Phases of the COPAR Process I. Pre-entry Phase A. Is the initial phase of the organizing process where the community/organizer looks for communities to serve/help. B. It is considered the simplest phase in terms of actual outputs, activities and strategies and time spent for it. Activities include: 1. Designing a plan for community development including all its activities and strategies for care development. 2. Designing criteria for the selection of site 3. Actually selecting the site for community care II. Entry Phase A. Sometimes called the social preparation phase as to the activities done here includes the sensitization of the people on the critical events in their life, innovating them to share their dreams and ideas on how to manage their concerns and eventually mobilizing them to take collective action on these. B. This phase signals the actual entry of the community worker/organizer into the community. She must be guided by the following guidelines however. 1. Recognizes the role of local authorities by paying them visits to inform them of their presence and activities. 2. The appearance, speech, behavior and lifestyle should be in keeping with those of the community residents without disregard of their being role models. 3. Avoid raising the consciousness of the community residents; adopt a low-key profile. III. Organization Building Phase A. Entails the formation of more formal structures and the inclusion of more formal procedures of planning, implementation, and evaluating community-wide activities. It is at this phase where the organized leaders or groups are being given trainings (formal, informal, OJT) to develop their skills and in managing their own concerns/programs. IV. Sustenance and Strengthening Phase A. Occurs when the community organization has already been established and the community members are already actively participating in community-wide undertakings. At this point, the different communities setup 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. 1. Strategies used may include: a. Education and training b. Networking and linkaging c. Conduct of mobilization on health and development concerns d. Implementing of livelihood projects e. Developing secondary leaders SAMPLE INITIAL DATA BASE - HEALTH CARE II Age Juvy Arizala 26 Helen Arizala 30 Jana Arizala 1 Sex Civil Status Occupation M Married Construction Worker F Married Housewife F Single None A. Family Structure, Characteristics and Dynamics The Arizala Family is a typical nuclear type of family consist of the father, Mr. Juvy Arizala who is a construction worker. Mrs. Helen Arizala, a full time housewife and their 1 year old baby girl Jana Arizala. Mrs. Helen is currently 7 months pregnant and is expected to give birth on the first week of June. Mr. and Mrs. Arizala don’t have a hard time in terms of decision making because each of them tend to consider each others opinion first before coming up with the final decision especially regarding health matters. The father is the head and breadwinner of the family while the mother takes care of the household chores and their first born baby girl Jana. B. Socio-Economic and Cultural Characteristics Low educational background seems to be an obstacle for Mr Arizala to get a good job. He never finished elementary education and was forced to work as a construction worker receiving only P250 per day. On the other hand Mrs. Helen Arizala was fortunate enough to finish second year high school but decided to stay at home to take good care of their first born child. Mr. Arizala’s monthly income is approximately P5,000 per month just enough to pay for their monthly rent, electricity bill, food and milk allowance and transportation expense. Most of the time, the budget for health maintenance is being sacrifice and not given enough priority due to lack of money. According to Mrs. Helen Arizala, she spends P150 per day to meet their daily basic needs. The Arizala’s are basically from Antique, Aklan. They migrated to Manila hoping for a better life, but unfortunately they found out that the lifestyle in urban offers very little opportunities. The family is not a member of any social organization in the community nor an a active member of the catholic church. C. Home and Environment The family resides in a depressed area in Brgy. Pasong Tamo, Area 3, Quezon City. Their house is made up of wood and light materials. The floor area is approximately 6 sq. meters. The family sleeps together in a wooden bed with foam situated near the entrance door which also serves as their receiving area. They usually sleep very early at around 8 p.m. and wakes up at 7 a.m. The house is not well ventilated and there is inadequate lighting. Breeding sites for mosquitoes, flies, cockroaches, and rodents are inevitable due to open drainage and poor environmental sanitation. Their toilet facility is located at the back of their house which they share with all the families in the compound. There is no water supply in the area so Mr. Arizala is force to fetch water 20 meters away from their house and costs 2 pesos per container. Mrs. Arizala buys their food in the market and stores it in an uncovered cabinet leaving it exposed to germ and bacteria. She usually cooks vegetable and fish dishes. The garbage is collected twice a week by a DPS truck. Tricycles roam around as their means of transportation while public phone for communication are available at the sari-sari store. Carinderia’s and mini-market are also visible within the vicinity. The overall surrounding of the family is unhygienic and the drainage system is open and very proximate to the houses. Only wooden walls separate them from their neighbors and the electrical connections are entangled and hazardous. D. Health Status of Each Family Member Mrs. Helen Arizala is in a critical stage since she is seven months pregnant to her second child and is expected to give birth on the first week of June. Her first pre-natal check-up was done three months ago and was never repeated due to lack of time and awareness. According to her, she had a hard time delivering her first child due to hypertension. She gave birth at home with the help of a ”hilot“ and plans to do the same with the second child. Her first baby Jana is quite small for her age, though, she was able to walk and stand at the age of 9 months. As of now she is already learning how to speak. She had already taken vitamins during the first three months of her pregnancy but wasn’t able to sustain it due to lack of money. She had her first dose of TT1 last February during her pre-natal check-up. She feeds her baby girl Jana 3 times a day with condensed milk and small amounts of solid foods like a mashed potato and rice with soup. Her husband Mr. Arizala sometimes complain of severe pain at the back of his neck maybe as a sign of hypertension and over fatigue but has no family history of hypertension in the family. The family doesn’t use herbal medicine and goes to the health center when need arises. E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention The family sleeps early to have enough rest and energy for the next day. Mrs. Arizala goes out every morning to walk and exercise outside together with Jana. The family uses bed nets at night to protect them from mosquitoes and other insects while they are sleeping. The first born baby is complete with all the immunization required. Pa-BINGO is held every month at their compound as a form of their relaxation and entertainment. NURSING PROCESS RECORDING I. Personal Data Name: Age: Sex: Civil Status: Educational Attainment : Order/Position in the family : Assessment prior to introduction Helen Arizala 30 Female Married Second Year High School Mother II. The area is congested, there are around 20 families in a compound who is expose to several health hazards like poor environmental sanitation, open drainage system and inadequate living space. The Arizalas is one of those families living in the area. Mrs, Helen Arizal is busy taking good care of her child who is about to sleep at the time when I arrived for the initial interview. III. Objectives A. Short-term Objectives To be able to achieve integration within the family and to promote health education and active participation in terms of general and distinct health necessities B. Long term Objectives To be able to study the conditions of the community with focus on the health aspects IV. Date, Place, Time and Duration of Nurse-Patient Interaction The interview took place dated April 23, 2005 in front of Mrs. Arizala’s house at exactly 10:10 a.m. It lasted for about 15 minutes and I was very glad that Mrs. Arizala was very accommodating. I did not hesitate to ask relevant questions because she showed a lot of interest in the conversation. V. Brief description of the setting I was able to visit Mrs. Arizala’s place twice and somehow I noticed that their house has no enough lighting and ventilation. I wonder how they manage to stay there for two years without water supply and no private toilet facility. Their house is considered to be a make shift type of house and has inadequate living space. The wooden bed found near the main door serves as the living room area leaving a small space for kitchen VI. Nurse-Patient Interaction VII. Evaluation Based on my interview, the family needs more orientation and information regarding health issues. They should value or prioritize their health above all. The importance of prenatal check up and malnutrition should be given emphasis to ensure the development of the baby. Inadequate living space and poor environmental sanitation seems to be a threat to the family’s health. Overall, the health requirements of the family are not being met due to poverty and lack of awareness. VIII. Future Plan or Objectives for the next interaction Promotion of health, prevention of diseases together with simple treatment and rehabilitation would be my next objective to help the family alleviate their health status and conditions Community Organizing Participatory Research (COPAR) Definitions of COPAR: A social development approach that aims to transform the apathetic, individualistic and voiceless poor into dynamic, participatory and politically responsive community. 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 issues and concerns towards effecting change in their existing oppressive and exploitative conditions (1994 National Rural Conference) A process by which a community identifies its needs and objectives, develops confidence to take action in respect to them and in doing so, extends and develops cooperative and collaborative attitudes and practices in the community (Ross 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 the people to develop their capability and readiness to respond and take action on their immediate needs towards solving their long-term problems (CO: A manual of experience, PCPD) Importance of COPAR: 1. COPAR is an important tool for community development and people empowerment as this helps the community workers to generate community participation in development activities. 2. COPAR prepares people/clients to eventually take over the management of a development programs in the future. 3. COPAR maximizes community participation and involvement; community resources are mobilized for community services. Principles of COPAR: 1. People, especially the most oppressed, exploited and deprived sectors are open to change, have the capacity to change and are able to bring about change. 2. COPAR should be based on the interest of the poorest sectors of society 3. COPAR should lead to a self-reliant community and society. COPAR Process: A progressive cycle of action-reflection action which begins with small, local and concrete issues identified by the people and the evaluation and the reflection of and on the action taken by them. Consciousness through experimental learning central to the COPAR process because it places emphasis on learning that emerges from concrete action and which enriches succeeding action. COPAR is participatory and mass-based because it is primarily directed towards and biased in favor of the poor, the powerless and oppressed. COPAR is group-centered and not leader-oriented. Leaders are identified, emerge and are tested through action rather than appointed or selected by some external force or entity.