The presentation gives information on types, approaches, various entry strategies etc.

1. Nischitha R Rao

2. Table of Contents
1. Community: Definition of Community
2. Multiplicity of Communities
3. The Community based approach
4. Community Entry strategies
5. CBR and Community development
6. Community initiated versus community oriented
programme
7. Community participation and mobilization
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3. Community
 “Community” can be described as a group of
people that recognizes itself or is recognized by
outsiders as sharing common cultural, religious or
other social features, backgrounds and interests
and that forms a collective identity with shared
goals.
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4. Multiplicity of Community
 What is externally perceived as a community
might in fact be an entity with many sub-groups or
communities.
 It might be divided into clans or castes or by social
class, language or religion. A community might be
inclusive and protective of its members; but it
might also be socially controlling, making it
difficult for sub-groups, particularly minorities
and marginalized groups, to express their opinions
and claim their rights.
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5. Example
 Refugees and displaced persons living in
temporary “communities” often have different
nationalities, religions, languages, ethnicity, and
backgrounds and do not perceive themselves as
belonging to any community.
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6. Community Based Approach
 A community-based approach is a way of working
in partnership with persons of concern during all
stages of programme cycle.
 It recognizes the resilience, capacities, skills and
resources of persons of concern, builds on these to
deliver protection and solutions, and supports the
community’s own goals.
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7.  A community-based approach can help
communities work to prevent social problems and
to deal directly with those that do arise, instead of
having external actors step in and assume these
responsibilities.
 It supports persons of concern in re-establishing
familiar cultural patterns and support structures.
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8.  The goals of the community-based approach are to
reinforce the dignity and self-esteem of people of
concern and to empower all the actors to work
together to support the different members of the
community in exercising and enjoying their
human rights.
 Example : vaccinating children, educating girls,
creating mechanisms for the fair distribution of
food and assistance items, encouraging women to
participate in decision-making processes, and
preventing sexual and gender based violence.
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9. A Rights-based Approach
 A rights-based approach is a conceptual
framework that integrates the norms, standards
and principles of the international human rights
system into the policies, programmes and
processes of development and humanitarian
actors. It therefore focuses on both procedures and
outcomes.
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10.  A rights-based approach is founded on the
principles of participation and empowering
individuals and communities to promote change
and enable them to exercise their rights and
comply with their duties.
 It identifies rights-holders (women, girls, boys and
men of concern) and duty-bearers (principally the
State and its agents), and seeks to strengthen the
capacities of rights-holders to make their claims
and of duty-bearers to satisfy those claims. This
requires an attitudinal shift in how we work with
and for persons of concern:
 They are no longer viewed as beneficiaries of aid,
but as rights-holders with legal entitlements.
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11. Community Based Approach
 A community-based approach is integral to a
rights-based approach as they are founded on
common principles and goals. The dual approach
requires that our policies, programmes and
activities be based on international legal
standards, and that members and leaders of the
community consider their roles as both rights-
holders and duty-bearers. It is important to
analyze, with all actors, the obstacles to exercising
these responsibilities and ways to overcome them.
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12.  Example, GOI - duty to provide education for
children, while parents have a responsibility to
encourage their children to attend school,
providing that they have access to schools and the
means to support their attendance.
 A rights-based approach also requires that
national legislation affecting displaced persons be
reviewed. If necessary, the programme planners
and the government partners may have to advocate
for change so that such legislation conforms to
human rights instruments.
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14. Educational Approach
 Aims at mere education of disabled person, his
family members and community and help him
gain more confidence and have access to
information and opportunities.
 Example : Teaching to Fish
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15. Service approach
 Aims a provision of services like assessment, aids
and appliances, medical and surgical treatment,
helping to fill up forms to seek government
schemes like bus pass, scholarship, identification
card etc.
 Example : Giving Fish everyday
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16. Legislative Approach
 Brings order to governmental efforts. PWD Act in
India
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17. Steps in Community Entry
1. Collect information and map out the community;
2. Conduct a stakeholder analysis;
3. Interact with key stakeholders identified; and
4. Conduct the open community meeting
These will then culminate in the initiation of the
programme and evaluation.
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18. Understand and appreciate the nature of the
community.
Plan an appropriate entry strategy
Focus on needs of community
Include person with disabilities/Health professionals
from local agencies/Community working mothers of
Children with Disabilities
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19. Practical
NEEDS ASSESSMENT
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20. Community entry
 Community entry refers to the process of
initiating, nurturing and sustaining a desirable
relationship with the purpose of securing and
sustaining the community’s interest in al aspect of
a programme.
 Community entry refers to the process, principles
and techniques of community mobilisation and
participation. This involves recognizing the
community its leadership and people and
adopting the most appropriate process in meeting,
interacting and working with them.
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21.  Preparations made before entry - form a
reconnaissance team which is a team which spy.
 Read about the community (read annual report
from the DHMT, District Assembly or from our
serious *or special report, disease durance report,
news papers health journals)
 Collect informal information about the
community (this is done through interview with
individuals, through focus groups discussion,
through mapping, contact opinion leaders,
through house to house census)
 Transect walk and observation.
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22. Critical actions in community
entry
Identify the community by gathering information
through formal and informal means
 Reading from available literature
 Talking to knowledgeable people
 Informal sources such as market places, drinking
bars, funerals, festive occasions etc
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23. Identify the leadership
 It is very important to recognise the position and
roles of the community leaders in order that they
will help the community health officer to develop
ways in seeking their co-operation and support for
programme implementation. In meeting with
chiefs and their stool/skin elders, it is important to
schedule meeting, times to suit the convenience of
the traditional leaders.
 Meet the paramount chief first and discuss your
mission e.g. to know the history of the community
and new health programme.
 Meet elders also if possible.
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24. Process
 Knock and enter upon response.
 First greet chief and elders. Introduce yourself to
the chief elders and other local leaders, inform
them of your work with them.
 Ask for their permission and advice and state your
mission e.g. getting information about the village
or introduction of new health programme.
 Thank them for their co-operation.
 The community health officer can get ideas on
contact persons/groups in the community whose
support would facilitate your work.
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25. Identify contact persons
 Apart from the chiefs and elders, there are various
interest groups and personalities in every
community who must be identified to serve as
contact persons in working with the community.
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26. Various interest groups and personalities in the
community who can serve as contact persons are:
 Prominent head of families
 Heads of schools/teachers
 Religious leaders/catechists
 District assembly members
 Unity committee members
 Youth leaders
 Women group leaders
 The water and sanitation committee
 Disease surveillance volunteers
 Traditional birth attendants (TBA’s)
 Other health workers.
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27. Advantages using contact persons
 Good organisers people respect their authority.
 Their presence helps people see the issues as
important.
 Trust by their people.
 They are credible
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28. Disadvantages
 Sometimes not respected-so people may not come
to the meeting.
 Presence at meetings may discourage people from
talking.
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29. Skills and attitudes required of health workers in
undertaking community entry
 Skills
 Maintain good eye contact
 Listen to both sides of and issue
 Paraphrase
 Show interest
 Be empathetic
 Encourage others to listen
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30.  Attitude
 Patience
 Tolerance
 Respect for other people
 Good listening attitude
 Humility
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31.  Physiotherapist role/Programme Co-ordinator
 Ensure that community members understand the
message and are encouraged to ask question when
necessary.
 Probe to find out reasons why the community
members may not be well with other leaders through
asking relevant questions, encouraging answers as well
as holding discussions with them.
 Ensure that message is clear and avoid unnecessary
semantics and jargons.
 Encourage effective dialogue through the use of
effective 2- way communication skills.
 Create humour and interacts in a way that helps to
build the environment for effective interpersonal
relationships.
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32. CBR and Community
Development
 The Millennium Development Goals have the
following aims: 1. Eradicate extreme poverty and
hunger 2. Achieve universal primary education 3.
Promote gender equality and empower women 4.
Reduce child mortality 5. Improve maternal health 6.
Combat HIV/AIDS, malaria and other diseases 7.
Ensure environmental sustainability 8. Develop a
global partnership for development
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33. CBR as part of social, cultural and political
development
 The issue is representation. The question is: how
can CBR contribute to the representation of
disabled people in their local communities,
socially, culturally and politically? The major
reason for disabled people's poverty, lack of rights,
and disempowerment, and the major reason for
ignorance and prejudice towards them, is voice-
lessness, which means lack of representation.
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34.  This is where an alliance between CBR
programmes and DPOs is so important. They must
be mutually reinforcing the United Nations
definition of community development, in the
context of community based rehabilitation, which
consists of programmes implemented to facilitate
local communities, combining outside assistance
with organized self-determination and effort, so as
to stimulate local initiative and leadership to
change attitude towards people with disabilities
and to assist people with disabilities with their
development within their own community.
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35. Community Initiated versus
Community Oriented
Programme
 Community programmes can be initiated within
the community or applied by an external source
but the critical element in both is the extent to
which the community has a voice in programme
development, direction and management.
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36. Community Initiated Projects
 The idea and concept of the project are conceived
within the community with the main goal being to
meet needs that have not been met by
conventional means.
 The projects are governed and implemented by
the community members who initiated the
activities.
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37. Community Oriented Projects
 Community oriented programmes target a defined
population of a community and may involve its
members in the implementation and decision
making process on a different degree.
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38. Community Initiated
Projects
Community Oriented
Projects
The idea and concept of the
CBR programme is conceived
within the community.
The programme does not
originate within the
community.
There is no external
intervention, initiative or
influence.
External human and financial
resources are always involved.
The primary decision makers
are the individuals/members
within the community.
The members of the
community may be involved
in various decision making
process on a different degree.
Example : Evening school
initiated by people within the
community.
Example : Immunization
programme
Cost effective and success rate
is high
Expensive, Success rate might
be compromised.
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39. Community Participation and
Mobilization
 Community mobilization is the process of
bringing together all intersectoral social allies to
raise awareness among people and to demand for a
particular development programme to assist in the
delivery of resources and to strengthen the
participation of people to achieve project
sustainability and self reliance.
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40. Participation
 Participation is key to all successful community
development programmes.
 Community participation is a social process where
by specific groups with shared needs, make
decisions and establish mechanism to meet these
needs.
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41. The three ways of categorizing participation
Participation as contribution – where the community
participates through contributions including labor, financial
resources, material products;
Participation as organization – where the community create
appropriate structures to facilitate participation;
Participation as empowerment- which involves group and
communities, particularly those who are poor and
marginalized, developing the power to make real choices and
by having an effective voice and control.
WHO Study Report on Community Involvement in Health (1991)
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42. Advantages of community
participation
 More can be accomplished
 Services might be provided at lower cost
 Participation has an intrinsic value for
participants, alleviating feelings of powerlessness
 Participation is a catalyst for further development
efforts.
 Participation leads to a sense of responsibility for
the project and eventual sustainability
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43.  Participation guarantees that people’s needs are
considered.
 Participation ensures the use of indigenous
knowledge and expertise.
 Participation brings freedom from dependence on
professionals
 Participation helps people understand and
question the nature of the constraints which are
hindering their escape from poverty.
 Participation ensures that the things are done in
the right way.
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44. Barriers to community
participation
 Participation may become ritualistic
 Participation often depends on one charismatic
leader
 Participation may lead to the development of a
participatory elite
 Participatory experiments are often not cost-
effective or replicable
 Participation may lead to coercion by neighbors
Cont..
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45.  Participation may raise expectations that cannot
be fulfilled
 Participation may lead to conflict
 Participation may lead to development of agendas
which do not match national or international
development goals.
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46. References
 Community Based Rehabilitation – Malcolm Peat
 A Community-Based Approach in UNHCR
Operations
 Disability in the developing World – Benedicte
Ingstad
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