Community Health Care Development Process

A. Community Health Care Development Process
1. Approaches to community development
2. HRDP-COPAR Model as a strategy for
community development
3. Phases of COPAR
4. Critical Activities
5. Roles and activities in community health
care development
10/25/2018Mary Aretha D. rocha 2

B. Working with Groups Towards Community Development
1. Stages of Group Development
2. Interventions to Facilitate Group Growth
a. Orientation, Structure, Direction
b. Process, Negotiate and Resolve Conflict
i. Understanding the Nature of Conflict
ii. Problem Solving Approach
iii. Generating New Ways
iv. Helping Members
c. Awareness of the Effects of Behavior
d. Application of New Learning
3. Collaboration and Partnership
a. Essential Ingredients in Partnership
b. Capabilities Necessary for Partnership

WHO defined COMMUNITY as
 “ A social group determined by geographical boundaries
and/ or common values and interests.”
WHO defined HEALTH as
 “A complete state of physical, mental, and social well-being
and not merely the absence of disease or infirmity.”

is defined as:
 a change, a process of unfolding from an un-
manifested condition to more advanced or effective
condition.
 In these process the qualities reveals possibilities,
capabilities emerge, and potentials are realized.

▪A multi-dimensional process involving major
changes in social structures, population, attitudes
and national institutions, as well as the
acceleration of economic growth, reduction of
inequality and eradication of absolute poverty.
▪The goal of development is to have a better life.
(Teodoro, 1978)

According to NEDA:
 Development includes consumption of basic
goods and services such as health and education
and the generation of more productive employment
and reduction of inequalities in income and access.

▪is a process designed to create a condition of
economic and social progress for the whole
community with its active participation and fullest
possible reliance on the community initiatives
This is achieved through:
▪Democratic procedures
▪Voluntary cooperation
▪Self-help
▪Development of indigenous leadership
▪Education

 How can we say that the community is developed?
◦ the people are working together
◦ have the vision
◦ know how
◦ capabilities and experience to confront and solve
problems of under development

 Community development principle is committed to the
services of the people to become self-reliant.
 Therefore, the health of the community depends on its
ability to work toward common health goals and upon
adequate distribution of health resources to all members.
 Furthermore, organized community effort to prevent
disease and promote health is valuable and effective.

 A group of people in a community reaching a
decision to initiate a social action process (planned
intervention) to change their economic, social,
cultural, or environmental situation.
 Advocates “self-help”, voluntary participation and
cooperation of the people.

1. Welfare
Approach
2. Modernization
Approach
3. Transformatory/
Participatory
Approach
▪ This is an immediate and/ or
spontaneous response to
ameliorate the manifestation of
poverty, especially on the personal
level.
▪ Assumes that poverty is caused by
bad luck, natural disasters and
certain circumstances, which are
beyond the control of the people.

1. Welfare Approach
2. Modernization
Approach
3. Transformatory/
Participatory
Approach
▪ This is also referred to as the
project development approach.
▪ Introduces whatever resources
are lacking in a given community.
▪ Also considered a national
strategy, which adopts the
western mode of technological
development.

1. Welfare Approach
2. Modernization
Approach
3. Transformatory/
Participatory
Approach
◦ Assumes that development
consists of abandoning the
traditional methods of doing things
and must adopt the technology of
industrial countries.
◦ Believes that poverty is due to
lack of education, lack of
resources such as capital and
technology.

1. Welfare Approach
2. Modernization
Approach
3. Transformatory/
Participatory
Approach
▪ This is the process of empowering/
transforming the poor and the
oppressed sectors of society so
that they can pursue a more just
and humane society.
▪ Believes that poverty is caused by
prevalence of exploitation,
oppression, domination and other
unjust structure.

Community Health Organizing Utilizing COPAR

 was developed and sponsored by the Philippine Center for
Population and Development (PCPD)
 PCPD is a non-stock, non-profit institution, which serves as
a resource center assisting institutions and agencies
through programs and projects geared toward the social
human development of rural and urban communities
 formerly known as The Population Center Foundation
 to make health services available and accessible to
depressed and underserved communities in the Philippines

 Community organizing as the main strategy to be employed
in preparing the communities to develop their community
health care systems and the establishment of community
health organization to manage the community health
programs.
 Organizing work in the communities were done in 3
phases.
 PAR as fascinating strategy for maximum community
involvement through collective identification and analysis of
community health problems and collective health action.
 Available funds to finance community initiated projects.

HRDP I
 Trained the faculty, medical/ nursing students to provide
health care services to the far flung barrios because of lack
of man power for health services at the same time that
similar activities fulfilled the curricular requirements of the
students for public health.
 The PCPD provides seed money for the income
generating projects.
 Short-term service.

HRDP II
 The 2nd cycle uses the same strategy but the program could
not be sustained by the schools or hospitals and the income-
generating projects eventually become the hindrance to the
goal of achieving the health program because the people
tend to be more interested in the income generated by the
projects.
 Both HRDP I and HRDP II have brought about some
changes in the community life of the people
 Established basic health infrastructure; basic health services
were increased; there were trained workers and organized
health groups to take care of the needs of the community

HRDP III
 PCPD refined the program and resulted to what is now called
HRDP III, which has these unique features:
 Comprehensive training of the staff and faculty of the
participating agency in which the community work was
initiated
 Periodic training program and regular assistance to the
participating agency were provided to strengthen the health
outreach program to become community oriented
 PHC as the approach with which all nursing/ medical
students, their CI’s and indigenous health workers are trained
for community health work and around which all other project
inputs will revolve

 A social development approach that aims to transform the
apathetic, individualistic, and voiceless poor into a dynamic,
participatory and politically responsive community.
 A collective, participatory, transformative, liberated,
sustained and systematic process of building people
organizations by mobilizing and enhancing the capabilities
and resources of the people for the resolution of their
issues and concerns towards affecting change in their
existing oppressive and exploitative conditions.

 A process by which community identifies its need
and objective. Develops confidence to take action
in respect to them and in doing so extends and
develops cooperative attitudes and practices in
the community.
- Rose, 1967

 A continuous and sustained process of educating the
people to understand and develop their critical
awareness of their existing condition, working with the
people, collectively and efficiently on their immediate and
long term problems, and mobilizing to pursue to develop
their capability and readiness to respond and take action
on their immediate needs toward solving their long term
problems.
 - A Manual of Experience, PCPD

 a collective, participatory, transformative, liberative,
sustained, and systematic process of building
people’s organizations by mobilizing and enhancing
the capabilities and resources of the people for the
resolution of their exploitative conditions
- National Rural CO Conference, 1994

➢ a continuous process of awareness building, organizing
and mobilizing community members towards community
development

 COPAR – is an important tool for community
development and people empowerment, as this helps the
community workers to generate community participation
and development activities.
 COPAR – prepares people/clients to eventually take over the
management of development programs in the future.
 COPAR – maximizes community participation and
involvement; community resources are mobilized for health
development services.

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

 a progressive cycle of
Action-Reflection-
Action
 Consciousness Raising
 Participatory & Mass-
based
 group centered & not
leader oriented
 which begins with small,
local, and concrete issues
identified by the people and
the evaluation and
reflection of actions taken
by them.

Action-Reflection- Action
 Consciousness
Raising
based
leader oriented
 through experiential
learning
 is central to the COPAR
process because it places
emphasis on learning that
emerges from concrete
action and which enriches
succeeding action.

based
leader oriented
 it is primarily DIRECTED
TOWARDS AND BASED
IN FAVOR OF THE
POOR, the powerless and
the oppressed

based
 Group centered & not
leader oriented
 leaders are identified,
emerge and are tested
through action rather than
appointed or selected by
some external force or
entity

 Pre-entry Phase
 Entry Phase
 Core Group Formation Phase
 Organization-building Phase
 Sustenance and Strengthening Phase
 Phase-out

 PRE-ENTRY
PHASE
 Entry Phase
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
 called the Social Preparation
Phase
 The initial phase of the organizing
process where the community
organizer looks for communities to
serve or help.
 It is considered the simplest phase
in terms of actual outputs,
activities and strategies and time
spent for it.

 Pre-entry Phase
 ENTRY
PHASE
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
 The IMMERSION Phase
 This includes the synthesis of
the people on the critical
events in their life, motivating
them to share their dreams
and ideas on how to manage
their concerns and eventually
mobilizing them to make
collective action on these.

 Pre-entry Phase
 ENTRY
PHASE
 Core Group
Formation
Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
 This phase signals the actual entry
of the community worker/ organizer
into the community.
 She must be guided by the following:
▪ Integration with the community
▪ Conduct of courtesy calls
▪ Conduct of information campaigns
about the community health
development programs
▪ Conduct of the community study and
social investigation
▪ Provision of health and health related
services
▪ Identification of potential leaders

 Pre-entry
Phase
 ENTRY
PHASE
 Core Group
Formation
Phase
 Organization-
building Phase
 Sustenance
and
Strengthening
Phase
 Phase-out
ENTRY IN THE COMMUNITY AND
INTEGRATION WITH THE PEOPLE
 before actual entry into the community,
basic information about the area in relation
to the cultural practices and lifestyles of the
people must be known
 establishing rapport and integrating with
them will be much easier if one is able to
understand, accept or imbibe their
community life
 living with the people, undergoing their
hardships and problems and sharing their
hopes and aspirations help build mutual
trust and cooperation

 Pre-entry Phase
 ENTRY
PHASE
 Core Group
Formation
Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
 Recognize the role of local authorities by
paying them visits to inform them of their
presence and activities.
 Health worker appearance, speech,
behavior and lifestyle should be kept in
low profile and health workers should
always serve as a role model.
 Avoid raising the consciousness of the
community residents
 Work always with community member to
identify potential leaders

 Pre-entry Phase
 ENTRY PHASE
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
GUIDELINES IN CONDUCTING
INTEGRATION WORK
 recognize the role and position of
local authorities
 adapt a lifestyle in keeping with
that of the community
 choose a modest dwelling which
the people , especially the
economically disadvantaged will
not hesitate to enter

 Pre-entry Phase
 ENTRY PHASE
 Core Group
Formation Phase
 Organization-building
Phase
 Sustenance and
Strengthening Phase
 Phase-out
 avoid raising expectations of
the people; be clear with your
objectives and limitations
 participate directly in
production process
 make house calls and seek
out people where they usually
gather
 participate in some social
activities

 Pre-entry Phase
 Entry Phase
 CORE
GROUP
FORMATION
PHASE
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase-out
 Once the community health
nurse identifies the potential
leaders, they are formed into a
core group.
 The core group will be given the
role of community organizer.
▪ Integration with the core
group members
▪ Deepening social
investigation
▪ Training and education
▪ Mobilizing the core group

 Pre-entry Phase
 Entry Phase
 Core Group Formation
Phase
 ORGANIZATION-
BUILDING PHASE
 Sustenance and
Strengthening Phase
 Phase-out
 Entails the formation of
more formal structures
and the inclusion of
more formal procedures
of planning,
implementing, and
evaluating community-
wide activities.

 Pre-entry Phase
 Entry Phase
Phase
 ORGANIZATION-
BUILDING PHASE
 Sustenance and
Strengthening Phase
 Phase-out
 It is at this phase where
the organized leaders or
groups are being given
trainings to develop their
KSA (knowledge, skills
and attitude,) in managing
their own concerns/
programs.

 Pre-entry Phase
 Entry Phase
 Core Group
Formation Phase
 ORGANIZATION-
BUILDING
PHASE
 Sustenance and
Strengthening Phase
 Phase-out
 Other community members are
encourage to join and form a
community organization
 Pre-organization building
activities
 Organizing the barrio health
committee
 Setting up community
organization
 Training and education for the
organization

 Pre-entry Phase
 Entry Phase
Phase
Phase
 SUSTENANCE and
STRENGTHENING
PHASE
 Phase-out
 Occur when the
has already been
established and the
community-wide
undertakings.

 Pre-entry Phase
 Entry Phase
Phase
Phase
 SUSTENANCE and
STRENGTHENING
PHASE
 Phase-out
 At this point, the different
committees set-up in the
organization-building phase
are already expected to be
functioning by way of
planning, implementing and
evaluating their own
programs, with the overall
guidance from the
community-wide-
organization.

 Pre-entry Phase
 Entry Phase
Phase
Phase
 SUSTENANCE and
STRENGTHENING
PHASE
 Phase-out
 Strategies used:
▪ Education and training
▪ Networking and linking
▪ Conduct of mobilization on
health and development
concerns
▪ Implementation of
livelihood projects
▪ Developing secondary
leaders.

 Pre-entry Phase
 Entry Phase
 Core Group
Formation
Phase
 Organization-
building Phase
 Sustenance and
strengthening
Phase
 Phase-out
 the phase when the health care
workers leave the community to
stand alone
 this phase should be stated during
the entry phase so that the people
will be ready for this phase
 the organizations built should be
ready to sustain the test of the
community itself because the real
evaluation will be done by the
residents of the community itself

 PRE-ENTRY
PHASE
 Entry Phase
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase out
Preparation of the staff:
✓ Statement of objectives and
realization of COPAR guidelines
✓ Development of criteria for site
selection
✓ Site selection
✓ Setting of issues/ considerations
related to site selection
✓ Preliminary Social Investigation (PSI)
✓ Community consultations/ dialogues
✓ Networking with LGU’s, NGO’s and
other departments

 PRE-ENTRY
PHASE
 Entry Phase
 Core Group
Formation Phase
Phase
 Sustenance and
Strengthening Phase
 Phase Out
CRITERIA FOR SITE SELECTION:
 Is the community in need of
assistance?
 Do the community members feel
need to work together to
overcome a specific health
problem?
 Are there concerned groups and
organizations that the nurse can
possibly work with?
 What will be the counterpart of
the community in terms of
community support, commitment
and human resources?

 Pre-entry Phase
 ENTRY
PHASE
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
Strengthening
Phase
 Phase out
 Courtesy call to mayor, or the local
government leader of the selected site.
 Courtesy call to the barangay level.
 Meeting with the “will be” foster parents
of health care students.
 Appreciating the environment.
 Coordination/ dialogue/ consultation
with other community organizations
 Self-awareness and Leadership training
(SALT), action, planning
 General assembly.
 Preparation of survey forms.
 Actual survey.
 Analysis of the data gathered.

 Pre-entry Phase
 Entry Phase
 Core Group
Formation Phase
 ORGANIZATION
-BUILDING
PHASE
 Sustenance and
Strengthening
Phase
 Phase Out
 Identifying problems.
 Spreading awareness and
soliciting solution or suggestion.
 Analysis of the presented
solution.
 Planning of the activities.
 Organizing the people to build
their own organization.
 Registration of the organization.
 Implementing of the said
activities.
 Evaluation.

 Pre-entry Phase
 Entry Phase
Phase
Phase
 SUSTENANCE &
STRENGTHENING
PHASE
 Phase Out
 Meeting with the organizational
leaders.
 Evaluation of the programs.
 Re-implementing of the
programs. (For unmet goals)
 Education and training.
 Networking and linking.
 Implementation of livelihood
projects.
 Developing secondary leaders

 Pre-entry Phase
 Entry Phase
 Core Group
Formation Phase
 Organization-
building Phase
 Sustenance and
strengthening
Phase
 Phase-out
 Leaving the immersion site
 Documentation

I. Pre-entry ▪ preparation of the staff
▪ site selection
II. Entry ▪ integration with the community
▪ courtesy call; information
▪ campaigns; identification of potential
leaders
III. Core-group formation &
mobilization
▪ integration with core group
IV. Organization-building ▪ organizing barrio health committee
▪ setting up the community organization
v. Consolidation &
expansion phase
▪ networking & establishing linkages
▪ implementation of livelihood projects
▪ developing secondary leaders

Activities in Building People’s Organization

 INTEGRATION
 Social Investigation
 Tentative Program
Planning
 Groundwork
 Meeting
 Role Playing
 Mobilization of Actions
 Evaluation
 Reflection
 Organization
 a community organizer
becoming one with the
people in order to:
• immerse himself in the
poor community
• understand deeply the
culture, economy,
leaders, history, rhythms
and lifestyle of the
community.

 INTEGRATION
Planning
 Groundwork
 Meeting
 Role Playing
 Mobilization of
Actions
 Evaluation
 Reflection
 Organization
Methods of Integration includes:
 Participation in direct production
activities of the people
 Conduct of house visits
 Participation in activities like
birthdays, fiestas, wakes, etc
 Conversing with people where they
usually gather such as stores, water,
walls, washing streams, or
churchyards
 Helping out in the household chores
like cooking, washing the dishes, etc

 Integration
 SOCIAL
INVESTIGATION
Planning
 Groundwork
 Meeting
 Role Playing
 Evaluation
 Reflection
 Organization
 A systematic process of
collecting, collating,
analyzing data to draw a
clear picture of the
community.
 Also known as community
study.

 Use of survey or questionnaires is discouraged
 Community leaders can be trained to initially assist the
community worker/organizer in SI
 Data can be more effectively and efficiently collected through
informal methods-house visits, participating in conversations
in jeepneys and others
 Secondary data should be thoroughly examined because
much of the information might already be available
 SI is facilitated if the CO/ community worker is properly
integrated and has acquired the trust of the people
 Confirmation and validation of community data should be
done regularly

 SI is facilitated if the CO/ community worker is properly
integrated and has acquired the trust of the people
 Confirmation and validation of community data should be
done regularly
 A systematic process of collecting, collating, analyzing data
to draw a clear picture of the community
 Also known as the COMMUNITY STUDY

 Integration
Planning
 Groundwork
 Meeting
 Role Playing
 Evaluation
 Reflection
 Organization
 Community organizer to
choose one issue to work
on in order to begin
organizing the people.

 Integration
Planning
 GROUNDWORK
 Meeting
 Role Playing
 Evaluation
 Reflection
 Organization
 Going around and
motivating the people on
something or an issues.
 A time to spot and develop
potential leader.
 The entry phase or
sometimes called the
social preparation
phase.

 Integration
Planning
 Groundwork
 MEETING
 Role Playing
 Evaluation
 Reflection
 Organization
 Core group formation.
 People collectively ratifying
what they have already
decided individually.
 The meeting gives the people
the collective power and
confidence.
 Problems and issues are
discussed.

 Integration
Planning
 Groundwork
 Meeting
 ROLE PLAYING
 Evaluation
 Reflection
 Organization
 To act out the meeting that
will take place between the
leaders of the people and the
government representatives.
 It is a way of training the
people to participate what
will happen and prepare
themselves for such
eventually

 Integration
Planning
 Groundwork
 Meeting
 Role Playing
 MOBILIZATION OF
ACTIONS
 Evaluation
 Reflection
 Organization
 Actual experience of the
people in confronting the
powerful and the actual
exercise power.

 Integration
Planning
 Groundwork
 Meeting
 Role Playing
 EVALUATION
 Reflection
 Organization
 determines whether the
goal is met or not
 The people reviewing the
steps 1-7, so to determine
whether they were
successful or not in their
objectives.

 Integration
Planning
 Groundwork
 Meeting
 Role Playing
 Evaluation
 REFLECTION
 Organization
 dealing with deeper, on-going
concerns to look at the positive
values CO is trying to build in
the organization
 It gives the people time to
reflect on the stark reality of
life compared to the ideal.

 Integration
Planning
 Groundwork
 Meeting
 Role Playing
 Evaluation
 Reflection
 ORGANIZATION
 the result of many
successive and similar
actions of the people.
 Occurs when the
has already been
established and the
community members are
already participating in a
community wide
undertaking.

▪ the community health worker keeps a written account of
services rendered, observations, condition, needs,
problems and attitude of the client in community activities,
accomplishments made etc.
▪ community workers takes responsibility to disseminate
pertinent information to appropriate authorities, agencies,
and most especially to the client

▪ at the same time, the community worker develops the
people’s capabilities to keep/ maintain their recording and
reporting system

 A state of disharmony between incompatible or antithetical
persons, ideas, or interests; a clash.
 Opposition between characters or forces in a work of
drama or fiction, especially opposition that motivates or
shapes the action of the plot.
 A psychic struggle between opposing or incompatible
impulses, desires, or tendencies.

1. Security
2. Inability to control self and others
3. Respect between parties
4. Limited Resources
5. Frustrations

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Interperson
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 conflict originates in the
sender who gives
conflicting instructions

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Interperson
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 arises when a person
receives conflicting
messages from one or
more sources

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Interperson
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 occurs when a person
belongs to more than one
group

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 result of a discrepancies
between internal and
external role

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 between people whose
positions require
interaction with other
persons who fill various
roles in the same
organization or other
organizations

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 occurs when a group faces
new problem, when new
values are imposed on the
group from outside, or
when one’s extragroup
role conflicts with one’s
intragroup role

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 common when two groups
have different goals and
can only achieve their
goals at the other’s
expense

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 condition where an
individual do not know
what is expected of them

1. Intra-sender
2. Inter-sender
3. Inter-role
4. Person-role
5. Inter-person
6. Intragroup
7. Intergroup
8. Role-ambiguity
9. Role-oriented
 individuals cannot meet
the expectations placed on
them

1. Latent
Conflict
2. Perceived
Conflict
3. Felt Conflict
4. Manifest
Conflict
 phase of anticipation
 It exists whenever individual, groups,
organization or nations have
differences that bother one or the
other but those differences are not
great enough to cause one side to
act to alter the situation.
 There is not yet an outright conflict
present but a number of factors exist
that create the conditions that could
result in a conflict.

1. Latent
Conflict
2. Perceived
Conflict
3. Felt Conflict
4. Manifest
Conflict
 indicates cognitive awareness of
stressful situation
 It exists when there is a cognitive
awareness on the part of at least
one party that events have
occurred or that conditions exist
favorable to creating overt conflict.
 Groups recognizes that a conflict is
emerging and starts to look for
possible explanation.

1. Latent
Conflict
2. Perceived
Conflict
3. Felt
Conflict
4. Manifest
Conflict
 presence of affective states such as
stress, tensions, anxiety, anger,
hostility
 Organization, groups or individual
become more internally cohesive.
 Other group in the organization are
viewed with suspicion as outsider.
 Us versus them mentality begins to
really take hold.

1. Latent Conflict
2. Perceived
Conflict
3. Felt Conflict
4. Manifest
Conflict
 overt behavior resulting from the
above three stages
 At this stage the conflicting parties
are actively engaging in conflict
behavior which is usually very
apparent to non-involved parties.
 Feelings of conflict are now
translated into actions and words
which could either be constructive
obstructive to problem solving
process.

1. Sublimation
2. Vigorous physical
exercise
3. Increase efforts
4. Identification
5. Re-interpret goals
6. Substitute goals
7. Rationalization
8. Attention getting
9. Reaction formation
10. Flight into fantasy
11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization
 a defense mechanism by
which the individual
satisfies a socially
prohibited instinctive drive
through the substitution of
socially acceptable
behavior.

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization
 a persons association with or
assumption of the qualities,
characteristics or views of
another person or group
 attribution to yourself
(consciously or unconsciously)
of the characteristic of another
person

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization
 setting another goal

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization
which your true motivation
is concealed by explaining
your actions and feelings
in a way that is not
threatening

1. Sublimation
exercise
3. Increase efforts
4. Identification
6. Substitute goals
7. Rationalization

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
which an objectionable
impulse is expressed in an
opposite or contrasting
behavior

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 the attribution of one’s own
attitudes, feelings or
desires to someone or
something as a naïve or
unconscious defense
against anxiety or guilt

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 unconscious defense
mechanism whereby the
mind redirects emotion
from a dangerous object to
a safe object

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 a strong attachment to a
person or thing especially
such an attachment
formed in childhood or
infancy and manifested in
the immature or neurotic
behavior that persists
throughout life

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 detachment as from social
or emotional involvement

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 the classical defense
mechanism that protects
you from impulses or ideas
that would causes anxiety
by preventing them from
becoming conscious

11. Projection
12. Displacement
13. Fixation
14. Withdrawal
15. Repression
16. Conversion
 repressed ideas conflicts
or impulses are
manifested by various
bodily symptoms, such as
paralysis or sensory
deficits that have no
physical cause
 a change in which one
adopts a new religion, faith
or beliefs

1. Accommodating
2. Compromising
3. Collaborating
4. Competing
 the person neglects
personal concerns to
satisfy the concerns of
others
 It is cooperative but
unassertive.

1. Accommodating
2. Compromising
3. Collaborating
4. Competing
 the individual attempts to
find mutually acceptable
solutions that partially
satisfy both parties in
reflects assertiveness and
cooperation

1. Accommodating
2. Compromising
3. Collaborating
4. Competing
 the individual attempts to
work with others toward
solutions that satisfy the
work of both parties it is
both assertive and
cooperative

1. Accommodating
2. Compromising
3. Collaborating
4. Competing
 the person pursues personal
concerns at another’s
expense
 It is a power oriented mode
that is assertive but
uncooperative.
 The competition is aggressive
and pursues one’s own goals
at another’s expense.

❑Negotiation
❑Collaboration
1. Awareness
2. Tentative exploration and mutual acknowledgement
a. Exploration
b. Mutual acknowledgements
3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration

❑ Negotiation – is a strategic process used to move
conflicting parties toward an outcome.
Process/ Phases of Negotiation:
▪ PHASE 1 Establishing the issue and agenda
▪ PHASE 2 Advancing demands and uncovering interests
▪ PHASE 3 Bargaining and discovering new options – inflict
resolution to both parties; options to resolve
▪ PHASE 4 Working out an agreement
▪ PHASE 5 Aftermath – is the period following an agreement
where parties are expending the consequences
of their decisions.

❑ Collaboration – is achieved through a developmental
process. It is sequential yet reciprocal and characterized
by seven strategies and activities.
1. Awareness
a. Exploration
b. Mutual acknowledgements
3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration

1. Awareness – makes a conscious entry into a group
process, focus on goals of convening together, generate
definition of collaborative process and what it means to
team members

a. Exploration – disclose professional skills for the
desire process; disclose areas where contribution
cannot be mace, disclose values reflecting priorities;
identify roles and disclose personal values, including
time, energy, interest and resources.
b. Mutual acknowledgements – clarify each members
potential contributions; clarify member’s work style,
organizational supports and barriers to collaborative
efforts.

3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration
 determines the degree to
which reliance on others
can achieve; examines
congruence between
words and behaviors; set
interdependent goals;
develop tolerance for
ambiguity

3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration
 defines the relations of the
members with each other;
define the responsibilities
and tasks of each; defines
entrance and exit
conditions

3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration
 determine the issues for
which consensus;
determine the process for
reevaluating consensus
outcomes

3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration
 realize the physical;
emotional and material
actions directed toward the
goal; clarify the
procedures for
reevaluating commitment
in light of goal depends
and group for deviance

3. Trust building
4. Collegiality
5. Consensus
6. Commitment
7. Collaboration
 initiate process of joint
decision making reflecting
the synergy that results
from combining knowledge
and skills

1. Win – Lose
a. Position Power
b. Mental/ Physical
Power
c. Failure to respond
d. Majority rule
e. Railroading
2. Lose – Lose
a. Compromise
b. Bribes
c. Arbitration
d. General Rules
3. Win – Lose
a. Consensus
b. Problem-solving

1. Research
▪ More powerful tool in generating knowledge
2. Participation
▪ Involves social trained researcher to guide the
people
▪ Involves stakeholders
3. Action
▪ Stakeholders will initiate the action done by the
people

Thank you ☺

Community Health Care Development Process

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