Transcript Community Involvement Some Lessons from Southern India

Community Involvement
Some Lessons from Southern India
 Hari
and Prem John
Deenabandu &
People’s Health Movement
 India

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Community Health
Community involvement in health or
development is not value neutral. It is
not a mere methodology to implement a
project.
 It is an intensely political involvement
where one identifies victims and
oppressors, takes sides, goes behind
the barricades with the people against
ruling structures that oppress them.
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 “Health
is politics on a social scale
- Halfdan Mahler
 “The Sole purpose of life is to
serve humanity”
- Leo Tolstoy
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those who were seen
dancing were thought to be
insane by those who could not
hear the music" (Nietzche)
 The medical professionals look down
upon other medical professionals working
at the community level. Call them quacks.
 “and
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The Analysis
 The
very basis of community
involvement in health lies in sociopolitical analysis
a
Class Analysis and Approach
(Marx).
 Clearly
defined class enemies,
therefore entirely pro-poor
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The Blocks
Ignorance
 Class, Caste, Ethnicity, Gender, Religion
 Cultural factors such as dress, food habits
 Preconceived notions
 Rigidity
 Arrogance
 Haste/Impatience
 Long history of insensitivity/oppression

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Therefore, the Need
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Humility
Open mind
Ability to transcend class, caste,
education factors
Willingness to deschool
Willingness to learn
Ability to go beyond the boundaries
Capacity in integrate into the community
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That would lead to
 Participation
as an internalised
value
 Participation as a methodology
 Where the community
participates from the stage of
conception to data collection, to
collation, analysis, planning,
implementation, monitoring,
evaluation, course correction
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Community Organisation
 Communities
divided along any lines
(caste, class, ethnicity, religion)
cannot work together
 Therefore, the necessity for
‘organising’ the community, to build
unity (Ivan Illich)
 The biggest investment is in terms of
time – to bring the community under
the same tree for discussions and
agreement on joint action
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Methods Used
 Participatory
Strategic Planning
(PSP)
 Participatory Action Research (PAR)
 Participatory Vulnerability Analysis
(PVA)
 Participatory Training Methodologies
(PTM)
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PSP
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PSP is a derivative of Strategic Planning. It
comes from the military and corporate
sectors and has been specially adapted
for communities
The Process affirms the belief that any
one, even illiterate, down trodden
communities have the capacity to look
back, take stock of their present situation
and state what they aspire for
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PSP
 Simply
stated, it means:
* What we want to be
* Where we want to be
* What is the path to take
* How do we want to reach there
on a specific time frame
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PSP
 Communities
and the organisations
that work with them learn to look at it
under three circles
 The
Context Circle (Community and
Organisation)
 The Vision Circle
 The Organisation Strengths Circle
(Community and Organisation)
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The Context Circle
 The
Critical Issues
 The Challenges
 Opportunities and Threats
 Key Players
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The Vision Circle
* Vision
* Mission
* Objectives
* Strategies
* Program
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The Third Circle
 Strengths
 Weaknesses
 Capabalities
 Potential
Resources
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The Three Circles
Context
Critical Issues
Challenges
Opportunities
Threats
Key Players
Vision
Mission
Strategies
Objectives
Programs
Role Models
Strengths
Weaknesses
Capabilities
Potential Resources
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The “F I T”
FIT
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The Fit
 The
three circles converge and the area
of convergence is called as the “FIT”
 The more they converge, the larger is the
fit
 When the “FIT” keeps getting larger, over
time, then the aspirations and
capabilities of the community and the
organisation and the goals and
objectives of the organisation are
congruent
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The Methods

The Community uses many
participatory techniques. One of
them is Village Mapping
The Older people map the village as it
was 10 years ago using available
materials
 The younger people map it as it is
today
 The community looks at it and sees
what changes have taken place over
time
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Then
 Our
role is only facilitatory
 The community then looks at the
reasons for change
 We help them to reason out why
these changes have taken place
and what can be done about
these changes eg water,
deforestation
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Changes

The Community looks at:
the reasons for change
 the trends
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If trends remain the same what would be
the scenario 5 years from now,
 if trends become better what would be the
scenario and
 if the trends worsen, what would be the
scenario
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The Probable Scenario
 Then
they pick from each of the
scenarios and come up with a probable
scenario, look at what problems would
be faced and how the scenario can be
improved
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Joint Action
 The
Community then gets to know
 what
needs to be done,
 what resources they have,
 what outside resources are needed,
 how they can go about it,
 what the blocks are,
 who the obstacles are and at what level –
local, national and international, and finally
 how to overcome those obstacles
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PAR
 It
is a methodology where the
community participates fully in getting
to know their situation
 Strengths
and weaknesses
 Resources
 Problems
 Opportunities
 Threats
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PAR
 Regenerate
and build upon existing
knowledge
 Regenerate and build upon existing
skills
 Regenerate, refine and build upon
existing practices
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From Day One
 The
community participates fully in:
 Investigation
 Analysis
 Planning
Appropriate and Joint Action
 Implementing the Program
 Monitoring and Evaluation
 Mid-course Corrections
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Goals of PAR
To release
 To restore
 To renew
 To empower and finally
 Transform
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PAR empowers,
achieves collective
power,
 Makes them realize
their collective worth
and
 Builds Self Reliance
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PAR
 Is
committed to the Marginalised and
the Poor. Is biased in favour of the
poor.
 Believes that everyone has
intelligence, create knowledge, the
right to make history.
 Develops critical understanding
 Insists on democratic interactions
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PAR
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Is an Action-Reflection-Action Process and
therefore is basic to community organisation
Build inter-personal and intra-community
relationships, bonds
Re-energises and fosters social capital such as
trust, confidence, sharing, care of the poor etc.,
Helps breakdown barriers
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Participatory Vulnerability Analysis
(PVA)
PVA is a systematic process that involves
communities and other stakeholders in an
in-depth examination of their vulnerability,
and at the same time empowers or
motivates them to take appropriate actions.
 The overall aim of PVA is to link disaster
preparedness (droughts, floods, state
oppression on a large scale) and
responses to long-term development.
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PVA-Community Level
PVA enables communities to play a dual role,
as informants, but also analysts, by breaking
down vulnerability to a point where they can
begin to take action to reduce their own
vulnerability.
The analysis itself has no value unless it is
followed by action: people can
take action themselves
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PVA Means
Community meetings
 Discussion sessions and analysis
 Training of local facilitators
 Participatory and reflection approaches
 Stakeholders and focal group meetings
 Local level advocacy and lobbying
 Documentation and liaison
 Studies on selected issues
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Participatory Training Methods
(PTM)
 Is
an enabling experience
 Best method for adult learning
 Learning by doing
 No one comes as empty vessels and
that even the illiterate have
experiential knowledge
 Equality between trainer-trainee
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PTM
Treats trainees as adults
 Shared responsibility for learning
 Is a confidence-building process
 Mutually enriching
 Builds on what they know
 Respects cultures, values and life
experience
 Translates scientific knowledge to real life
 Leads to behavioural changes
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Rights-based Approach
Participatory Approaches empower communities
to stand up to ruling structures
 Communities know what their rights are:
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Human rights
 Women’s rights
 Peasants’ rights
 Rights of outcastes, indigenous people
 Children’s rights
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And have the knowledge, skills and capacities to
fight their own battles
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