Transcript COMMED 3 SY 2010 -2011 Estrella P. Gonzaga M.D. HEALTH PROVIDER MANAGER SOCIAL MOBILIZER LS EDUCATOR 5- STAR Lasallian PHYSICIAN epgonzaga DFCM DLSC HSI 2010 RESEARCHE R.

COMMED 3
SY 2010 -2011
Estrella P. Gonzaga M.D.
HEALTH PROVIDER
MANAGER
SOCIAL MOBILIZER
LS
EDUCATOR
5- STAR Lasallian
PHYSICIAN
epgonzaga DFCM DLSC HSI 2010
RESEARCHE
R
FCM3
The Doctor as a Manager and
Social Mobilizer
PERSON
Highest in
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Hierarchy
BIOMEDICAL
Lowest
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BIOPSYCHOSOCIAL
BASIC/CLINICAL
FAMILY and COMMUNITY
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SOCIAL Hierarchy
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COMMUNITY HEALTH DEVELOPMENT PROCESSES
CO
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SOC MOB
WHY
Critical recognition characterized by
a sense of urgency that something
must be done to improve the
identified health problem
Beginnings
Social mobilization...
term used by the United Nations
International Children's Emergency
Fund (UNICEF) to describe a
comprehensive planning approach
that emphasizes
a) political coalition building and
b) community action
(UNICEF 1993, Wallack 1989).
Source: Communication Initiative 2001 website
Beginnings
Definition 1:
Process of bringing together all
feasible
and practical inter-sectoral social allies
to
- raise people's awareness of and
demand for a particular development
program,
- assist in the delivery of resources and
services and
- strengthen community participation
for sustainability and self-reliance.
Source: Communication Initiative 2001 website
Beginnings
A successful mobilization must be built on:
a) the basis of mutual benefits of partners
and
b) a decentralized structure.
…the more interested the partners are,
the more likely that a project of social
mobilization can be sustained over time.
…does not require partners abandon their own
interests and perceptions on a given issue
but are willing to coalesce around a certain
problem
WHAT
Definition 2: Deliberately planned strategy
* Uses various channels to elicit actions
* Among those who can contribute to the
solution of a problem,
* more particularly
Changing the specific behavior of members
of a society who can contribute
to the
achievement of a definite goal
(UNICEF)
WHAT
Assures sustainability by providing a framework for
action linking- up various sectors at all levels
i.e. Community,
SubnationalMunicipal, Provincial,
Regional),
National and
International.
WHAT
Definition 3 .
Social mobilization is a process that enables
people in different sectors and at various
levels of society to engage in dialogue,
negotiation and collective action.
Purpose of social mobilization: bring together
organizations, policymakers and communities
to forge a collective identity and to work
toward a goal.
(Social Mobilization for Safe Motherhood website)
WHAT
Social development is linked to concerted
public action. No matter how valid and
worthy the cause, little progress is made in
achieving it until a ground swell of public
support is built and diverse sectors of
society become actively involved in the
process of change. - James Grant, UNICEF
(Source: Safe Motherhood)
WHAT
WHO
People
Definition 4
HOW
taking Action
FOR WHAT
towards a Common
Good
(WHO /WPRO Social Mobilization for Health Promotions)
WHAT
DEFINITION:
WHO – HOW – FOR WHAT
PEOPLE- range of players
* decision / policy makers, opinion leaders,
religious, professionals, commerce/
industry,non- government orgs, community,
individuals
* all relevant segments of society
community to national to international
NATIONAL
REGIONAL
INTERNATIONAL
DEPARTMENT
OF HEALTH
LOCAL GOVERNMENT UNITS
PROVINCIAL
MUNICIPAL
BARANGAY
GOVERNOR
PHO/Hospital
MAYOR
RHU
BHS
Primary Care
RHU
BHS
3o
2o
MH
DH
PH
RH/MC
Private Clinics
BARANGAY
REFERRAL SYSTEM
SELF-CARE
Agriculturist
LGU
Engineer
Teacher
Municipal-District-Provincial-Regional-National
WHAT
DEFINITION:
WHO – HOW – FOR WHAT
* Planned action
* Deliberate strategy
* Broad scale movement
* Engage people’s participation
* Interrelated and complementary
efforts
* Dialogue, negotiation and consensus
for mobilizing action,
* Take into account people’s felt needs
WHAT
DEFINITION:
WHO – HOW – FOR WHAT
* Achieving a specific goal for common
good
* Create an enabling environment
effect positive behavior and social
change
* Successful transformation of
development goals into social action
(Unicef)
HOW
PROCESS FRAMEWORK
1. Recognize critically a health problem
- participatory research,
community surveys, dialogues,
barangay assemblies and
information from experts.
2. Determine factors affecting the
identified health problem with key
decision maker
HOW
PROCESS FRAMEWORK
3. Describe the desirable action from
these key contributors at various levels
a- Policy/ Program Decision-Making
b- Allocation of Resources
c- Delivery of Services
4. Plan, carry out and assess the desirable
action for the desired changes.
Commed 1: (HEALTH EDUCATION)
Commed 3
(HEALTH ADMINISTRATION)
Appropriate messages should be designed for
a particular
audience
based
on
a
particular problem.
o
o Use of various mechanisms and forms of
communication
One-way
communication:
information
dissemination and agenda- setting.
- Two-way communication aims to accomplish
behavioral change.
-
o Education uses appropriate modes of teaching
and learning;
Develops skills, attitudes and values to help
people manage the environment that affects their
situation.
Calls for greater use of popular media – people’s
theatre, folk songs, cultural competitions, social
gatherings, community debates etc.
Develop competencies of the community,
health sector workers and those of the
other sectors
in undertaking the identified tasks from
resource sharing to
provision of specific health
procedures.
EXAMPLE: TRAINING FOR LOCAL
GOVERNANCE
ISSUE
UNICEF’s experience in promoting a childfriendly
approach to local governance… through development of
four essential tools:
1)
2)
3)
4)
the Local Development Plan for Children,
the Local Investment Plan for Children,
the Local Legal Code for Children and
the Local Annual State of the Children Report
In addition, emergency preparedness and response is best
handled at local level
Build the community’s capability for
problem-solving, decision making and
collective action
while developing and strengthening its
own networks
Individuals
Babies
Child
boy/girl
Teens
boy/girl
HOUSEHOLDS
Families
Better Off
Medium
Barangay
Management
Bgy Council
Health Committees
Poor
Adult
Men/Women
Older
Men/Women
Service Providers
THP / BHW
Poorest
Of Poor
Barangay Managed Health Care
People
Organizations
…Implementation required to identify
and utilize village communication
networks, train field workers, locate and
mobilize opinion leaders, activate link
persons, establish rotating peer group
discussions, provide information and
supplies at meetings .
“ Communication initiative Social Mobilization
Mobilization of communities should
focus on building confidence, trust and
respect, increasing knowledge base,
and enabling community members to
participate, and become more
proactive with regard to their own
health behavior.”
o
Organization of information into arguments
used to persuade or convince a specific group of
people to take necessary action on a specific
goal.
o Involves the generation and utilization of
reliable information to help national leaders,
policy makers, and decision makers to help adopt
necessary policies or programs.
CONSIDERATIONS IN ADVOCACY
1. Study the key actors, particularly their
needs
2. Establish mutual trust – cite mutual benefits,
substantiate arguments with good examples
3. Provide positive reinforcement to sustain
collaborative work
HOW
Some Adverse Characteristics of
Stakeholders
Community
NGO’s
GO’s
Apathy, prejudice
– result of past
sad experiences
Apathy,
Indifference result of past sad
experience
Indifference/
lukewarm
response
Over
dependence
Tolerance of over
dependency
Authority
Conscious
domineering
attitude
HOW
Community
Some Adverse Characteristics…
NGO’S
Wait and see,
timidity, lack self
confidence
Indifference to
initiate contact
and follow – up
‘ningas cogon’;
manana habit,
neglect of
appointments;
Government Orgs
Impatience to
accommodate
and act on
inquiry/ request
Inadequate
preparation of
community
leaders before
visit to GO/ NGO
offices
Arrogance,
aggravate
community’s
timidity/ lack of
self confidence
Parochial
context ‘Padrino’
HOW
Some Adverse Characteristics…
Community
Non-government
Orgs
Lack of knowledge of agencies
assistance / procedures to avail of
services
Government Orgs
Unclear ,
complicated
procedures,
delay in
processing, loss
of papers, wrong
information to
clients
Lack personnel/
logistics
HOW
TOOLS
ONE WAY
Interpersonal
Newsletters,
publications
Radio, TV,
websites;
DVD
TWO WAY
Face to face
meetings, visits,
conferences,
“events”
Correspondence
E mails,
telephones
HOW
TOOLS
“EVENTS ORGANIZING”
Big Bang: Launching activities by high
ranking
officials
Big Visit: Visits by national/
international leaders
Little Bang: “Kapihan”
“Having Champions”
- NID
- Kilatis Kutis Kit : Toni
Rose Gayda
HOW
“Yosi Kadiri, Sangkap Pinoy, Kilatis Kutis,
Oplan Alis Disease”
Four Basic rules in communication
strategies.
1. Know the culture of your audience
2. Do not overload people with Data
People’s Preference for Testimony
(Statistic of One)
3. Know the issue – roots of problem
4. Be as specific as possible in your
call to action.
Slogans and Mascots: Packaging Campaigns
Let’s DOH it ! Dr. Juan M. Flavier pp 140- 144
Few basic things that the
private sector looks for in
any partnership...
First, they want control of their
own resources
Second .. is imagination and
creativity.
Third… They look for a
program’s
potential benefit
and advantage to themselves
Let’s DOH IT!
Dr. Juan M. Flavier
Improve the implementer’s efficiency in advocating
and mobilizing action (Monitoring)
o
Determine the effectiveness of the program
(Evaluation)
SO WHAT
Implications to Health Worker
1. Acceptance of concept of Total Health
2. Effective communication among and within
agencies
3. Shared ownership and responsibilities for
health program
4. Capacity for joint planning, implementation
and evaluation of health development
program
5. Capacity to make effective and assertive
presentation of programs to decision makers
Decision makers have to be aware that an
Abundance of Resources and Technology
does not guarantee good health
it is up to governments to create an
enabling environment in which civil
society can participate.
Measures that encourage such an
environment include legal recognition,
tax incentives, and agreement on the
ground rules for accountability and
transparency, and participation in
decision making. (Social Mobilization ,
Aids)
Social Mobilization EPI
ACTION LEVELS
International:
Policy/ Program
WHO - technical
UNICEF: refs, cold
boxes
ROTARY – vaccines
National
Executive Order
DOH resources
LGU – local funds
HEALTH
WORKERS –
training/ service
delivery
Traditional/religious
leaders – IEC, CO
BHW - service
Parents – children
LOOK BACK
LOOK FORWARD
WHAT IS
WHAT WILL BE
WE ACT
NATIONAL
Regional
WE SEE
Provincial
I SEE
INTERNATIONAL
Municipal
Barangay
Time 0
Time N
EXAMPLE:CONTROL OF
IODINE DEFICIENCY
ASSESSMENT INDICATORS
BY LEVELS
I. Policy/ Political Level
Formulated Policy/ Legislative Action
- Comprehensive development policy;
documented health status goals of children
and mothers among stated prioritites
- Health policy; intersectoral and community
involvement strategy objective
Public Agenda Setting
- Appropriate media, modern and traditional
for specific audiences
Resource commitment
- Approved budget items in national plan
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
II. Bureaucratic/ Technical Level
National Plan of Action
Guidelines that recognize inter and intra-sectoral
collaboration
Designated Responsible Officers
Communication, advocacy, negotiation, community
organizing and development skills
Proper Orientation and Training
Manpower resources and skills
Advisory committee, Implementing committees
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
II. Bureaucratic/ Technical Level
Technical Resources
Information System
Monitoring and Evaluation
Media and message
Production of Information Materials
Interpersonal Communication
Audience Response
Sustainability
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
III. Professional, Civic and Social Levels
Organized and Demonstrated
Intersectoral Support: Commerce,
Industry, Agriculture, Education, Media,
Sports Culture
Alliances
Professional support from NGOs,
religious civic groups, women’s
organiztions
Collaborations
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
IV. Community Level
Assessment of Community Status
Support of Government and Traditional
Leaders
Community decision input and participation
- identified community groups/
organizations
- community specific goals
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
IV. Community Level
Training
Physical and Financial Support of
Government and Traditional Leaders
Evaluation
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
V. Family / Individual Level
Capacity Required
Social and Technical Support
Behavioral Action
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
EXAMPLES: CONTENT
TB IN
THAILAND
TOBACCO FRAMEWORK
Our message is simple. We can break free
 Individuals can break free
by stopping smoking, if necessary with the help
of smoking cessation programs.
 Families can break free
by parents setting an example for their children.
 Communities can break free
by supporting legislation and ordinances of local
governments that ban smoking in public places
and ban advertising.
Our message is simple. We can break free.
The media can break free
by insisting that the issue of tobacco
control is one that belongs to the arena of
public policy.
The Department of Health and the World
Health Organization are committed to
supporting smoking cessation programs
that are available, affordable and
accessible.
 Countries can break free
by supporting national legislation such as SB 1554:
STOP FOR HEALTH ACT (STOP TOBACCO AND
OTHER PRODUCTS FOR HEALTH) that will restrict the
legitimate use and sale of tobacco in the interest of
public health through WHO's INTERNATIONAL
FRAMEWORK CONVENTION FOR TOBACCO CONTROL
(FCTC).
 Together we can break free from this epidemic of
addiction and disease.
 Support this signature campaign by signing up
now!
Concerned with the ill effects and evil
threats of tobacco use and its
advertisements as well as the conspicuous
sale of cigarettes to minors, we are
affixing our signatures hereunder to
manifest our pleadings to our legislators
and other authorities
– to enact a law that would prohibit
cigarette and other tobacco product
advertisement and its sale to minors;
and
- to support Senator Flavier's bill
1554: Stop for Health Act (Stop
Tobacco and Other Products for
Health) and the international
framework convention on tobacco
control (FCTC). …
or its equivalent in Filipino: "Warning"
Cigarette Smoking is Dangerous to your
Health". ...
EXAMPLE:
Social Mobilization
FOR/ OF CHILDREN
UNICEF ANNUAL REPORT 2003
MAP OF PROGRAMMES FOR ADOLESCENT
PARTICIPATION DURING CONFLICT AND
POST-CONFLICTSITUATIONS
Sept 2003 UNICEF
The project activities
1. Begin with a child-led process of risk mapping
and community mobilization. Groups of 8-10
children (7-12 years of age) and youth (12-18
years of age) draw a map of their village and
locate the places that are dangerous or where
accidents happen to children.
2. Then they choose the top two risks to young
people and present their findings to village
adults by means .of a role play, which typically
evokes keen interest and animated discussion.
The project activities
3. Adults and young people who show
strong interest in helping and who
represent different groups in the
community then form a CWBC.
4. Initially, the CWBCs focus on reducing
physical risks such as open wells,
landmines, or lack
of public latrines for
.
women.
5. With additional experience and training,
however, they also address emotional and
social risks such as stigmatization,
hopelessness, or continued association
of young people with a local commander.
6. The CWBCs also monitor children’s
wellbeing and risks by means of a Child
Protection and Monitoring Tool developed
by Save Alliance with input from many
partners.
.
Critical allies on the ground, especially in efforts
1) to reach the hard to reach,
2) improve district performance,
3) leverage resources
4) achieve optimum coordination
o Local governments,
o Non-governmental organizations,
o Traditional and religious leaders, and
o Civil society organizations
Progress for Children, Report Card on ImmunizationNo.3 Sept 2005
1990
2003
FILM-MAKERS
Wilmot a young Liberian boy describes the impact of war on
children at a UN Security Council Meeting on Children and
Armed Conflict. At the conclusion of the meeting, the Security
Council committed to redoubling its efforts to protect
children, affected by armed conflict, condemned the targeting
or exploitation of children in armed conflict…
Due
2008
3.Social mobilization and long term
political sustainability of the Social
Determinants of Health agenda, which
is being organized through an
extensive civil society lead process
PHM advocates people's health
issues at 59th WHA
health issues at 59th WHA
A delegation of People's Health
Movement (PHM) activists attended the
59th World Health Assembly of the World
Health Organization in Geneva in order to
advocate relevant issues. They threw their
support behind a proposed global
framework on essential health research
and development
Health : physical,
mental and social
well –being
Not merely the
absence of disease
A LEVEL OF HEALTH THAT PERMIT PEOPLE TO LEAD
SOCIALLY AND ECONOMICALLY PRODUCTIVE
LIVES
HEALTH PROVIDER
MANAGER
SOCIAL MOBILIZER
LS
EDUCATOR
RESEARCHER
5- STAR Lasallian
PHYSICIAN
epgonzaga DFCM DLSC HSI 2010