Community Health and Development
FCM3
Isabelita M. Samaniego MD
June 25 2008
Objectives
1. Define and explain terms
2. List and discuss the perspectives in approaching health care
delivery influencing a community health development
3. Discuss how communities address their health concerns
4. Discuss community organization and health promotion
planning
Health
- A state of complete physical, mental, and social well being
and not merely the absence of disease and infirmity.”
World Health Organization - 1947
- A dynamic state or condition which is multidimensional in
nature and results from the adaptation to his/her
environment.
Community
- Group of people who have common characteristics; can be
defined geographically or administratively
Community Health
- The health status of a defined group of people and the
actions and conditions, both private and public, to promote,
protect, and preserve their health.
Population Health
- The health status of people who are not organized and have
no identity as a group or locality and the actions and
conditions to promote, protect and preserve their health
Public Health
- Health status of a defined group of people and governmental
actions and conditions to promote, protect, and preserve the
people’s health
Community Health vs Personal Health
- Personal
o Individual actions and decision making that affect
the health of an individual or their immediate family
- Community
o Activities aimed at protecting or improving the
health of a population or community
Development
- growth in one or more sectors of society plus associated
changes in attitudes, social institutions and knowledge,
resulting in desired changes in people’s standard of living
Community Health Development (CHD)
- Process of putting in the hands of community members the
power to make effective health decisions and to influence
the management of available health resources so that they
can start to address their own health concerns
- Active players: community leaders, barangay health
workers, community volunteer health workers,and people in
the community
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First Shifting
Perspectives in Approaching Health Care Delivery
1. Health is a Social Phenomenon
2. All Sides of Reality must be Considered
3. The Community should be Partners in Health, not Just
Beneficiaries
Factors Affecting Community Health
- Physical: industrial development, community size,
environment, geography
- Social/Cultural
o beliefs, traditions and prejudices
o economy, politics, religion
o socioeconomic status
o social norms
- Political
o local and external decision making process
o policy-making policies (?)
- Individual Behaviour: takes the concerted effort of many, if
not, most to make a community volunteer program work
All Sides of Reality Must Be Considered
- Strengths: internal capacities, positive traits and values,
experiences, physical and human resources
- Weaknesses: internal to the community (problems, issues),
acts as barriers
- Opponents: possibilities, generate strength, help realize
health goals
- Threats: external conditions/situations affect health or effort
to improve health
Community Should Be Partners in Health, not Just
Beneficiaries
- Putting health in the hands of the people
- Encouraging comunities to assume responsibility for their
health and become partners
- Paradigm shift for health professionals
Actions that Help Community Address Health Problems:
- Community organizing
- Community mobilization
- Education and Training
- Establishing effective linkages for the future
- Mobilization of financial, technical or other resources
Community Organizing
- A process through which communities are helped to identify
common problems or goals, mobilize resources, and in other
ways develop and implement strategies for reaching their
goals they have collectively set.”
Community Mobilization
- Helping the community to recognize that health is a
community concern, and not just the concern of the medical
profession or the government, and motivating community
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Community Health and Development
members to take sustained action to address health
concerns in their own barangay
Assumptions of Community Organizing
1. Can develop the capacity to deal with their own
problems
2. People want to change and can change
3. People can participate in making, adjusting or
controlling major changes
4. Changes in community living, which are self-imposed or
self-developed have a meaning and permanence
5. A “holistic approach” can deal successfully with
problems
6. Democracy requires cooperative participation and action
in the affairs of the community and people must learn
the skills
7. Frequently, community of people need help in
organizing to deal with their needs, not as many
individuals requiring help with individual problems
Education and Training
- Disseminating knowledge and/or information needed to
enable people to act together for barangay health
development
o Up-to-date knowledge on health issues
o Information on leadership
o Community diagnosis techniques
o Strategies for community-based health promotion
- Helping communities have a voice in health issues which
cannot be resolved at the community level
o Participation of representatives of the community in
decision-making
o Advocacy/lobbying for change in health care
delivery by either community members or by a body
established to give the community a voice
Stakeholders in the Process
- Community
- Initiating agency
o may be from community, LGU, NGO, external
funding agency
- Facilitating agency
o may be the initiating agency or some other agency
- Supporting agencies
o agencies that can help with lobbying or advocacy
Process for Organizing a Community (presented in a flowchart
form)
1. Recognize the problem
2. Making entry in the community
3. Organize the people
4. Assessing the Community
5. Determine priorities and setting goals
6. Selecting a solution to the Problem
The Final 4 Steps

Establishing Effective Linkages for the Future

- Ensuring that the community has access to information that
can enable them to make informed choices
Implementing Evaluating
Actions to address Health Concerns in Policies
- Training in basic advocacy skills and in how health system
works
o Ex: Policies affecting availability of drugs at the
Barangay Health station
o Ensuring representation on appropriate special
bodies
o Ex: people’s organization to have a seat on District Looping Back Maintaining
Health Boards

- Formation of alliances
o Alliances with agencies to support certain causes
- Formation of a municipal or provincial body
o a special body with representatives from
communities, NGOs and government agencies, can
be nominated or established to have direct Student Activity
responsibility for tapping the concerns of local
communities •Community A : felt need is the high prevalence of hypertension
in their barangay: Describe how you will organize the community
System for Putting Health in the Hands of the People to develop a health project focusing on hypertension.
•Community B : High prevalence of PTB.
- Helping communities address their health problems where
these can be addressed •Community C : High Incidence of Dengue
o Facilitating a paradigm change on the part of the •Community D : High Prevalence of DM
health workers
o Community organization, diagnosis, training and
establishing linkages as part of CHD intervention
o Community-based health promotion

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