POPULATION REFERENCE BUREAU

September 2006

IDENTIFYING OUR OWN PROBLEMS

Working With Communities for Participatory PHE Research

by Rainera L. Lucero, World Neighbors

D etermining the most important develop-ment

challenges at the community level can be
Part 1: Problems in Cabacnitan
It was Monday afternoon. Lolo Jose was sitting
difficult, especially when they entail on the floor by the doorstep of a bamboo house,
complex cause-and-effect relationships across lis-tening to an old transistor radio.
different sectors. This case study relates the story of “Lolo, I am back. How are you?” said
how World Neighbors (a nongovernmental Inday, approaching her grandfather.
development organi-zation) involved community “Oh Inday, why are you back from the city? I did
members in identifying both critical development not expect to see you again until our town fiesta next
challenges and the relation-ships among those month,” Lolo Jose responded in surprise.
challenges in their community. World Neighbors then “I met an ‘accident,’” Inday explained, sob-
supported a process through which the community bing. “I am pregnant and my employer kicked
members formed a plan of action to achieve their me out. What will I do now? I can no longer
goals in the areas of liveli-hoods, natural-resource work and help our family.”
management, and reproduc-tive health. Lolo Jose tried to get some water for Inday to
drink but the jar was empty. He sighed and turned
back to his granddaughter. “It is okay, Inday,” he
Background: Cabacnitan said. “It is not uncommon for a girl to get
The barangay (the Filipino term for a village, pregnant. Two of your friends also came back
dis-trict, or ward) of Cabacnitan is located in the from Manila last month. They are pregnant just
southern tip of Batuan, Bohol, a like you.” Lolo Jose consoled Inday.
municipality in the Loboc Rene, a development worker with World
Watershed. Loboc Watershed Neighbors, came by. She stopped momentarily,
cov-ers four protected areas: the wanting to join the conversation of the grandfa-
Chocolate Hills National ther and granddaughter. Listening to them talk-
Ph i l i p Monument, the Rajah Sikatuna ing, Rene was speechless. She began to wonder
pineS National Park, the Loboc how a development program could address a
Manila
ea Watershed Reforestation Project, problem like Inday’s, a problem that was increas-
and the Loay Marine Reserve. ingly common in Cabacnitan.
Se a

Cabacnitan occupies 311 Other challenges were also mounting in the rural
n

h i

hectares (about one-third of which barangay. Rene had just come from a meet-ing with
h C

t
u

is within the protected area) and is the barangay captain, who described to her how the
S

five kilometers from the national farming situation of the barangay had changed over
Cabacnitan highway. It has a population of the years. Because irrigation water had become
785 people in 135 households (as increasingly scarce, the people of the barangay were
of 2001) and has no barangay converting more and more of their rice fields into
health station. Farming is the corn production. The farmers now felt it was better to
main occupation of its residents. grow corn since it needs less

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 2 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research

water and takes only three months from planting women perceive this situation? What do
to harvest, while producing rice takes much men think about it?”
longer. But even with these changes, the farmers The next morning, Rene realized that the
worried that they were still not producing enough solution to Cabacnitan’s problems wasn’t likely
to adequately feed their families. to be found in any of the books on her shelf. As
Back in her office, Rene went through a shelf an outsider, she knew she couldn’t fully grasp
of reading materials, trying to find a model for the extent of the challenges in the barangay or
programs that address such interrelated problems under-stand how those challenges related to
on a community level. She called up her friends in each other. The problems of the village could
other NGOs, asking about projects that respond to only be solved by the community itself, and
the problems of teenage pregnancy, water scarcity, Rene trusted that, with guidance and support,
and food insecurity together, but met with no luck. the women, men, and youth of the community
She was frustrated. had the capacity to reverse the village’s
The following week, Rene returned to worsening conditions and improve their lives.
Cabacnitan and met Jojo, the technician fielded by Rene also realized that the local
the Soil and Water Conservation Foundation government would need to be key players in
(SWCF) in Cabacnitan. Jojo told her that the the development process in Cabacnitan. She
SWCF had been working in Cabacnitan for three decided to talk with Babes—a project
months and that it had conducted a natural- coordinator for Kauswagan Community Social
resource-management needs assessment of the Development Center, World Neighbors’
barangay; he added that a farmers’ organization partner in Cabacnitan—about how they might
(BACOD) had been formed in the village to share get the community involved in their efforts.
information on sustainable farming practices.
Rene’s face lit up. She was delighted to learn Consulting Health Staff
that some work had been done to address some of and Community Leaders
the difficult living conditions in Cabacnitan. Rene and Babes made a plan to get the com-
However, there was still the challenge of address- munity involved in addressing Cabacnitan’s
ing teenage pregnancy resulting from the out- chal-lenges. As a first step, they met with
migration of young girls to work in big cities. And Batuan’s municipal health officer and her staff.
she began to wonder if there were other problems “What kinds of reproductive health issues
that the people were not talking about. “Why did exist in your municipality?” Babes asked the
Inday’s mother die?” Rene wondered. “Why did health workers. A young volunteer doctor told
young girls have to leave Cabacnitan? Why did stories of adolescent boys and girls engaging in
they get pregnant at a young age? How do the sexual activities, explaining that “most, if not all,
teenagers who marry do so because the young

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 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research 3

woman is pregnant.” Dr. Nenita Tumanda, the The barangay officials and the officers of
municipal health officer, said she had female BACOD who participated in the discussion
clients who had many children and wanted to use decided to further investigate their problems by
contraceptives. “My department needs training on doing a community needs assessment on repro-
family planning to be able to help women who no ductive health. Together, they drew up a set of
longer want to have children,” Dr. Tumanda said. cri-teria for identifying research volunteers who
Rene engaged the municipal health staff in a would be trained to collect data for the commu-
guided discussion on the reproductive health nity needs assessment. They decided they would
problems in the municipality. She put on the recruit volunteers who could read and write,
floor a large piece of paper with a table that hear and listen, do simple calculations, had
helped identify the reproductive health problems respect within the community, and could
of males and females at different ages. “We have commit time to the research activity.
many cases of teenage pregnancy and
reproductive tract infections affecting men 20 to
45 years old,” offered one staff member. These
issues were two among many health problems
identified by the Batuan health staff. Discussion Questions
To narrow down their knowledge of the com-
munity health conditions to Cabacnitan, which is 1. What problems do you see in Cabacnitan,
just one barangay among many in the municipal- and how do you think they might
ity, Rene and Babes engaged the village leaders of be related?
Cabacnitan in the same process. The discussion
2. Why did Rene think it was necessary to
showed that Inday was not at all an isolated case.
involve the community in identifying and
One community member explained that the con- addressing the problems of the barangay?
flict between the government and the New What are the biggest benefits of involving
People’s Army, a communist-based revolutionary the community in development projects?
group in the Philippines, had resulted in disori-
ented social relationships in the community; con- 3. What kinds of challenges do you think
sequentially, sexual values and interaction in the Rene and Babes might face in getting
barangay had changed. Others confirmed that the community to be involved?
childbearing before and beyond marriage had
4. Why did Rene and Babes begin by consult-
started to become a common occurrence. ing the municipal health staff? What are the
advantages of using this approach?

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 4 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research

Part 2: Training Community volunteers collected data in focus group discus-

Volunteers sions and household surveys throughout the next
Once the barangay officials had identified a month. Male researchers interviewed and facili-
group of research volunteers from the tated focus group discussions among male
community, Babes talked with each of them to respon-dents, while female researchers did the
describe their tasks and find out their same with female respondents. Kauswagan
preferences for the time and place of the training provided meals for the research volunteers and
as well as their needs for transportation or other focus group discus-sion participants.
kinds of support. A month later, Babes and Rene The information gathered in these focus group
convened the group to pro-vide an orientation to discussions was used to further refine the
the goals of their work and provide the household survey questionnaire. For example, the
necessary research-skills training. There were 14 family planning methods men and women sepa-
community research volunteers, with one man rately identified during focus group discussions
and one woman from each of the seven puroks were listed in the household questionnaire as pos-
(administrative subdivisions) in Cabacnitan. sible responses. The results of the household sur-
Rene engaged the volunteer researchers in a vey showed the extent of use of each of the family
series of experiential learning exercises. Using planning methods in the village.
the information on reproductive health issues
that Rene and Babes had gathered from the Sustaining the Interest of Volunteer Researchers
municipal health staff and community leaders, Rene and Babes realized that they would need to
the volunteers developed questions on these plan carefully to keep the research volunteers
issues for use in focus groups and a household motivated and engaged throughout the data col-
questionnaire. The issues included sexual lection process. In addition to providing meals,
behavior; family planning; health conditions of materials, and uniform shirts to the volunteers
women during pregnancy, childbirth, and after and community members during the focus group
delivery; health practices; and gender relations. discussions, Rene and Babes planned periodic
The volunteers pretested their new Focus Group check-ins with the team of volunteers. During
Discussion Guides and Household Survey these check-in meetings, Rene and Babes
Questionnaire among them-selves, practicing solicited feedback on the volunteers’ work such
asking questions and writing down responses. as inspiring stories and challenging situations.
They also pro-vided guidance on the next steps
Collecting Data for the volun-teers. They kept on reminding
The volunteer researchers were now ready to begin them that their leadership and untiring efforts
their research among community members in the could awaken the community to initiate changes
barangay. Equipped with supplies and materials toward their own development.
from Kauswagan and supported by Che-che, a
Kauswagan community organizer, the research

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 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research 5

Analyzing and Presenting Results

Rainera L. Lucero
Over the next several weeks, the volunteers col-
lected, collated, and analyzed the research data. They
then put the results onto charts and pre-sented their
work to the community through a barangay
assembly. The presentation was attended by officials
of the municipal government—includ-ing the
barangay captain, the municipal health officer, the
midwife assigned in the barangay, the municipal
social welfare and development officer, and those
municipal councilors representing local committees
on health and women.
Volunteers in Cabacnitan examine the range of problems
After hearing the presentation, the commu-nity
identified through the community needs assessment.
members attending the assembly affirmed that the
survey results were correct and the prob-lems it
identified were true. The municipal health officer their needs. The following month, the community
listened while the people discussed why the planning team made a cross-visit to a reproductive
community had low adoption rates of family plan- health project in San Miguel, Bohol, to learn the
ning methods and why they preferred traditional approaches that project used to address reproduc-
birth attendants to professional midwives. The tive health problems at the community level.
discussion boiled down to the absence of a health
station in the village and the discouragement com-
munity members had met when they tried to visit
the health station in the next barangay or Rural Discussion Questions
Health Unit.
The village meeting ended with the formation 5. Which techniques did Rene and Babes
of a group of community planners from among the use to ensure full participation from the
volunteer researchers from each of the puroks. research volunteers? What other
strategies have you used to recruit and
Barangay leaders selected representatives who
retain volun-teers?
had the following characteristics: They had
creative ideas; they were critical thinkers; they 6. Rene and Babes recruited one male and
were open-minded, expressive, enthusiastic, one female research volunteer from each
optimistic, and sincere; and they could commit purok in Cabacnitan. Why might they
time to attend an extensive planning workshop. have thought this balance was important?
The 12 barangay planners included seven women
and five men ages 23 to 63. 7. Why would Rene and Babes ask the
research volunteers to present the results
After the community confirmed the needs
instead of presenting the data themselves?
identified during the assessment, the villagers got
ready for developing community plans to address

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 6 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research

Part 3: Taking Action Through the of the planners. “The family size grows, but
Community Planning Workshop the farm size doesn’t. The farm gets smaller
With the community’s needs identified and with and smaller as parents divide their land
community research volunteers having obtained among their children.”
ideas on how to address these problems, Rene “When farms are overused due to the
and Babes facilitated a workshop through which pressure to produce food for the family, they
the volunteer community planners formed their become less and less productive,” added Noy
com-munity development plan. Meling, another member of the planning team.
The planners reviewed all the problems and “We are forced to move into the forest because
issues that emerged from the research, including the soil there is still fertile. However, I have
those on natural-resource management and noticed that water for the rice fields has receded.
repro-ductive health. They wrote these issues on I think it is the result of kaingin (clearing land
large cards that were then spread out on the from trees and shrubs by cutting and burning
floor. They connected the problems with arrows them and using the land for agriculture).”
indicating cause/effect relationships, creating a Nang Ebing stood up and pointed to the
“problem tree.” One card—low farm production arrow she had drawn linking low production and
and income—had many arrows coming in and income to out-migration and teenage
out of it, and the planners agreed this was their pregnancies. “Families are forced to send their
main problem. They used the problem tree to young girls to Manila to work as house helpers
demon-strate how the other problems related to so that they could send back money to their
low farm production and income (see Box 1). families,” she explained. “However, many of
Rene’s attention was rapt as the planners them come home pregnant because of sexual
traced and explained the cause/effect relationships abuse and unsafe sex-ual relationships with
of the problems identified in the problem tree. peers of the opposite sex in Manila.”
“Having many children results in more family The process allowed the community planners
needs and low income,” explained Nang Ale, one to identify and illustrate the links among these

Box 1
Problem Tree Analysis
Problem tree analysis is a community activity for analyzing data from a community needs assessment to be used for
community plan-ning. It is carried out using blank cards, large sheets of paper, marking pens, and masking tape.

Community representatives review the needs and problems identified in the needs assessment, write each of
them on a blank card, and spread them out on a wide sheet of paper. With marking pens, the participants trace
the cause/effect relationships of the needs and problems. They draw arrows from a “cause card” to an “effect
card,” keeping in mind that a need or a problem can be both a cause and an effect.

The need/problem with the most number of arrows coming in and going out is considered the main problem (the tree trunk).
Tracing back, the needs/problems with arrows going into the main problem are considered the causes (the tree roots), and those
with arrows coming out of the main problem are considered the effects (the tree branches and leaves). On another sheet of large
paper, the participants arrange the cards to make the problem tree. From the problem tree, the community develops its plan.

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 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research 7

reproductive health and natural-resource minds—was critical to maintaining the

manage-ment problems. Using the problem tree, momen-tum of their work.
the com-munity planners drafted their action The new year saw Babes working with the
plans with a set of objectives, timeframes, municipal and barangay governments to
responsible persons, locally available resources, identify strategies to increase capacity in the
and other necessary resources. community in Cabacnitan and to support them in
After the workshop, Rene wore a big the imple-mentation of their plans. With the
smile. She was very happy looking back at united support and engagement of the
the entire process. She saw that the regular community, Babes and Rene were confident that
meetings with the community volunteers to the community had made an important first step
share updates and feedback (as well as to in addressing its development challenges.
decide on the next steps) had been one of the
keys to sustaining the volunteers’ interest and
ensuring their ongoing involvement.
The community needs assessment uncovered Discussion Questions
the answers to many of Rene’s questions. It
brought the community’s problems to the surface 8. Are participatory approaches for commu-
and clearly showed how each related to another. nity research particularly useful for
The assessment also made people think and talk projects that involve issues from different
sectors such as health and economic
about the relationships among the problems as
development? Why or why not?
well as to begin to plan how to address them in a
holistic manner. 9. Sustaining community involvement over
long periods of time can be a challenge.
Next Challenges What kind of advice might you give to
In December, Babes and Rene sat down together Rene and Babes in their efforts to ensure
to draw up a program that would support the effective participatory processes
community in implementing their community throughout the implementation of the
community development plan?
development plan. Babes and Rene recognized
that taking action as soon as possible—while the
10. This is one example of an approach to
community volunteers had the memory of the participatory research and planning.
community planning workshop fresh in their What other kinds of approaches or
methods have you learned about or used
in your own work?

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 8 IDENTIFYING OUR OWN PROBLEMS: Working With Communities for Participatory PHE Research

Acknowledgments PRB’s Population, Health, and Environment (PHE)

This case study was written by Rainera L. Lucero, Philippines Program works to improve people’s lives around the world
Program Coordinator for World Neighbors. The author would by helping decisionmakers understand and address the
like to thank Purita (Babes) Sanchez for reviewing the content consequences of population and environment interactions
of her work, Dr. Cel Habito for being her mentor in for human and environmental well-being. Since 2001, the
developing the case study, and Kathleen Mogelgaard for PHE Program has worked with partner NGOs in the
guiding her as she wrote the story and inspiring her to move Philippines to build organizational capability for cross-
forward amidst heavy work demands. sectoral development programming; to expand the appli-
PRB gratefully acknowledges the assistance of cation of integrated development approaches; and to
individuals who reviewed and commented on this case increase policymakers’ knowledge and understanding of
study, including Antonio La Vina, World Resources population, health, and environment dynamics. The PHE
Institute; Robin Marsh, University of California, Berkeley; Program engages in similar activities in other countries and
and Melissa Thaxton and Nancy Yinger, PRB. Robert regions around the world. For more information on PRB’s
Lalasz edited the case study; Michelle Corbett designed it. PHE Program, please write to [email protected].
This case study was produced with the support of the David The Population Reference Bureau informs people
and Lucile Packard Foundation; and the University of around the world about population, health, and the envi-
Michigan Population Fellows Programs, which are funded ronment, and empowers them to use that information to
by the Office of Population and Reproductive Health at the advance the well-being of current and future
United States Agency for International Development. generations. For more information, including
membership and publi-cations, please contact PRB or
© September 2006, Population Reference Bureau visit our website: www.prb.org.

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