COMMUNITY MOBILIZATION

A community is a small or a large social unit that has something in common such as norms
religion values or identity

Community mobilization a process of engaging communities to identify community priorities,

resources needs and solutions in such a way as to promote representative participation good
governance accountability and peaceful change

A lot can be achieved when people from different parts of the community share a common goal
and actively participate in both identifying needs and being part of the solution. Community
mobilization helps to empower communities and enable them to initiate and control their own
development.

In other words, it can be viewed as a process which begins with dialogue among members of the
community to determine who, what, and how issues are decided, and also to provide an avenue
for everyone to participate in decisions that affect their lives

DEGREES OF COMMUNITY PARTICIPATION AND ITS IMPACT ON COMMUNITY

OWNERSHIP & SUSTAINIBILITY

Collective Action: local people set agenda, mobilize to carry it out in the absence of outside
facilitation.
Co-learning: local people and outsiders share their knowledge to create new understanding work
together, form action plans with outside facilitation.
Cooperation: Local people work together with outsiders to determine priorities; responsibility
remains with outsiders for directing the process.
Consultation: Local opinions are asked; outsiders analyze and decide on a course of action.
Compliance: Tasks are assigned with incentives; outsiders decide agenda and direct the process.

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Co-option: Token involvement of local people; representatives are chosen, but have no real
input or power

Collective Action

Co-Learning

Cooperation

Consulting

Compliance

Co-option

AWAY FROM
TOWARDS OWNERSHIP AND
OWNERSHIP AND SUSTAINABILITY
SUSTAINABILITY

Reasons for community mobilization

 To build on social networks to spread support, commitment, and changes in social norms
and behaviors.
 To build local capacity to identify and address community needs.
 Through strengthening capacity, it helps to shift the balance of power so that the
community gains a voice in decision making, increased access to information and
services while addressing many of the underlying social causes of their vulnerability
(discrimination, poverty, low self-esteem and self –efficacy, low social status, violence
etc.).

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  To mobilize local and external resources to address the issue and establishes coordination
and monitoring systems to ensure transparency, accountability, and effective
management of these resources.
 To motivates communities to advocate for policy changes to respond better to their real
needs.
 To help in linking communities to programmer’s related health services, helping to
define, improve on, and monitor quality of care from the joint perspectives of community
members and service providers, thereby improving availability of, access to, and
satisfaction with health services.

WHAT DONORS AND POLICY MAKERS NEED TO KNOW ABOUT COMMUNITY

MOBILIZATION

 Make every effort to integrate community mobilization into broader national targeted
health program strategies to complement and work with other components, such as
service strengthening, policy, training, communication and logistics.

 Support community mobilization processes that aim for higher levels of community
participation using community development approaches that treat community members
as full partners rather than as passive recipients or consumers of health services. This
shared responsibility between communities and health services promotes greater
community ownership and more sustainable improvements over the long term.

 Provide appropriate funding levels, taking into account that most funding will go toward
personnel costs for facilitation and capacity- strengthening. Consider acquiring some kind
of match from communities, even in-kind contributions such as volunteer time, local
materials etc.

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  Don’t prescribe or dictate how communities must act; they need to be the protagonists in
their own development and in finding solutions that are feasible and culturally
appropriate to their settings.
 Hold programs that achieve improved health outcomes and strengthens community
capacity to sustain the results.

 Set realistic timelines based on the context. Well-organized communities will not need as

long to demonstrate results as communities that do not have a long history of community
participation and local governance. Build in at least 3-5 years to strengthen community
capacity.

 Provide the necessary resources for implementing agencies and communities to monitor,
evaluate and document results in both health outcomes and community capacity.
Additionally, support documentation of these efforts several years after program support
has ended, to learn more about the real program sustainability that can inform future
program design.

 Hire experienced organizations to help train community facilitators and provide technical
assistance to the programs. Community facilitators can set bad precedents and create
challenging situations if they are not properly trained.

 Encourage the involvement and leverage the resources of sectors outside of

services/health to contribute to improvements within the community. Programs should be
designed to acknowledge and maximize these linkages and resources.

advantages of encouraging community participation in health programs

 It will contribute to the success of the program me since they have an experience and
insight into what works for them, what does not work for them and why

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  It will increase their commitment to the program me and can help them develop
appropriate skills and knowledge to identify and solve their problems
 Will help increase the resources available for the program, promote self-help and self-
reliance
 Improve trust and partnership between the community and health workers
 It will act as a way to bring social learning for both health workers and local people

importance of community mobilization in health programs

 It creates a strong sense of local ownership and the sustainability of the programs
 Helps in motivating the people and encouraging participation
 helps in building community capacity to identify and address community health needs, and
empowering the community
 Helps in local resource mobilization

Challenges in community mobilization

 The process may lose its steam halfway if the Mobilization process is designed only to
address particular program rather than exploring community needs and priorities
 Programs that carry out all of the community mobilization steps but do not embrace its
values and principles will not empower communities to achieve lasting results. They may
also run the risk of setting poor precedents that leave communities feeling co-opted,
manipulated, and reluctant to work with external organizations in the future.
 When communities do not develop the skills necessary to leverage their own resources,
the problem arises when the external support comes to an end and citizens refuse to work
on their own because future programs cannot or will not meet the established
expectations.
 It is a challenge to develop/adapt and document in a user-friendly way, a methodology
that any facilitator can pick and use, manuals that serve to provide guidance on how to
facilitate each phase of the action cycle.

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COMMUNITY ENTRY TECHNIQUES
Gatekeepers
Are people or policies that can act as a go between, controlling access from one point to another.
They may refuse, control or delay access to services/information
opinion leaders
are important people to keep informed about the sorts of health issues you feel should be
addressed. Indeed, as you move forward, everyone in the community needs to be informed about
these matters.

Techniques
• identify the right people in the community who can explain to you their habits, customs,
values, taboos and the rules of that community. -norms

• identify the people who can introduce you to the most influential members of the
community-workers, and to the community as a whole

• know and develop relationships with other influential people within your localities, such
as the religious leaders, in order to be accepted by the community. -opinion leaders

Community mapping
Community mapping is an assessment tool that can help communities and Health Extension
Practitioners identify and understand the real situations in local communities that positively or
negatively impact their health

• The natural resources. (Water point, mines, forests

• The poverty pattern(s).
• The territory of the village.
• The housing pattern(s).
• The cropping pattern(s).
• The space and the area the village occupies. /Administrative boundaries
• Infrastructure (transport and communication)
• Economic activities (markets, shopping centers)
• Churches/mosques
• Schools
• Hospitals
• Police stations/posts

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A stakeholder is either an individual, group or organization who is impacted by the outcome of
a project. They have an interest in the success of the project, and can be within or outside the
organization that is sponsoring the project. Stakeholders can have a positive or negative
influence on the project
Examples of stakeholders
• MOH (National, county, subcounty)
• Donors, Associations
• NGO/CBO partners
• Health Facility (service providers, support staff, outreach workers)
 Community (chiefs, religious leaders, women leaders, community group leaders,
community resource persons and traditional health workers)

A community mobilizer
Is a person that prepares and organizes the community through motivation leadership skills to
urge and prompt a community into action against shared issue or problem

Key Task involved in Community Mobilization

• Developing an on-going dialogue between community members

• Creating or strengthening community organizations (Committees etc.)
• Creating an environment in which individuals can empower themselves to address
their own and their community’s health needs
• Promoting community members’ participation
• Working in partnership with community members
• Identifying and supporting the creative potential of communities to develop a
variety of strategies and approaches
• Assisting in linking communities with external resources
• Committing enough time to work with communities, or with a partner who works
with them

Role of Community Mobilizers

• Bringing People Together
• Building Trust
• Encouraging Participation
• Facilitating Discussion and Decision-making
• Helping Things to Run Smoothly.
• Facilitation in community mobilization process

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 Qualities
• Good communication skills
• Good facilitation skills
• Good listener
• Committed
• Decision maker
• Active
• Negotiation skills
• Honest
• Known to culture and values of society
• Well dress
• Catalyst
• Management skills

How to encourage active community participation

• Do not rapidly introduce new interventions that are different from existing practices and
beliefs. Take gradual steps to introduce such practices.
• Try to analyze community dynamics and adjust to each situation.
• Involve the entire community in the program me right from the beginning.
• Give respect and importance to negative experiences of the community, if any, and
try to minimize the negative feelings verbally and in your actions

Community mobilization process

A process is a series of actions which are carried out in order to achieve a particular result.
[Link] the problem

The first step in community mobilization is to collect the basic information about the issue in
your community and/or catchment area. This will give an idea of the extent of the problem and
what the underlying causes are. In doing so, you will have a clear statement of the problem and
identify the target population in the community affected by it. e.g. Traditionally, the most at-risk
groups of HIV infection include female sex workers, uniformed forces, long-distance drivers,
migrant laborers and men having sex with men, among others. But it may also include family
men who are unfaithful to their wives and will not use condoms, or cannot afford them
Discussion of problems in preventing HIV transmission can help communities to mobilize their
efforts to find solutions.

[Link] a community mobilization group

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The aim is to establish a group that can influence community mobilization activities. It usually
consists of partners that have a stake in the issue (e.g. PLHIV and/or their families), as well as
influential groups and members of the community such as formal and informal leaders and
religious and traditional leaders.
[Link] strategies, setting objectives and selecting target groups

To achieve a planned change at community level, resources need to be mobilized from the
community and other external partners. After obtaining resources, the community mobilization
group should design strategies to address the identified problem with objectives that are SMART
(Specific, Measurable, Achievable, Relevant and Time-bound.) The objectives should be
assessed for their impact on the targeted groups in the community.

[Link] an action plan with a time line

An action plan links the general community mobilization plan with time lines for the actual
implementation of the planned activities, and the deadlines set for goals to be achieved. This
enables the progress of activities to be monitored against the targets set during the planning
phase.
Define a problem of your choice, set an objective (SMART) and formulate an action plan.
5. Building capacity

Capacity building involves identifying existing capacity resources and assessing the gaps that
exist to implement the community mobilization. The gaps identified should be supplemented by
capacity building of the community groups and other relevant stakeholders in the community
involved in community mobilization.
6. Identifying partners

In the community there are various partners that work independently to achieve similar goals.
Therefore, it is important to identify relevant partners through a simple mapping exercise. With
respect to for, instance prevention and control of HIV/AIDS, as such, the following partners may
be relevant: religious institutions, local non-governmental organizations (NGOs),

[Link] the plan of activities

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Based on the action plans developed with all of the relevant community level partners, I
implementation of the community mobilization activities is the main task. In the implementation
process, a clear role for any partners that are involved should be put in place and communicated
with all of them.

8. Monitoring and evaluation

Monitoring and evaluation are the last, but essential, element of community mobilization. It
enables you to check whether the action plan has been implemented effectively and the specific
objectives are met with respect to the issue the community is mobilized to achieve

[Link] activities, based on the findings of the monitoring and evaluation.

Based on the set objectives and the results derived from the M&E process the program me can
either decide to re- evaluate the set targets or make adjustments. Failure to achieve the set targets
can be influenced my several factors including market dynamics, donor priority changing etc.

COMMUNITY MOBILIZATION STRATEGIES

Strategy; a plan of action designed to achieve a long-term or overall aim
Community mobilization is essentially a process for reaching out to different sectors of a
community and creating partnerships in order to focus on, and ultimately address, a pressing
issue
This includes mobilizing necessary resources, disseminating information, generating support,
and fostering cooperation across public and private sectors in the community. Mobilization
efforts are often described in the literature as “building community or collaborative
partnerships,” “community engagement or involvement,” or “coalition building.”

1. SECURE STRONG LEADERSHIP

Engage strong leadership with community member support to drive the community-wide
efforts. Strong leaders can include both individuals who take on the work and the or

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 animation(s) that spearhead collaborative efforts. Lead organizations should possess a number
of key characteristics including: the will to serve as the leader of the community mobilization
effort over a significant period of time; the capacity to provide both infrastructure and human
resources; financial stability; the ability to garner and manage financial resources, and the
respect and support of the community.

Ensure that individuals and organizations in leadership positions have adequate support and
resources.

2. ESTABLISH A FORMAL STRUCTURE

Develop a formal structure that can effectively lead community change efforts. This structure
serves six essential functions: providing overall strategic direction, facilitating dialogue
between partners, managing data collection and analysis, handling communication,
coordinating community outreach, and mobilizing funding.

These may include specific committees (such as steering committees and subcommittees
dedicated to a certain issue or strategy), organizational charts, codified rules of operation (such
as bylaws), policy statements adopted by the partnership, and formal letters of agreement for
those who lead, organize, and participate in the community-wide effort.

3. ENGAGE DIVERSE ORGANIZATIONS, COMMUNITY LEADERS, AND

RESIDENTS
Engage stakeholders who are most likely to support evidence-based programs (e.g. teen
pregnancy prevention). Engage young people, parents, educators, health care providers, and
community-based organizations. Reach out to organizations and key players that are outside of
the “usual suspects” (such as sexuality educators or family planning centers). This includes
religious leaders, businesses, policy makers, media personalities, and others who have
significant influence in the community.

4. ENSURE AUTHENTIC PARTICIPATION AND SHARED DECISION MAKING

Support a sense of commitment and ownership of the vision and plan for the community-wide
effort by establishing clear roles and responsibilities for all group members, developing shared
decision making processes, and ensuring that community members are in key decision-making
roles.

[Link] AUTHENTIC AND PRODUCTIVE ROLES FOR YOUNG PEOPLE

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 Engage young people in all aspects of program planning, development, implementation, and
evaluation. Provide training on how to effectively develop youth-adult partnerships. Create
opportunities for both youth and adults to share decision making. Be sure to carve out specific
roles for both groups based in part on their age and prior experiences.

Remember to consider the practical challenges of involving young people such as scheduling
meetings after school and on weekends, providing transportation, and offering meals as
incentives for attendance

6. DEVELOP A SHARED VISION

Create a shared understanding of the goals of the community partnership by drafting a written
mission statement specific to the collaboration. Though this statement may share aspects with
the mission guiding the lead organization and/or its partners, making it distinct and different
can help unify a vision. Once the mission statement has been agreed upon, be sure to make all
partners aware of it so that everyone is working toward the same goal.

7. CONDUCT A NEEDS ASSESSMENT

Build a solid understanding of the current state of the identified program (teen pregnancy and
sexual health in the community) by conducting an environmental scan and community
mapping process. Use a variety of techniques such as surveys, focus groups, and interviews
with residents and key stakeholders. Compile data (on adolescent sexual behavior rates, teen
birth rates, health factors, school data, and information on out-of-school or youth at high risk
as well as knowledge, attitudes, perceptions and behaviors). Assess what is already available
to young people by gathering information on community-based, school system, youth
development, and family planning / health center resources.

The needs assessment research will inform the direction of the mobilization effort by serving
as the basis for creating a strategic plan, program activities, internal communication plans, and
public education campaigns. Be sure to clearly define the community that the partnership is
designed to serve whether it is by geographic location or other population characteristics.

8. CREATE A STRATEGIC PLAN

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 Draft a strategic plan that lays out the partnership’s goals (the explicit ways that community
partners are going to address the problems identified in the needs assessment) and objectives
(the activities that will be carried out in pursuit of the goal). The strategic plan should identify
the social, structural, and individual changes that will lead to achimenes of the set targets
(reductions in teen pregnancy and birth rates.)

Social changes include increased public will; greater community leadership capacity;
increased and high quality community participation, and supportive community norms.

Structural changes include changes made by institutions such as schools, health

departments, and family planning centers and/or changes in policies and practices that support
individual behavior change.

Individual changes include shifts in knowledge, skills, and behaviors among both youth
and adults.

Ensure that goals and objectives are SMART (specific, measurable, achievable, realistic, and
time-framed).

9. IMPLEMENT MUTUALLY REINFORCING STRATEGIES

Decide on the activities that participants —whether individuals or organizations— will undertake
to support the goals and objectives enumerated in the strategic plan. Identify a range of key
strategies aimed toward youth – such as implementing evidence-based sexuality education
programs in schools or improving access to youth friendly family planning services – as well as
key strategies that support the overall mobilization effort. For example, develop strategies that
will improve stakeholder participation, develop local leadership, and improve resource
mobilization.

Remember to reevaluate these activities as conditions in the community change or new

funding becomes available.

10. CREATE A FUNDRAISING STRATEGY

Explore a wide range of funding opportunities to ensure that the strategies and activities can
continue beyond the life of the original funding cycle. Consider diverse funding sources
including foundation

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 grants, gifts from individual donors, and in-kind donations from organizations and business in
the area. Focus on local resources whenever possible.

Consider drafting standard fundraising language that can be used for a variety of “asks.” Make
sure to include the best argument for why the community partnership is important as well as
your mission, goals, objectives, strategies, and plans for evaluation. Don’t forget to add
specific information about the community from the needs assessment

11. ESTABLISH EFFECTIVE CHANNELS FOR INTERNAL COMMUNICATION

Ensure a constant flow of information by adopting formal communication strategies that allow
for frequent, deliberate, and productive exchanges between partners.

Consider appointing a skilled communicator to the role of “relationship manager” and putting
this person in charge of continually informing members about what the partnership, the
committees, the subcommittees, and even individual members are doing to advance the
mission and strategic plan.

12. EDUCATE THE COMMUNITY

1][Educate and inspire the community by holding forums, engaging local media, designing
public service announcements, creating billboard campaigns, drafting letters to the editor,
launching web-based and social media campaigns, or holding home health parties, parent
meetings, roundtables, and conferences. The goal of public education campaigns is to generate
awareness, motivate action, encourage funding, and keep the community focused on the issue
at hand.

Remember to tailor the messages to the community, incorporate data from the needs
assessment, and chose spokespeople who resonate with the intended audience.

13. CONDUCT PROCESS AND OUTCOME EVALUATIONS

Decide in advance how the partnerships are going to define success and remember that there is
often a long delay between when a partnership begins its activities and when there is a
measurable impact in the community (such as a reduction in teen birth rates). Set key
benchmarks and progress points along the way.

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 Design both process and outcome evaluations and decide on the intervals at which each will
be conducted. Process evaluations will help determine, for example, how many community
members have participated in each activity and whether the activity was carried out as
originally planned. Outcome evaluations will assess whether the partnership resulted in
expected changes in the community.

14. EVALUATE THE COMMUNITY MOBILIZATION EFFORT SEPARATELY

Conduct an evaluation to help determine the impact of the mobilization effort – that is, whether
the partnership was successful in building leadership, shifting norms in the community,
harnessing community buy-in, and mobilizing financial resources. Evaluate the partnership by
looking at the quality of the strategic plan, level of member participation, total number of
actions implemented, satisfaction of members and staff, collaboration of members and member
agencies, members’ knowledge of the problem at hand, perceived ownership and
empower1ment of members, partner mobilization and maintenance, and team functioning.

REASONS FOR MEASURING RESULTS OF COMMUNITY MOBILIZATION

Monitoring
Monitoring is the process of routinely gathering information to ensure that activities are going
according to the plan. Monitoring is also used to fine tune activities. It aims at providing
managers and major stakeholders with regular feedback and early indications of progress or lack
thereof in the achievement of intended results. It generally involves collecting and analyzing data
on implementation processes, strategies and results, and recommending corrective measures
Why monitor
To analyze the current situation, to identify trouble spots that need attention and adjusting, to
discover trends and patterns, to keep activities on schedule, and to measure progress toward
campaign objectives.
Who monitors
Different members of the coalition can be responsible for collecting certain kinds of
information, depending on their organization's staff capacity and roles in the campaign.
Monitoring responsibilities should be spelled out in the campaign plan.
Evaluation

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Measuring the achievements of the mobilization campaign: goals, objectives, results, impact,
etc..). An evaluation should provide information that is credible and useful, enabling
incorporation of lessons learned into the decision-making process of both recipients and donors.
(

When
At the end of a campaign, also sometimes half way through the campaign.
Who
Campaign participants can evaluate with objective instruments, but often it is preferable for
evaluators from the outside to do it for objectivity reasons. Donors or funders might provide
evaluator

Reasons for measuring community mobilization activities

 Measure and demonstrate change in the short and longer term.

 Discover trends and patterns.
 Identify approach areas that need revision or support.
 Identify places, organizations, or activities that need support.
 Identify and understand successes.
 Monitor progress toward goals and objectives.
 Increased accountability.

INDICATORS

indicators are criteria for measuring success. They are related to the issue around which we have
chosen to mobilize. Indicators can be numbers, opinions, measurement of physical changes, or
facts. They must be measurable. Indicators are closely linked to objectives. They must be defined
as part of the overall campaign plan.

Different types of indicators

Input indicators: describe what resources go into a campaign; answer the question "What
resources are going/have gone into this campaign? “These concern human and financial
resources devoted to a campaign, project, or program.

-amount of money spent on program me

-number of publications/flyers produced and distributed
-number of television/other mass media spots/interviews, etc.
- number and types of organizations planning and collaborating
- number and types of media spots aired

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Process indicators: These monitor achievements during implementation, serving primarily to
track progress toward the intended results. "What occurred as a direct result of the inputs?"

For instance:

-rallies/events held
- people attending rallies/events
- no. of people tested for HIV during campaign
- women coming to clinics for prenatal care
- caregivers trained in counseling and vaccination techniques
- people reached via mass media
- health facilities doing special events as part of campaign
- national prenatal care incentive programs developed

Outcome indicators: measure results in terms of knowledge, attitudes and behaviors, or policy
and program changes, as a result of campaign activities; These relate directly to the longer-term
results of the campaign after donor involvement is complete. "What change has occurred as a
result of the campaign?"
For instance
-decrease in specific types of childbirth complications linked to prenatal care
- increase in number of pregnant women receiving tetanus toxoid vaccinations
- increase in practice of attending prenatal clinics
- increase in purchase of disposable delivery kits during pregnancy
- increase in national-level resource allocation for prenatal care services

in addition to focusing information-gathering on monitoring and evaluation indicators, it is

critical to document the entire campaign in order to determine later what has been accomplished
and how.
Input and process indicators are easier to measure than outcome indicators, but they provide only
an indirect measure of success of the mobilization campaign. They assume that the achievements
of certain activities will result in change, but they don't actually prove it.

Uses community-level indicators?

Community assessment. Community-level indicators can be useful in community assessments
for different purposes. An assessment to identify community issues and problems, for instance,
might rely on such indicators as the incidence of a disease or medical condition either in the
community at large, or in a particular social, ethnic, or geographic group. The number of
children receiving free or reduced-price school lunches, or the number of schools instituting
breakfast programs can speak volumes about the community’s economic problems, or about
child hunger.

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Community-level indicators can also provide information about the effects of community
projects and initiatives. A reduction in the number of children infected with HIV might be
evidence that PMTCT/EMTCT prevention program is working; a reduction in the number of
people who are unable to be initiated on ART or have to delay the initiation on care due distance
to heath facilities might be evidence that the new clinic in the area is helping a previously
underserved population.
Accountability. Community-level indicators, by providing evidence of progress, can help
maintain accountability for those who are running initiatives and projects. A community
initiative to provide maternity services might be measured, for instance, by a reduction in the
number of home deliveries or reduction in neonatal deaths. Levels of economic prosperity can be
measured by looking at the community’s unemployment rate, average wage for workers, etc.
Evaluation. You’re most likely to use community-level indicators to measure your progress
toward the outcomes you’re aiming at. A substance-abuse initiative, for example, might look at
admissions to treatment programs for signs of progress. Outcomes might be measured by such
indicators as drug-and-alcohol-related arrests, emergency-room admissions related to substance
abuse, underage drunk-driving incidents, or single vehicle, nighttime crashes.
Policy change. Community-level indicators can help determine where policy change is needed,
and whether a change in policy is having the desired effect. Many communities, for example, as
a result of the reformed policy on PMTCT have seen many children born HIV free. These
reforms came about because of (community-level) indications that these children were being
infected by their mothers. Checking the trends of childhood HIV infections before and after
such trends might tell you whether fewer children are getting infections or not

Choosing community-level indicators

Decide on just what your goals are in using community-level indicators. What exactly is it
you want to find out? For instance, if your initiative is working to increase health care access for
those in your community, your goals might be to determine the number of uninsured people who
have to delay getting medical care because of high costs, and then as your initiative progresses,
determine whether your initiative has reduced this number.
Determine what kinds of information you’d need to achieve your goals. You’d want to assess
the nature of the problem as it currently exists, which means looking at issues such as how many
people in the community are uninsured, the percentage of uninsured people who are receiving
annual checkups and recommended cancer screenings, etc. The same issues could be examined
later to find out how successful you were, and what else might need to be done.
Choose community-level indicators that reflect the information you want, and that can be
measured, so that they can be compared, and give you real information to work with. Some
community-level indicators you might choose in this case are the number people who have a
primary care physician or stable source of ongoing care, the number of families seeking
treatment in healthcare facilities (as reported by hospital registry INTA/ data), and the number of
people who have to delay receiving treatment or obtaining prescriptions because of the costs. All
of these might be compared to measurements from previous years, and then analyzed again in the
future to determine if there has been progress.

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Measure the indicators and analyze the results. You might find that there are high numbers of
uninsured people in the community, and they are not receiving the recommended annual
checkups and cancer screenings. Then your efforts should focus on disseminating information
about the importance of such screenings and information about the availability and affordability
of those services.

EXAMPLES OF COMMUNITY LEVEL INDICATORS IN HEALTH

Health covers a range of areas – wellness promotion and health maintenance, disease and injury
prevention, detecting and addressing medical issues unique to the community, and providing
health services to all who need them.
Wellness promotion and health maintenance. Research shows that healthy eating, regular
exercise, and stress reduction contribute to a longer and better-quality life. In addition, most
people benefit from regular health maintenance and monitoring – visits to health professionals,
care about exposure to dangerous condition ns or substances, etc. Some community-level
indicators include:

 Percentage of adult’s people with a Primary Care Provider

 Percentage of people who have had a Primary Care Provider checkup in the past 12
months
 Percentage of adults who receive regular dental checkups
 Percentage of adults receiving annual vision screenings
 Percentage of children receiving regular medical checkups
 Percentage of children who have regular dental visits
 Vision screening for children (percent)
 Average number of prenatal doctor visits for pregnant women
 Shelf space devoted to healthy and/or organic products and foods in supermarkets
 Shelf space in stores devoted to tobacco
 Number of liquor stores in the community
 The mileage of bike paths and hiking/running trails, compared to road miles in the
community

Disease and injury prevention. Unlike most wellness and health maintenance activities, disease
and injury prevention involves taking specific measures to prevent or minimize the effects of
specific diseases and conditions. Some community level indicators include:

 The percentage of the over-65 population inoculated for flu

 The percentage of children registering for school with proof of all recommended
inoculations
 The number of people receiving regular cancer screenings – mammograms, Pap smears,
prostate antigen tests, colonoscopies, etc.
 Condom sales, especially among teens. These might be related to the incidence
of sexually-transmitted infections (STI’s), including HIV, and might also relate to teen
pregnancy rates
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  The percentage of schools providing sex education
 The number of homeless people tested for TB and other infectious diseases
 Number of single vehicle, nighttime crashes

Detecting and addressing health issues unique to the community. Any community may have
unique health needs, stemming from the prevalence of a particular disease or condition, or from a
threat to the community’s health. The causes here may range from the environmental – pollution
of drinking water, poor air quality, chemicals in the soil, etc. – to the genetic – a large population
of an ethnic group that’s susceptible to a certain disease – to the cultural – a population at risk of
heart attack because of a traditional diet high in saturated fat. Examining some community-level
indicators can help you find and deal with these kinds of conditions.

 Results of screenings for blood pressure and cholesterol, HIV/AIDS, TB, various cancers,
neurological conditions, diabetes, and other chronic conditions, both for the community
as a whole and for specific populations
 The number of hospital admissions and/or deaths resulting from particular diseases or
conditions – certain cancers, diabetes, HIV-related illnesses, etc.
 The number of miscarriages, stillbirths, and birth defects, both for the community as a
whole and for specific populations
 Infant mortality rate, low-birthweight babies, babies with fetal alcohol syndrome, etc.
 The incidence of obesity in children
 The frequency of emergency room visits for asthma attacks, particularly among children
 The average number of cavities per childhood dental visit
 Number of children’s visits to mental health facilities

Providing health services to all who need them. A community may have excellent health
services, but if many people are unable to take advantage of them – because of cost, difficulty of
access, or some other reason – then they do those people no good. Community-based indicators
can tell you whether there’s a large segment of your community that’s denied proper health care.

 Number of practicing primary care providers

 Patient to primary care provider ratio
 Percentage of people who have a usual primary care provider
 Proportion of insured persons with coverage for clinical preventive services
 Proportion of persons who receive appropriate evidence-based clinical preventive
services
 Percentage of uninsured families in the community. The number of free or sliding-fee-
scale clinics, and their rate of use
 Percent of dental care providers who accept Medicaid
 The number of families using the emergency room as their primary care provider (as
reported by emergency room intake data)
 Proportion of individuals who are unable to obtain or delay obtaining necessary medical
care, dental care, or prescription medicines
 Proportion of hospital emergency department visits in which the wait time to see an
emergency department clinician exceeds the recommended timeframe
 The number of elders receiving in-home health and care services

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  Average waiting time to obtain non-emergency medical services – for regular checkups,
follow-ups, chronic conditions, etc.
 Handicapped accessibility of health facilities – hospitals, clinics, medical buildings and
practices, dentists’ offices, optometrists, etc.
 Availability of ambulance and emergency medical services, particularly in rural areas
 Availability of interpreters in various languages at health facilities

REASONS FOR DOCUMENTING:

 To give feedback
 To collect baseline data against which to measure change
 To collect specific information on what has been done, including descriptive information and
data
 To review lessons learned
 To use as an advocacy tool
 To inform all stakeholders how the campaign went
 For future fundraising
 To let donors know what has been accomplished

 To give feedback-this enable the donors /program me sponsors to make

important decisions pertaining the program me
 To collect baseline data against which to measure change-this is important
especially for evaluation purposes which can take place at any stage of the
programs lifecycle
 To collect specific information on what has been done, including descriptive
information and data-a donor/a stakeholder may be interested in a particular
aspect of the program me which calls for that specific information
 To review lessons learned, this can be used for comparison with previous
programs and a basis for new findings as well as what did not work out well for
the program me.
 To use as an advocacy tool, information from documentation can be used as a
basis for policy change through advocacy
 To inform all stakeholders how the campaign went, all stakeholders may not
get the opportunity to track the programs progress but through documentation it
becomes organized and easy
 For future fundraising, just like in evaluation this information can be an
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 important funding tool to help in mobilization of funds for similar activities
 To let donors know what has been accomplished, in every program me it’s the
success or failure can be determined using information collected even before the
program me comes to a close

WHAT NEEDS TO BE DOCUMENTED:

 Process
 Outcomes: people reached or participated
 Problems
 Comments from event participants
 Reactions of people
 Community-level information
 Amount spent
 Materials developed and produced
 Difficulties overcome
 Number of participating organizations
 Geographic reach

HOW TO DOCUMENT:

 Interview people during the event

 Video the event
 Collect and tabulate information
 Photograph the event and various activities
 Write event reports

WHAT IS THEN DONE WITH THIS INFORMATION?

 Organize future events

 Report back to donors
 Recruit and involve new coalition members
 Determine whether new issues have been raised
 Track behavior, social, or legal change

Leadership

Leadership is the ability to influence the behavior and actions of others in a given
situation to work towards achieving a common goal.

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 Functions of a Leader

Convey vision and the ability to achieve goals

Ensure that tasks are carried out
Motivate the team
Build team work
Plan, organize and clarify tasks and responsibilities
Arbitrate disagreements on issues

Qualities of a Good Leader

Flexible
Good listener
Knowledge, wise, seeks knowledge
Innovative, creative
Time conscious
Honest, exemplary
Confident enough to delegate
Accepts criticism

Seeks new knowledge

Types of leadership

Delegative leadership (Laissez –faire)

It’s a type of an invisible leader, the one who allows others to do more. They’re a kind of
manager whose job is to distribute the tasks. It is especially effective in those groups of highly
trained and motivated people who are simply waiting for someone to point them in the right
direction. He provides guidelines and ensures communication among the rest of the members of
the group. The danger of having a delegative leader stems from situations which require their
actions, and in which they might not intervene. Here we are dealing with a leader who sins by
default instead of by excess. Therefore, it’s easy for one destabilizing factor to make everything
fall apart.

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Autocratic leadership
is an interventionist type of leader. Their lane goes in only one direction, since they only speak
to but don’t listen to the group they are directing. On the other hand, they tend to be very
controlling, which works especially well in groups that are very motivated but have a lot of
doubts about how to develop the tasks that have been assigned to them. The danger is that
this leader can be very discouraging for groups that are very well prepared, making everyone fall
off the edge once the leader unknowingly decides to move towards it.
He tends to harbor a feeling of superiority towards the people they lead. a contamination that can
make the warning described above enough more dangerous. An example of an autocratic leader
in history is Margaret Thatcher
Democratic leadership
As you can probably guess, this is the ideal in many Western political systems. A democratic
leader tries to maximize communicative bidirectionality. They lead, but without forgetting the
importance of being sensitive to the feedback provided by the group about their decisions. In
fact, a constant consultant element characterizes this type of leadership
Democratic leaders are good for groups that are prepared, but which don’t have much
motivation. The feeling of being listened to can be the best remedy for this kind of deficit, thus
significantly increasing their interest, for the procedures as well as the objectives.
Transactional leadership (its primarily based on processes and controls and
requires strict management structures)
Transactional leadership is focused on objectives. This type of leader acquires the role of the
guardian of the motivation for the group. They provide rewards and enforce punishments
depending on the group’s interest and performance This type of leader, if clever with their task,
is good for long and tedious processes in which the group can’t find intrinsic motivation easily
— i.e., motivation linked to the task itself — in the task they are performing Thus, since only
external rewards can be provided, a good leader will focus on their distribution and will manage
to do so effectively
The danger of this type of leadership resides in the things surrounding the objective, such as the
environment within the group itself, which many times ends up harmed by the competitiveness
towards these rewards we spoke of (promotions, vacations, flexibility, etc.). An example of
transactional leadership can be seen in soccer coaches

Transformational leadership (focuses on inspiring /motivating followers by appealing to

their own self-interest)
Transformational leadership is focused on the group’s motivation, but viewed from the task
itself. His intention is that the group will achieve its goals, but without neglecting other goals.
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These lateral objectives can be very different and varied: the acquisition of skills by the group
members, the dynamic that is generated within the group, caring for the environment, etc. This
type of leader is especially good when they have to lead a group that doesn’t have a high degree
of knowledge or motivation, and one which doesn’t have a very high degree of pressure to
achieve its main objective

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