COMMUNITY PARTNERSHIP

GANANA INSTITUTE OF MEDICAL SCIENCE AND

TECHNOLOGY

LECTURE NOTES
LEVEL : DIPLOMA
UNIT: COMMUNITY PARTNERSHIP
TABLE OF CONTENT
 Introduction
- Overview of participatory
- Characteristics of community entry program
- The community structure
 Levels of partnership
- Ideal partnership relationship
- Benefits of genuine relationship
- Challenges of developing relationship.
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 Community entry process

- Steps in community entry and partnership process.
- Tools and methods
 Community mobilization
- Steps in community mobilization
- Functions of a community acting group
- Levels of participation
- Particular techniques

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INTRODUCTION

This course unit is intended to provide the trainee with knowledge, skills
and attitudes in community partnership skills

At the end of the course, the trainees should be able to:-

 Understand the concept of community partnership
 Identify different levels of participatory partnership
 Identify possible problems and challenges in developing a genuine
partnership
 Describe and carry out community entry process to establish a
partnership, using participatory methods.
 Develop community mobilization skills

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CHARTER ONE: INTRODUCTION

Definition of Terms:

Community

It’s a group of people in the same geographical area who share a common culture
of similar traditions customs ways of living and share same social facilities.

Development

It’s a process of expanding and improving social infrastructure such as education,

health, food, security, social welfare as the environment is safeguarded with the
aim of improving people quality of life and also contributing to the growth of the
national economy.

Sustainable Development

It is the development which meets the needs of the present generation without
compromising the ability of the future generation to meet their needs using the
same resources.

Participation

It is when the community is actively involved in the development process i.e.

involved in problem identification, prioritization, planning, implementation,
monitoring and evaluation using available resources.

Participation allows community to give feedback on project success and failure and
the reasons for them and propose corrective measures.

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Mobilization

It is recruiting or gathering people together in the community for a common

purpose e.g. social or political purpose.

Health

A state of physical, mental and social wellbeing and not merely absence of
diseases

Public Health

Ensuring an environmental in which people can achieve and maintain health.

Partnership:

working together (by individuals/institution) in sharing of resources, ideas and

experience to supply and enrich the work of each other to reach a higher level of
quality outcome of positive value to all parties involved (it seeks to improve on
participation and involvement by highlighting recognition of all partner, their areas
of influence and contribution working together by individuals or institution and
sharing of resources, ideas and experiences to support and enrich the work of each
other to reach a higher level of quality outcome of participation.

Partnership focuses on: value to all parties involved.

1. Enhancing ability of HHS, Culty, state to take care of wealth and yet daily
needs and challenge is called lifestyle and livelihood)
2. Partnership beliefs that all people and community capacities to undertake
individual, collective action to solve own problems (on which they depend
their survival and that they are fully engaged in its tasks to the best of their

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ability, hence capacities be identified and strengthened not to be eroded or

displaced.
3. Partnership seeks to recognize, affirm and build on the strength of energy
stakeholder and partner to transform health and the situation based on their
own capability.

Theoretical frame work

The vicious cycle

Overview of Participation

Participatory methodologies are effective tools for causing development by the

people for the people. These methodologies are empowering processes that will
enable people to make informed choices and decisions based on collective
analysis. The more involved or consulted people are the greater will be their
commitment in the implementation and sustain of the project at hand.

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For health promotion to work well it must be carried out by and with people
(people shad participation)

This means at all stages of health intervention communities are involved with the
retain ownership of any health action.

Participatory approaches allows communities to express and analyze the realities

of their lives, plan themselves what action to take, to change the situation, monitor
and evaluate the results, and also share whatever benefits or losses they incur.
Participatory community development enables communities/groups of people
strive to make it possible for all its members to satisfy their fundamental human
needs and enhance the quality of their lives.

Importance of understanding the community

Community development practitioners should understand the community by

knowing what will make them be acceptable at individual and community levels.
Therefore it is essential to:

1. Understand each member as a person as regard to:

A) Individual interest
 Strength
 Weakness
 Experience

b) People are busy doing the best for themselves and household

c) We are not the only source of knowledge, skills and ideas

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d) We are unaware of what clients (community) accepts and use

e) We can reduce competition through partnership

f) We need to reduce division/differences between provider and consumers

g) Both providers and consumer need behavior change

h) The bulk of care occurs at the HHS level

l) The need for enhancing capacity for HHS and community for health action,
through continuous respectable dialog.

 Levels of mobilization

b) Individuals person’s beliefs, values, perceptions, peer inhabitants and

aspirations or hopes for self-development and altitudes.

2. To recognize the social cultural realities

o Group decision making procedures
o Traditional values and norms
o Gender and age relationships
o Communication patterns
3. Be involved in the life of community by:
o Meeting with groups and participating in the activities so as to gain
acceptable and to identify with their interests
o Interviewing or talking to willing contacts community leader’s trader’s
chief’s market women to gain better understanding of their worries, hopes,
problems and expectations.
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o Identifying leaders and innovations who are likely to influence others

Assignment:

Discuss the community structure and characteristics of community entry

program.

CHAPTER TWO: COMMUNITY ENTRY PROCESS

This is a careful process of penetrating the various levels of the services system to
reach the targeted individuals or groups in a community, (this is the first step of
integration into the community).

Reasons for community entry

i) To gain an understanding of the community interest

ii) To develop a sustainable relationship with the stakeholders at all levels
iii) To maneuver through the thick layer of gatekeepers to reach the target
households where most issues occur

Steps involved in entry process

What’s involved in entry process?

1. Exploration
It is gathering of information to enable us gain as much knowledge and
understanding of their situation as possible before making official contact.
Process should be non-invasive to avoid raising expectations. Share findings

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first with colleagues, people who know the community and then eventually,
with the community highlighting the generative themes.

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2. Protocol
Identify the gatekeepers (formal and informal leaders). Introduce the idea to
them and if they are convinced of its relevance then they can assist.
Formalize the process and gain authority to work with the community.
Introduce the idea and the team to the rest of the community through
existing channels. Clarify the objectives. Identify target and task group.
Methods for information gathering during entry process
 Review available literature, reports and records
 Observation
 Informal group discussions
 One to one conversations
 Formale KII based on a checklist or interview guide.
 Visit to information rich sites like market places ceremonies, worship
sites and festivals.

3. Situation analysis
It is a participating process carried out to determine the current situation,
identify priority issues and determine possible cause of action. It promotes
self assessment for effective decision making regarding the local situation.
Why situation analysis
 To understand the real cause of the problem in the community. Thus
the context that is determining the status of health and development
 To hear the voices of people and observe their ways of addressing
their own problems.

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 To begin to identify themes for action. This ensures that the

introduction of any new ideas takes full appreciation of what is going
on in the community.

Methods used in situation analysis.

 Transect walk
 Key Information Interviews (KII)
 Focus Group Discussion (FGD’s)
 Observation
 Literature review
4. Planning
Key elements n planning
 Knowing where we are (situation)
 Deciding where we want to go (vision/objectives)
 Deciding what we need to reach where we want to go (resources)
 Deciding how to get there (methods/process/how)
 Deciding how far we can get towards our target in a period of time
(timeline/when).
 Regular evaluation to see (indicators)
 How far you have gone
 Where you are not target
 How you can do better in future

 Amending the implementation plan (re-planning).

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Planning matrix

Activity Timeframe Indicators Responsibility Resources

Capacity building

Once a skill gap is identified, facilitator supports front-liners, based on the actions
planned and the skills of front line implementers. Training is based on the gap
between what needs to be done and the skills of those supposed to do it.

5. Implementation
Done base on the plan. Emphasize actions that can be completed within a
relatively short time and yield tangible results- particularly the elements in
the plan in which the community people have a leading role. Repeated
dialogue sessions enhances positive results and builds confidence leading to
adoption of the new ideas even if with some modification
Management skills
 Negotiation skills
 Counseling skills
 Advocacy skills
 Research

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Planning (Action Plan)

 Done before going to the field

 Given to the supervisor for assessment
 To guide both student and supervisor to monitor progress during the
session and guide the community towards what is going to be done
during the day.
 Any change made will appear in the activity repeat.
 Will answer the 5W’s + H questions (why, what, who, when, where and how)

Objective Activity Time Duty Method Venue/place Objectively Means of Critical

bearer. used verifiable verification assumption
Why What When Who How Where indicator

Implementation (practical activity)

 This is the way you put into practice what has been planned in a real
interaction with the community or the agency/organization
 Have constant furtive look at the planned activities during the process.
 Any new activity dictated by the situation is welcomed if necessary.
 Any remainder is a sign of poor planning but should not disturb you
(do what you can)

Report writing

 Reports need to really depict what has happened

 Reports may vary according to activities
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CHAPTER THREE: COMMUNITY MOBILIZATION

It involves assembling and making the community member ready to participate in

community development activities. Community mobilization involves awareness
creation, sensitization of the community on their roles in the project and sharing
development ideas.

Appropriate ideas of development are needed to motivate the community. It is for

this reason that mobilization is conducted as a forum where a group of people
come together to share ideas, discuss agree or disagree and finally reach an
appropriate action or process to be able to meet their needs.

Strategies of community mobilization

People within the community can be mobilized through several ways:

i.) Public education

This involves those people who will positively and negatively get affected by
changes

ii.) Community extension services

It involves an extension of community awareness and information campaign

iii.) Community training

This is geared towards beneficiaries of the project

iv.) Handing over of completed projects to the beneficiaries

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Importance of community mobilization

1. Clarification of technical issues is made possible

2. First hand understanding of each party is enabled i.e. the change agent
develops his knowledge about the community and its characteristics
3. It gives a sense of community ownership of development program of objects

Steps in community mobilization

1. Identify entry points to the community e.g. community leaders, religious

organization, family gatherings and other social events
2. To develop correct attitudes, have a positive attitude towards the community
so as to empower them towards getting involved in their own affairs
3. To identify the community problems or needs and prioritize them e.g. water,
health, education, roads etc.
4. To involve community resource personnel e.g. people who has shown
leadership skills, people with special skills and are charismatic, and the
opinions leaders.
5. To plan carefully on what you intend to do with the community. Care should
be taken when dealing with people’s attitude. Exercise patience and
persistence because this process can be slow.

Barriers to community mobilization

1. Failure to identify community needs

2. Failure to involve community leaders

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3. Poor or lack of planning on what you intend to do with the community

4. Insecurity
5. Lack of resources e.g. funds or treatment
6. Impatience and lack of persistence
7. Failure to identify correct entry points

Community Participation

It allows communities to give feedback on project success and failures to the

reasons for them and propose corrective measures.

Different forms of participation

a.) Consultation participation

This is about involving the beneficiaries in gathering information concerning

the project and also giving the views.

b.) Contribution participation

In this form, beneficiaries give items for the project implementation in material
form. For example; money or funs, labor, sand, stones and timber.

It also involves

i. Establishing of beneficiary management committee

ii. Beneficiaries having a role in maintenance of project monitoring and
evaluation
iii. Involving the beneficiaries in project monitoring and evaluation

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Control participation

It is when beneficiaries make decisions take responsibilities or are in charge during

the project implementation. Beneficiaries are responsible for their own affairs.

c.) Passive participation

Beneficiaries are told what is going to happen or has already happened.

Announcements are made by authorities. For example; government, NGOs,
leaders without listening or taking into account beneficiary concern or
responses.

Barriers to community participation

a.) Failure to respect community culture

b.) Lack of transparency or openness
c.) Inappropriate use of government resources
d.) Poor community entry points
e.) Failure of community members to respond to project advisors
f.) Participation driven by outsiders
g.) Unclear policies or laws
h.) Lack of motivation
i.) Wrong timing

Community groups

A community group is a group of members at least a minimum of 5 people who as

voluntarily come together with a spirit of cooperation to work together for a mutual

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social or economic benefit or to achieve a common goal they are managed initiated
and owned by community members.

Types of community groups

1. Formal groups – these are registered by government authorities and are

governed by leadership structure with a binding contribution. They are legal
status e.g. registered women groups, youth groups, self-help groups and
welfare societies.
2. Informal groups – they are unregistered with loose management structure
usually guided by cultural value of common good. They as no legal status
e.g. clans group traditional/cultural institutions.

Benefits of community groups

1. When people form themselves into groups they create opportunities for
identifying and analyzing their needs and problems for better understand of
their situations to finding lasting solutions to their needs.
2. Group members can pull together limited resources which they can own and
manage in order to address community needs such as poverty, food
shortages, lack of water and poor health illiteracy.
3. Any projects developed by the group are owned by them this gives them a
sense of ownership which is important for success and sustainability of the
projects.
4. Community groups are built on the cultural tradition of self-help hence will
be easy to mobilize and organize them.

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5. Groups are easily accessible they develop partners and stakeholders, have
easy access to goods and services and move faster in activities than an
individual basis.
6. Community groups serve to empower the poor by giving them a platform for
a collective voice.
7. Groups provide opportunities from members to talk matters over with those
whom they intimately know and trust therefore get much needed information
for decision making.

CHAPTER FOUR: COMMUNITY PARTNERSHIPS

Community partnership focuses on the following:

a.) Partnership believes that all people and communities have capabilities to
undertake individuals and collective actions to solve their own problems or
challenges and those they are fully engaged in this task and the best of their
ability. These capabilities should be identified and strengthen not to be
eroded or displaced.
b.) Partnership seeks to recognize affirms and build on strength of all
stakeholders and partners to transform health and development situations
based on their own capabilities.
c.) Enhancing the abilities of the household communities and the state to take
care of the health needs and challenges.

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Rationale of partnership

All people and communities have inherent capacities to undertake sustainable and
collective actions to solve their own problems. However, they may need
facilitation and support from a member of partners such as the private sectors,
academic institution and the service system.

It strengthens linkages among levels of action and participation.

Community partnership recognizes the following

a.) Their inputs must compete with the existing expertise

b.) They are not the only source of knowledge skills and idea
c.) Competition can be reduced through partnership
d.) Both providers and consumers need behavior changes
e.) The need for enhancing capacities of household and communities for health
action through a continuous respectable dialogues
f.) The bulk of care occurs at the household levels
g.) Partnership is unaware of what clients accept and use.

Characteristics of a well-functioning partnership

a. It should respect and value the diversity, variety, identities, seeking their
strengths not weaknesses and upholding the dignity of all particularly the
apparent weak.
b. The commitment to marginalized and low income populations or at risk
groups.
c. It should be responsible to community needs.
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d. Power sharing is necessary in partnership i.e. involvement in all decision

making processes.
e. Maintenance of high standards of integrity.
f. Responsible stewardship and accountability to curb vandalism.
g. It should recognize the sense of community belongingness, cohesion, mutual
connection and loyalty being part of larger dependable structure.

THE MODIFIED UNICEF CAPACITY MODEL

The capacity of an individual is directly proportional to ability, resources, authority

and responsibility in that order.

a+r+a=c and is a proportional to responsibility

Acting within the area of influence

Effort within area of influence leads to greatest returns. Effort within area of
interest may enlarge areas of influence. Bringing together varying areas of
influence leads to jointly enlarged areas of influences for all where the total is
bigger than the sum of the parts.

Other models

Community or civil society

Poverty

Training and research Household Services provided

s

Ill health
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This framework provides network/linkages to enhance effective participation of

partners. It recognizes, affirms and builds on the strengths of every stakeholder
engages in development and health. In developing partnership the focus is on
building and promoting synergistic relationships in which each partner equitability
benefits from the relationship leading to a level of symbiotic interdependence.

Types of partnership

a) Dependence paradigm

The partnership is one sided hence the receivers contribution is hardly noticed.

b) Neutral/independence paradigm

The partnership adds no tangible value i.e. they can make it with you or without
you.

c) Synergistic/relative interdependence paradigm

Different stakeholder collaborate to better their programs than working on their

own

d) Symbiotic/absolute interdependence paradigm

It is an advanced cooperation and it is an absolute necessity for success

Benefits of a genuine partnership

1. Great credibility – its greater support for the organization work because of
the association with certain organization.

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2. Improved skills and knowledge of partners to work collaboratively and in

more participatory ways.
3. Enhance opportunity for professional development to enable all partners to
gain or enhance needed competencies.
4. Expanded network and relationship i.e. strengthening or establishing new
links with different communities and stakeholders.
5. Better alternatives to conflict i.e. addressing an issue in a productive way
(joint problem solving).

Challenges of partnership

a.) Clarifying accountabilities

Accountability means knowing who is answerable to whom this is often

difficult in a partnership where paid staff as different employers e.g. whose
permission is needed for someone to act.

b.) Ensuring sufficient resources

Resources are more than in starting or running a partnership look for other
groups that may be prepared and share premises equipment staff and ideas and
contact.

c.) Building trusting relationships

The heart of partnership working is building relationship and trust this takes
time and more than formal meetings

d.) Amount of investment required

The time energy and money it takes to develop and sustain a partnership

e.) Power imbalance

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Disproportionate control or influence in decision making

f.) Unpredictability of results

The possibility that a partnership may not generate anticipated results because
it’s more difficult to work together than alone.

Tools and methods used in community entry process

1. Focused Group Discussion

It’s a good way to gather people together from similar backgrounds or

experiences to discuss a specific point of interest. The group of participants is
guided by a moderator or a group facilitator who introduces topics for
discussions and helps the group to participate in a lively and natural discussion
among them.

Focus groups are groups that are special in terms of purpose, size, composition
and procedures. Their purpose is to thoughtfully explore through discussion of a
topic or phenomena of interest to researchers, marketers, or consultants. The
size of an individual group generally varies from 4 to 12 people with the ideal
size (according to Krueger) of 7-10 people. Multiple groups may be used in a
focus group study. The composition of the group is relatively homogeneous
along some predetermined meaningful characteristic.

This is done in order to facilitate communications. Other homogenous groups

representing other characteristics may be conducted. The procedures involve
the use of a skilled moderator using a list of topics or specific questions to fully
explore the topic at hand.

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Additionally, appropriate ground rules are used to establish a permissive

environment where points of view are not judged and consensus or decisions
are not sought. The participants should feel free to discuss the topic. The
discussion is generally tape recorded and transcribed. The transcriptions are
carefully analyzed the resulting patterns or themes are used to more thoroughly
understand the topic of interest.

For example, a physician focus group may include all generalist physicians
from a particular area while another may contain all specialists. The questions
used in the focus group have been carefully developed and field-tested to
stimulate exploration of a topic where all respondents feel comfortable
suspending judgment. Together these mechanisms assist in creating a successful
focus group.

Focus Group Characteristics

Focus groups generally have six characteristics:

o Focus group involve people

o Focus group are conducted in series
o Participants are reasonably homogeneous and familiar with each other
o Focus groups are a data collection procedures
o Focus groups make use of qualitative data
o Focus groups have a focused discussion

Advantages of focus groups

o Socially – oriented procedure

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o Moderator can probe responses

o High face validity
o Lower cost
o Can be speedy/quick
o Larger sample size than other qualitative techniques

Disadvantages of focus groups

o Less control compared to individual interview

o Data analysis is difficult
o High levels of training and skill needed for moderators
o Groups can vary considerably
o Groups are difficult to assemble
o Discussion must be conducted in an environment conductive to conversion

2. Key informant interview

They are qualitative in-depth interviews with people who know what is going on in
the community, the purpose of key informant interviews is to collect information
from a wide range of people including community leaders, professionals or
residents who have 1st hand knowledge about the community. They provide insight
on the nature of problems and give recommendations for solution.

Key informants are people who may have special or additional knowledge on a
particular topic or issue. A good key informant will be useful in helping a
researcher to ask appropriate questions in the clearest and most productive manner.
Key informants have a wider knowledge about a topic – the big picture – and
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hence can formulate connections between different questions and issues otherwise
not visible to the researcher. A key informant is a person who is knowledgeable,
who is willing to be interviewed. Key informants may be important or influential
people, people with a lot of experience, or people who have insights on a particular
topic. Choosing key informants wisely also help us address problems of
representativeness and sampling in qualitative research. However if not properly
chosen key informants may be a source of bias.

Interviewing a key informant need to be done with care. Prior permission is

required, as well some preparation.

The steps for interviewing key informants are:

 Early contact
 Select your key informants. ...
 Develop your interview process. ...
 Prepare your interview guide. ...
 Engage your partner.

a. Early contact: conducting a pre –interview, getting first impressions,

describing and deciding data collection goals, and obtaining permissions
b. Preparation for the interview: selecting topics, formulating questions,
ordering questions, deciding appropriateness of topics and questions, and
negotiating the form and content of questions.
c. The actual interview: the interview is conducted in a site where the
respondent feels comfortable, is not intimidated, and feels at home. The
interview may be conducted in one or more sessions. If permission is given,
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the interview may be recorded by note taking or using audio – visual

methods.

The following issues need to be kept in mind while conducting key informant
interviews:

 Setting of the interview

 Interviewer strategies
 Recognizing cultural differences
 Choosing the right informants
 Recording the information, and
 Reporting the results truthfully and accurately

The analysis of key informant interviews follow the same strategies as outlined
earlier for informal interviews.

3. Transect walk

The transect walk is conducted by the research team and community members it
helps to learn more details about the environments, economic and social resources
in a community.

A transect walk is a systematic walk along a defined path (transect) across the
community/project area together with the local people to explore the water and
sanitation conditions by observing, asking, listening, looking and producing a
transect diagram. The transect walk is normally conducted during the initial phase
of the field work. It is best to walk a route, which will cover the greatest diversity

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in terms of water resources and sanitation infrastructure. The transect walk is

conducted by the research team and community members.

The information collected during the walk is used to draw a diagram or map based
on which discussions are held amongst the participants.

The transect is a tool to help us learn more details about the environmental,
economic and social resources in a community.

Things they will be looking for include:

o Housing conditions
o NGOs
o Religious centers
o Neighborhoods
o Institutions
o Pharmacies
o Grocery stores
o Open air market
o Location of health facilities
o Public spaces and contaminated spaces
o Garbage collection

A transect is a sort of one-dimensional map of a line cut through a village. It

depicts a cross-section of an area along which a number of issues are recorded. The
purpose of a transect is to organize and refine spatial information and to summarize

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local conditions in the area. The information is gathered from direct observation
while walking a straight line through the community.

4. Observation

Observation is a way of gathering data by watching behavior, events, or nothing

physical characteristics in their natural setting. Observations can be overt
(everyone knows they are being observed) or covert (no one knows they are being
observed and the observer is concealed). The benefit of covert observation is that
people are more likely to behave naturally if they do not know they are being
observed. However, you will typically need to conduct overt observations because
of ethical problems related to concealing your observation.

Observations can also be either direct or indirect. Direct observation is when you
watch interactions, processes, or behaviors as they occur; for example, observing a
teacher teaching a lesson from a written curriculum to determine whether they are
delivering it with fidelity. Indirect observations are when you watch the results of
interaction, processes, or behaviors; for example, measuring the amount of plate
waste left by students in a school cafeteria to determine whether a new food is
accepted to them.

Advantages of Observation as a method of Data Collection

Directness

The main strength of observation is that it provides direct access to the social
phenomena under consideration. Instead of relying on some kind of self-report,

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such as asking people what they would do in a certain situation, you actually
observe and record their behavior in that situation.

This, in principle at least, avoids the wide range of problems associated with self-
report. In an interview situation or in response to a questionnaire item, for example
a person may not always provide accurate or complete information, or they might
answer in ways that correspond to what is socially desirable. There is a recognized
source of bias in self-report techniques referred to as a “social desirable set”, which
means that in many spheres of social life there are socially desirable ways of
behaving and, consciously or unconsciously, individuals will tend to respond in
that way, although in the ‘real world’ they might behave differently. Asking
children whether they would tend to be helpful to other children in certain
situations, for example, would be susceptible to such a source of bias.

Diversity Flexibility and Applicability

Observation can take diverse forms, from informal and unstructured approaches
through to tightly structured, standardized procedures and can yield associated
diverse types of data, both qualitative and quantitative. Observation, therefore, is
applicable in a wide range of contexts.

Provision of a permanent record

Much of human socio behavior that may be of interest to the researcher is highly
transient. The fact that all observations entails some form of recording means that
it provides a permanent record of such events or behavior, thus allowing further
analysis or subsequent comparisons across time or location to be carried out.

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Complementarities with other approaches

Using more than one technique of data collection through a process of

triangulation is seen as highly desirable as an overarching research strategy.
Therefore, strength of observation is that it can effectively complement other
approaches and thus enhance the quality of evidence available to the researcher.

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