster of Arts in Nursing

Gubat, Sorsogon

Name: Ynneb Reine H. Manginsay, R.N.Topic: Community Organizing and COPARSubject: MAN 212: Dynamics of Communication Health and DevelopmentProfessor: Mr. Gaspar Santos, R.N., M.N.Term: 2nd Semester, S.Y. 2012-2013

COMMUNITY ORGANIZING

Healthy Community

(WHO 1998)

-It is a social group determined by:

Geographical boundaries Common values and interests Members know and interact with each other Creates norms, values and social institutions

(Jimenez)

Not only the absence of disease in individuals It is a state of physical, social and mental well-being People are aware of political, religious, economic and cultural factors that affect

their health Could act to prevent illness and promote health

Classification of Communities

Urban Rural Rurban

Characteristics of Community

(Reyes and Layug)

1. Environment – physical, socio-cultural, educational and employment milieu2. Population – Behavior/lifestyle, self responsibility, self care competency3. Human Biology – Genetic characteristics of a population4. Systems of Health Care – Prevention, promotion, cure and rehabilitation

Characteristics of a Healthy Community

(Hunt and Zurek, 1997:12)

1. Awareness that “we are a community”2. Uses and conserves its natural resources3. Recognition of and respect for the existence of subgroups and welcomes their

participation in community affairs4. Prepared to meet crises5. Has open channels of communication6. Resources available to all7. Settling of disputes through legitimate mechanisms8. Encourages maximum citizen participation in decision making9. Promotes high level wellness among all its members

Components of Community

1. The PEOPLE – core2. Subsystems of Community

Housing Education Fire and Safety Politics and Government Health Communication Economics Recreation

Factors Affecting Community Health

Political factors – way of leadership Socio – cultural factors– Composed of beliefs and practices of the members of

the community Economic factors – refers to the production, distribution and consumption of

goods and how these affect health and development Environment – The sum total of all conditions and elements that make up the

surroundings

Approaches in Community Development

1. Welfare Approach (Traditional Approach)2. Modernization Approach3. Transformative/Participatory Approach

Community Organizing

Definitions:

(Maglaya)

-Process whereby community members develop the capability:

To assess their health needs and problems Plan and implement actions to solve these problems Put up and sustain organizational structures Support and monitor implementation of health initiatives by the people

Keyword: EMPOWERMENT

(Human Resource Development Program (HRDP III))

A continuous and sustained process of educating the people It is working with the people collectively and efficiently, discover their immediate

and long term problems and mobilizing the people to develop their capabilities and readiness to respond and take action on their immediate needs toward the solution of their long term problems.

(Jimenez)

- It is the people who organize themselves into a working team who can effectively solve their own health problems As applied to Primary Health Care – it is defined as the process and structures

through which people are tapped to become organized to participate in health care and community development activities

As a process – is the sequence of steps whereby the members of the community work together to critically assess, evaluate and improve its condition

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

(Wikipedia)

Assumes social change involves conflict and social struggle Core goal is to generate durable power (collective power) allowing it to influence

key decision makers on the range of issues overtime

(Mike Miller)

Is a developmental strategy for building people’s capabilities towards self determination and self reliance

A method and a process of educating, organizing and mobilizing people which leads to their own development.

2 things to rectify the problem of power of imbalance: Builds a permanent base of power – dominant institutional power can be

challenged

Transforms individuals and communities – aims to transform the apathetic, individualistic, voiceless poor into a dynamic, participatory and politically responsive community.

Objectives of Community Organizing (as identified by PHC)

1. To make people aware of social realities 2. To form structures that hold the people’s basic interests 3. To initiate the responsible actions

History of Community Organizing in the Philippines

September 21, 1972 –Marcos declaration of martial rule led to:

Elimination of social movements and groups Church-based programs functioned as NGOs and started community organizing

Urban and rural Missionaries of the Philippines Taskforce detainees of the Phil. Episcopal Commission on Tribal Filipinos Share and Care Apostolate for poor Settlers and PEACE

NGOs followed and resumed grassroots activities discretely Political formations saw the need to set up NGOs in order to pursue their own

interest Positive side vs. Negative side

December 1972- Developmental institutions saw the need for more coordinated activities from 10 foundations to 40 by 1976.

Association of Foundations

1977- Repression continued, human rights violation increased

-Advocacy was used to organize mass movement

-NGOs recognized the need to band together into networks for purposes of linkaging, synchronization of activities and cooperative exchange of experiences and resources.

1983- Assassination of Benigno Aquino led to:

Widespread street protests Attracted cooperation of unpoliticized sectors of society (businesses and church) Coalitions were formed Major organizations among the ranks of the peasant, fisherfolks and indigenous

people were organized Other venues of developmental work were explored

Elements of Community Organizing

(Joan Minieri, Paul Getsos and Chardon Press, Tools for Radical Democracy)

1. Power Ability to make something happen Getting people understand the source of problem, devise solutions, strategies,

take on leadership and move to action thru campaigns that win concrete changes2. Relationship Building

People are accountable to one another for their activities on behalf of the group

2 kinds

1. One on one2. Public relationships

3. Leadership Development must build a base of members, get them to see the root of the problem and get

them involved to develop them into leaders4. Political Education

Form of training whether formally or informally about issues, social movements and history of the organization

5. Strategy Overall approach to achieving objectives Way that a community uses its power to win what it wants by:

Campaigns Research Collaboration and alliances

6. Mobilization Essential process of moving people to action

7. Action A public showing of an organization’s power Takes place during campaigns

8. Winning Organizing focuses on winning Unless the organization wins concrete, measurable benefits for those who

participate, it will not last long. They must see a potential for either benefit or harm to themselves if the

group succeeds or fails Their personal involvement has an impact on the whole effort.

9. Movement Building Groups engage in broader social justice activities that are not solely connected to

winnable campaigns or self interest of community 10. Evaluation

Monitors and improves performance (Action-reflection-action) Continuous process of assessing actions whether the goals are met or not

Principles of Community Organizing

1. People are motivated by self-interest2. Community Organizing is a dynamic process3. Learn to deal with conflict and confrontation4. Take into account the fundamental definition of an issue5. Tactics should be within the experience of the people and outside the experience of

the target6. Man learns more effectively from his own actual experiences7. Man needs to deepen and widen his horizon8. People must make their own decisions

Types of Community Organizing

Grassroots FBCO Coalitions

Strengths of Community Organizing (Miller)

Builds self-reliant, creative grass root organizations Openness to experiment Rooted in the community Generates immediate success Empowers people – simple and can be learned by anyone

Emphases of Community Organizing in Primary Health Care (Jimenez)

1. The community works to solve their own problems2. The direction is internal rather than external3. The development of the capacity to establish a project is more important than the

project4. There is a consciousness-raising to perceive health and medical care within the

total structure of society.

Characteristics of Consolidated and Viable Organization (Miller)

1. Ability to facilitate, lead and effectively carry out policies, etc. with maximum participation of members in decision making

2. Ability to achieve desired objectives through maximizing their planning and implementing skills.

3. Capable of effecting institutional and development changes within the organization that would accrue to the welfare of the members

4. Consciousness content: organizational matter

Characteristics of Stable Organization (Miller)

1. Keeps and maintains self-reliance and self-sufficiency

2. Capable of effecting institutional and development changes that would increase the benefit of the people

3. Seeks meaningful participation in policy making bodies where some sectors are not represented at all but which decision affect them

4. Conscious content, community or regional matters affecting the whole population

Phases of Community Organizing

(Maglaya)

A. PREPARATORY PHASE 1. Area Selection2. Community Profiling3. Entry in the Community and Integration with the People

Guidelines: Recognize the role and position of local authorities Adopt a lifestyle in keeping with that of the community Choose a modest dwelling Avoid raising expectations of the people Participate directly in production process and social activities Make house calls Seek out people where they usually gather

B. ORGANIZATIONAL PHASE 1. Social Preparation2. Spotting and developing potential leaders3. Core Group formation- Represented by different sectors of the community

The core group serves as training ground for developing potential leaders in:

Democratic and collective leadership Planning and assuming tasks for the formation of a community wide

organization Handling and resolving group conflicts Critical thinking and decision making process

4. Setting up the Community OrganizationC. EDUCATION AND TRAINING PHASE

1. Conducting Community Diagnosis2. Training of Community Health Workers3. Health Services and Mobilization4. Leadership Formation Activities

D. INTERSECTORAL COLLABORATION PHASE As the organization grows, its needs also grow Assistance and support can be achieved through collaboration with other

organizations and communitiesE. PHASE OUT

Turn-over of work Monitoring and subsequent follow up of activities until the community is ready for

full disengagement

Basic Community Organizing Process

(Jimenez)

I. ENTRY TO THE COMMUNITY The decision to enter a community and establish a helping/working relationship should consider the ff:

A. Clarity of purpose of the relationship between the agency/community organizer and the people

B. Existence of social problems and needsC. Community’s desire and willingness to work for change

II. INTEGRATION WITH THE PEOPLE - Is establishing rapport with the people in a continuing effort to imbibe in their

community life- Immerses himself/herself in the community to know and respect the culture,

history, economy, leaders, and lifestyle of people- Facilitates social investigation and vice versa

III. SOCIAL INVESTIGATION/COMMUNITY STUDY - Is the process of systematically learning and analyzing the various structures and

force in the community study – economic, political and socio-cultural- Comes at the beginning and as a process. It is continuous. “no community study

is ever complete”

Objectives:

1. To gather data2. To identify the classes and sectors present3. To determine the correct approach and method of organizing4. To provide a basis of planning and programming of organizing activities

General methodology and guidelines in social investigation:

A. InterviewB. ObservationsC. Examination/Review of Secondary Data

- Assumes that much of the initial information needed is already available

- Major data to be gathered:a. Geographic and demographic datab. Economy system/type of economic productionc. Political system/decision-making structure/sd. Socio-political system

IV. PARTICIPATORY APPROACH IN SOCIAL INVESTIGATION

- Peoples participation should be observed

Participatory Data Gathering – the process of involving the community residents in the collection and consolidation of data or information

Knowing the answers to the ff:

1. Why data are gathered2. What data to gather3. How data are to be gathered (tools to be used)4. Where data are to be gathered (sources)

It is important in CO because it provides:

1. Demographic profile2. Inventory of community resources3. Identification of community trends and issues4. Picture of network of service and organization in the area5. Opportunity for raising the level of consciousness

Aids the community organizer in:

1. Identifying the situation he/she is entering2. Initial view of the social problems3. Specifying his role face to face with the people4. Setting relevant objectives and effective programs5. Evaluating the community’s progress

V. PROBLEMS/ISSUES IDENTIFICATION AND ANALYSIS

Problem Identification – process of defining, analyzing and ranking community problems and needs

- Helping communities perceive and analyze their situation from a more comprehensive and analytical viewpoint

Guide in Problem Identification:

1. Scope/degree of the problem2. Past change efforts3. Origin of the problem4. Factors that maintain/increase or eliminate the problems5. Consequence analysis6. Problem on organization

VI. PLANNING AND STRATEGIZING

Planning – process of translating goals/objectives into specific activities to meet community needs or solve community problems

Planning process involves:

A. Identification of perceived problems and needsB. Identification of existing resourcesC. Study on the block to the utilization of their resourcesD. Formulation of the possible solutions E. Setting Plans of Actions- Plans are further broken down into strategies and tactics

- Strategy – general/over-all direction that organizing process will take course (long range goal)

- Tactics – a specific action/goal within a strategy

Guidelines for forming strategies:

a. Principal issue/ problemb. Solution to the problemc. Strengths and weaknessesd. Other secondary issuese. Larger outside issues

VII. CORE GROUP FORMATION - Identification of potential leaders

Criteria:

Belongs to poor sectors and classes –engaged in production Well-respected and has relatively wide influence Willing to work for change Can find time, conscientious and resourceful Must be able to communicate effectively

Functions of a core group:

Training ground for democratic and collective leadership Builds people’s potential and self-confidence Helps gather data, spotting other potential leaders and members for a community

wide organization Helps in laying out plans and tasks for the formation and maintenance of the

organizationVIII. ORGANIZATION DEVELOPMENT

- Forming a community-wide organization after formation of the core group

Techniques to recruit members:

A. Ground Work – to go around and motivate people on a one-on-one basis (agitation)

B. The Meeting – the people collectively ratify what they already have decided individually

- Gives a sense of collective power and confidence

- creation of working committees and tasksC. Organizational structure – formal setting up of the community organization where

constitution and organizational plans are ratified and approved- Organizing process results in consolidating a viable people’s organization

D. Leadership Training and development – revolves on indigenous leaders who will eventually take over the role of community organizer- Promotes collective or shared leadership

- May be done formally or informally

Principles and Concepts of Leadership training

1. Leadership as service2. Corporate/collective leadership3. Delegation of Authority4. Eliciting Participation5. Problem Solving

Activities in informal leadership training:

Groundwork Continuous exposure to and active participation to mobilization activities Action-reflection and criticism-self criticism

Activities in Formal leadership training

Seminars Workshops Structured study Sessions

IX. MOBILIZATION - Refers to the activities undertaken by the community to solve problems

- Builds and strengthens people’s self-confidence and collective spirit

- Actual experience of the people confronting the powerful and the actual exercise of people power

Steps and guidelines in preparing Conflict Mobilization:

A. Issue(s) spotting and analysisB. Target AnalysisC. PlanningD. Role playing

X. REFLECTION AND EVALUATION

Reflection – analyzing the finished mass action, its good and weak points identified.

- Relates practice to theory and creates an awareness of global issues

Continual self analysis – necessary to maintain and consolidate a cooperative and participatory spirit to ensure that no oppressor-oppressed relationship emerge within the group

Evaluation - Process of discovering the way it has been accomplished, what has been left out and what remains to be done

- People’s participation in evaluation is as important

Guidelines for evaluating a community:

PART I. QUANTITATIVE ANALYSIS

A. General DescriptionB. Listing of activities

1. People’s issues handled, completed, on-going and potential2. Mobilization/Negotiation taken3. Meeting/Reflection sessions held4. Seminars and Conventions

PART II. QUALITATIVE ANALYSIS

A. Area DescriptionB. IssuesC. Organization/Groups

1. Knowledge gained2. Involvement and outlook of people3. Attitudinal changes

XI. TURN OVER AND PHASE OUT - After some time, community organizers become dispensable and the people’s

organization takes over.

Turn-over of the organizing process is done if the ff. are satisfactory achieved:

High level of sociopolitical awareness Sustained membership participation Trained pool of leaders Well set up community structures and linkages Delineated goals, directions, plans of actions are clear- Organizers may assume a supportive role monitoring, consultant, and evaluator

Five Stages of Organizing: A Community Health Promotion Model

(Public Health Nursing in the Philippines, 10th edition)

STAGE 1: COMMUNITY ANALYSIS

Five Components:

Demographic, social and economic profile from secondary data Health risk profile Health/Wellness outcomes profile Survey of current health promotion programs Studies in certain target groups

Steps:

1. Define the community2. Collect data3. Assess community capacity4. Assess community barriers5. Assess readiness for change6. Synthesis data and set priorities

STAGE 2: DESIGN AND INITIATION

a. Establish a core planning group and local organizerb. Choose an Organizational structurec. Identify, select and recruit organizational membersd. Define the organization mission and goalse. Clarify roles and responsibilities of the peoplef. Provide training and recognition

STAGE 3: IMPLEMENTATION

a. Generate broad citizen participationb. Develop a sequential work planc. Use comprehensive, integrated strategiesd. Integrate community values into the programs, materials and messages

STAGE 4: PROGRAM MAINTENANCE – CONSOLIDATION

a. Integrate intervention activities into community networksb. Establish a positive organizational culturec. Establish an ongoing recruitment pland. Disseminate results

STAGE 5: DISSEMINATION – REASSESSMENT

a. Update the community analysisb. Assess effectiveness of interventions/programsc. Chart future directories and modificationsd. Summarize and disseminate results

COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH (COPAR)

PARTICIPATORY ACTION RESEARCH

(Jimenez)

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

A community-directed process of gathering and analyzing information or an issue for the process of taking actions and making changes

PARTICIPATION – main element

The beneficiaries of the research are the main actors of the research process Involves research, education and actions to empower people to determine the

cause of their problems, analyze these problems and act by themselves in responding to their own problem

CHARACTERISTICS OF TRADITIONAL AND PARTICIPATORY ACTION RESEARCH

Traditional PAR1. Purpose: to identify and meet

individual needs within existing social systems

1. Purpose: Social Transformation

2. Community problems or needs are defined by experts

2. Research problems are defined by the community

3. Research problems is studied by the researchers

3. The community undertakes the research process. External researchers work alongside

4. Recommendations are based on the researcher’s findings and analysis

4. Community formulates recommendations and an action plan based on research outcome

PARTICIPANTS 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 local researchers are trained in the process of research and are made aware of the needs of their people

COPAR

Definition:

Is a social development approach that aims to transform the apathetic, individualistic and voiceless poor into a dynamic, participatory and politically responsive community

is a continuous and a sustained process of:1. Educating the people - to understand and develop their critical

consciousness2. Working with people - to work collectively and effectively on their

immediate and long term problems3. Mobilizing with people - develop their capability and readiness to respond,

take action on their immediate needs towards solving the long term problems It is a process and a structure through which the members of the community are

tapped to become organized for participation in health care and community development activities

A strategy used by the HRDP III in implementing the Primary Health Care delivery in depressed and underserved communities to become self-reliant

Process:

The sequence of steps whereby members of the community come together to critically assess to evaluate community conditions and work together to improve those conditions

Structure:

Refers to a particular group of community members that work together for a common health and health related goals

Emphasis of COPAR

1. Community working to solve its own problem2. Direction is established internally and externally3. Development and implementation of a specific project less important than the development of the capacity of the community to establish the project4. Consciousness raising involves perceiving health and medical care within the total structure of society

Importance of COPAR

1. COPAR is an important tool for community development and people empowerment 2. COPAR prepares people/clients to eventually take over the management of a development programs in the future.3. COPAR maximizes community participation and involvement; community resources are mobilized for community services.

PRINCIPLES

1. People especially the most oppressed, exploited and deprived sectors are open to change, have the capacity to change and are able to bring about change.2. COPAR should be based on the interest of the poorest sector of the community.3. COPAR should lead to a self-reliant community and society.

Process/Methods Used in COPAR

A Progressive Cycle of Action Reflection Action – begins with small, local and concrete issue identified by the people and the evaluation and reflection of and on the action taken by them

Consciousness – Raising – through experiential learning is central to the COPAR process because it places emphasis on learning that emerges from concrete action and which encircles succeeding action

COPAR is Participatory and Mass-Based – because it is primarily directed towards and biased in favor of the poor, the powerless and the oppressed

COPAR is Group Centered- not leader centered. Leaders are identified, emerged and are tested through action rather than appointed or selected by some force or entity

CRITICAL STEPS (ACTIVITIES) IN COPAR1. Integration – the health worker becomes one with the people in order to:

a) Immerse in the communityb) Understand deeply the culture, economy, leaders, history, rhythms and

lifestyle in the community2. Social Investigation (Community Study)

- Systematic process of collecting, collating, analyzing data to draw a clear picture of the community

- Must remember the following:a) Use of survey questionnaires is discouragedb) Community leaders can be trained to initially assist in the social

investigationc) Secondary data should be thoroughly examinedd) Social investigation is facilitated if the health worker is properly integrated

and has acquired the trust of the peoplee) Confirmation and validation of community should be regularly done

3. Tentative Program Planning – CO to choose one issue to work on in order to begin organizing people

4. Groundwork – going around and motivating the people on a one on one basis to do something on the issue that has been chosen

5. The meeting – people collectively ratify what they have decided individually- Gives collective power and confidence

- Problems and issues are discussed

6. Role Play – acting out the meeting that will take place between the leaders of the people and the government representatives- way of training people to anticipate what will happen and prepare them for such eventually

7. Mobilization or action – actual experience of the people in confronting the powerful and the actual exercise of people power.

8. Evaluation – the people reviewing the steps 1-7 so as to determine they were successful or not in their objectives

9. Reflection – dealing with deeper, ongoing concerns to look at the positive values CO is trying to build in the organization- Gives people time to reflect on the stark reality of life compared to the ideal

10. Organization – the people’s organization is the result of many successive and similar actions of the people.- a final organizational structure is set up with elected officers and supporting members

COPAR Process

1. Pre-entry Phase

Organizers look for communities to serve/help. It is considered the simplest phase in terms of actual outputs, activities and strategies

and time spent for it

Preparation of the Institution

o Train faculty and students in COPAR.

o Formulate plans for institutionalizing COPAR.

o Revise/enrich curriculum and immersion program.

o Coordinate participants of other departments.

Site Selection

o Initial networking with local government.o Conduct preliminary investigation.

Criteria for Initial Site SelectionEconomically depressed.Health services are inaccessible/ inadequatePoor community health statusAcceptance of the program by community.No serious peace and order problem.No similar group or organization holding the same program.

o Do final networking and consultation with local government and NGOs

o Generate secondary data.o Make long/short list of potential communities.

o Do ocular survey of listed communities.Choosing Final Barangay/Site

o Conduct interviews with barangay officials and key informants to choose project site.o Discuss suitability of project siteo Coordinate with local government and NGOs for assistance of the program’s

implementation in the future.o Develop community profiles from secondary data.o Develop survey tools.

After site selectiono Pay courtesy call to community leaders.o Conduct Community Assemblyo Create a working committeeo Conduct baseline studyo Conduct Staff planning, strategizing for entry phase

2. Entry Phase (social preparation phase) crucial in determining which strategies for organizing would suit the chosen

community Success of the activities depend on how much the community organizers has

integrated with the communityGuidelines for Entry

o Recognize the role of local authorities by paying them visits to inform their presence

and activities.o Her appearance, speech, behavior and lifestyle should be in keeping with those of

the community residents without disregard of their being role model.o Avoid raising the consciousness of the community residents; adopt a low-key profile.

Activities in the Entry Phase

1. Integration - establishing rapport with the people in continuing effort to imbibe community life.

living with the community seek out to converse with people where they usually congregate lend a hand in household chores avoid gambling and drinking

2. Deepening social investigation/community study verification and enrichment of data collected from initial survey a previous investigation was done but this time it is needed to better view how

the community and its people perform in general conduct baseline survey by students results relayed through community

assemblyCore Group Formation

Leader spotting through sociogram.

Key persons - approached by most peopleOpinion leader - approach by key personsIsolates - never or hardly consulted

define roles and functions of the core group prepare community for health and development work organize research team set-up community health organization

The staff can assist the community leaders and core group in creating a project: Management of health programs and to ensure the collective participation

of the residents establish networks and linkages Generate resources Raising consciousness of the community in health and other issues Mobilize residents to act

identification of possible community worker scrutinize and mobilize residents

Conduct team building activities and informal education of the group Train community researchers

3. Community Study/ Diagnosis Phase (Research Phase) Is a comprehensive documentation of the data about the community gathered through

social investigation

Components of the study:

1. Physical and geographical data2. Demographic data3. Economic Condition4. Mortality and morbidity data5. Food Supply and Nutrition6. Cultural Patterns7. Health Services and Facilities8. Education9. Community Leadership and organization10. Development agencies11. Community Problems and Needs

Activities

1. clustering of household and spot mapping2. selection of the research team3. training on data collection methods and techniques/ Capability building (data

collection tools)4. Planning for the actual gathering of data5. data gathering

6. Training on data validation (tabulation and preliminary analysis of data7. Community Validation8. Presentation of the community study/ diagnosis and recommendations9. Prioritization of community needs/ problems for action

4. Community Organization and Capability Building Phase

Activities

1. draw up guidelines for the organization of Community Health organization2. Election and induction of officers3. Development of management systems and procedures4. team building activities5. Action-reflection-action session (ARAS)6. Working out legal requirements of CHO7. Organization of the working committees8. Training of CHO officers and members

5. Community Action Phase

Activities

1. Organization and Training of Community Health Workers:a. development of selection criteria of CHW’sb. selection of CHWs – each zone of group of families will select from their

membersc.training of CHWs

2. setting up linkages, network and referral systems3. Project implementation, monitoring and evaluation (PIME) of health services,

intervention schemes and community development projects4. Initial identification and implementation of resource mobilization schemes

6. Sustenance and strengthening Phase

1. Develop financial and management systems2. Identification and development of secondary leaders3. Formulation and ratification of the constitution and by-laws of the CHO4. Work for the registration of CHD with the securities and exchange Commission5. Formalize and institutionalize linkages, networks and referral systems6. Development and implementation of viable management systems and

procedures, committees, continuing education/training of leaders, CHWs, community residents

7. Continuing Education and upgrading of community leaders, CHWs and CHO members

8. development of medium and long term community health and development plans