COURSE

GUIDE

PHS 322
COMMUNITY MOBILISATION AND PARTICIPATION

Course Team Mr. Ibet-Iragunima, M. W. (Course

Developer/Writer) - Rivers State College of
Health Science and Technology, Port Harcourt
Dr. Uchendu, F. N. (Course Reviewer) - NOUN
Dr. Anetor, G. (Course Coordinator) - NOUN
Asst. Prof. Agbu, J. F. (Programme Leader) -
NOUN

NATIONAL OPEN UNIVERSITY OF NIGERIA

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ISBN: 978-978-970-015-8

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INTRODUCTION

PHS 322: Community Mobilisation and Participation is a 3-credit unit

course for BSc. Public Health Science and related disciplines. The
course is broken into four modules. It introduces you to the importance
of community mobilisation and participation in a community, LGA,
State and Federal Government Projects.

It equips you with concept of community mobilisation, rationale for

community mobilisation and steps involved in community mobilisation.
It emphasises on community participation, rationale for community,
participation, formation and organisation of development committees,
community diagnosis, situation analysis and advocacy.

At the end of this course, it is expected that you will be adequately

equipped on issues concerning community mobilisation and
participation.

The course guide, therefore, tells you briefly what the course is all
about, the types of course materials to be used, what you are expected to
know in each unit, and how to work through the course material. It
suggests the general guidelines and also emphasizes the need for self-
assessment and tutor-marked assignments (TMA). There are also tutorial
classes that are linked to this course and you are advised to always be in
attendance.

WHAT YOU WILL LEARN IN THIS COURSE

The overall aim of this course, PHS 322, is to introduce you to the
variables associated with community mobilisation and participation.
During this course, you will learn about community mobilisation,
rationale for community mobilisation and steps involved in community
mobilisation, community participation, rationale for community,
participation, formation and organisation of development committees,
community diagnosis, situation analysis and advocacy.

COURSE AIMS

This course aims at giving you an in-depth understanding of issues

concerning Community Mobilisation and Participation.
COURSE OBJECTIVES

Note that each unit has specific objectives. You should read them
carefully before going through the unit. You may want to refer to them
during your study of the unit to check on your progress. You should
always look at the unit objectives after completing a unit. In this way,
you can be sure that you have done what is required of you by the unit.

However, below are the overall objectives of this course. On successful

completion of this course, you will be able to:

• discuss rationale for community mobilisation

• list steps involved in community mobilisation
• be able to mobilise community participation
• discuss rationale for community participation
• describe formation and organisation of development committees
• carry out community diagnosis
• describe concept of community diagnosis
• discuss rationale for community diagnosis
• list steps in community diagnosis
• describe methods for community diagnosis
• discuss information sought during community diagnosis
• table concept of situation analysis
• list rationale for situation analysis
• list steps in situation analysis
• state instruments used in situation analysis
• discuss the role of situation analysis
• discuss concept of advocacy
• state rationale for advocacy
• identify steps in advocacy
• describe processes and methods for the design of advocacy
messages
• illustrate the use of advocacy materials.

WORKING THROUGH THIS COURSE

To complete this course, you are required to read the units, the
recommended textbooks, and other relevant materials. Each unit
contains some self-assessment exercises and Tutor-Marked Assignments
(TMA), and at some point in this course, you are required to submit the
tutor marked assignments. There is also a final examination at the end of
this course. Stated below are the components of this course and what
you have to do.
COURSE MATERIALS

The major components of the course are:

1. Course guide
2. Study units
3. Textbooks and references
4. Assignment file
5. Presentation schedule

STUDY UNITS

There are 21 study units and four modules in this course. They are:

Module1 Community Mobilisation

Unit 1 Concept of Community Mobilisation

Unit 2 Rationale for Community Mobilisation
Unit 3 Steps involved in Community Mobilisation
Unit 4 Community Participation
Unit 5 Rationale for Community Participation
Unit 6 Formation and Organisation of Development Committees

Module2 Community Diagnosis

Unit 1 Concept of Community Diagnosis

Unit 2 Rationale for Community Diagnosis
Unit 3 Steps in Community Diagnosis
Unit 4 Methods for Community Diagnosis
Unit 5 Information Sought During Community Diagnosis

Module3 Situation Analysis

Unit 1 Concept of Situation Analysis

Unit 2 Rationale for Situation Analysis
Unit 3 Steps in Situation Analysis
Unit 4 Instruments used in Situation Analysis
Unit 5 Role of Situation Analysis

Module 4 Advocacy

Unit 1 Concept of Advocacy

Unit 2 Rationale for Advocacy
Unit 3 Steps in Advocacy
Unit 4 Processes and Methods for the Design of Advocacy
Messages
Unit 5 Use of Advocacy Materials

TEXTBOOKS AND REFERENCES

These texts will be of immense benefit to you:

Kyari, U. M. U. (2002). Introduction to Primary Health Care for

Beginners in Community Health Nigerian Experience, Zaria,
SankoreEducational Publishers.

Gbefwi, N. B. (2004). Health Education and Communication Strategies:

A Practical Approach for Community Based Health practitioners
and rural health workers, Lagos. West African Publisher

Federal Ministry of Health (2004) .Operational Training Manual and

Guidelines for the Development of Primary Health Care System
in Nigeria, Abuja.

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo
Publishers.

WHO/UNICEF (1978). Primary Health Care Report of theInternational

Conference on Primary Health Care Alma Ata USSR,6-
12September1978.

ASSIGNMENT FILE

The assignment file will be given to you in due course. In this file, you
will find all the details of the work you must submit to your tutor for
marking. The marks you obtain for these assignments will count towards
the final mark for the course. Altogether, there are 21 tutor-marked
assignments for this course.
PRESENTATION SCHEDULE

The presentation schedule included in this course guide provides you

with important dates for completion of each tutor marked assignment.
You should therefore try to meet the deadlines.

ASSESSMENT

There are two aspects to the assessment of this course. First, there are
tutor- marked assignments; and second, the written examination.

You are thus expected to apply the knowledge, comprehension,

information and problem solving gathered during the course. The tutor-
marked assignments must be submitted to your tutor for formal
assessment, in accordance with the deadline given. The work submitted
will count for 30% of your total course mark.

At the end of the course, you will sit for a final written examination.
This examination will account for 70% of your total score.

TUTOR-MARKED ASSIGNMENT

There are 21 TMAs in this course. You need to submit all the TMAs.
The best three out of four will therefore be counted. When you have
completed each assignment, send them to your tutor as soon as possible
and make sure that it gets to your tutor on or before the stated deadline.
If for any reason you cannot complete your assignment on time, contact
your tutor before the assignment is due to discuss the possibility of
extension.

Extension will not be granted after the deadline, unless on exceptional

cases.

FINAL EXAMINATION AND GRADING

The final examination of will be a two (2) hour duration and have a
value of 70% of the total course grade. The examination will consist of
questions which reflect the self-assessment exercise and e-tutor marked
assignments that you have previously encountered. Furthermore, all
areas of the course will be examined. It is also better to use the time
between finishing the last unit and sitting for the examination, to revise
the entire course. You might find it useful to review your TMAs and
comment on them before the examination. The final examination covers
information from all parts of the course.
COURSE MARKING SCHEME

The following table includes the course marking scheme:

Table 1 Course Marking Scheme

Assessment Marks
Assignment 1-21 21 assignments, 30% for the best 3
Total = 10% x 3 = 30%

Final Examination 70% of overall course marks

Total 100% of Course Marks

COURSE OVERVIEW

This table indicates the units, the number of weeks required to complete
them and the assignments.

Table 2 Course Organisation

Unit Title of Work Weeks Assessment
Activity (End of Unit)
Course Guide Week 1

1 Rationale for community Week 1 Assignment 1

mobilisation
2 Steps involved in community Week 2 Assignment 2
mobilisation
3 Mobilise community participation Week 3 Assignment 3
4 Rationale for community Week 4 Assignment 4
participation
5 Formation and organisation of Week 5 Assignment 5
development committees
6 Community diagnosis Week 6 Assignment 6
7 Concept of community diagnosis Week 7 Assignment 7
8 Rationale for community diagnosis Week 8 Assignment 8
9 Steps in community diagnosis Week 9 Assignment 9
10 Methods for community diagnosis Week 10 Assignment
10
11 Information sought during Week 11 Assignment
community diagnosis 11
12 Concept of situation analysis Week 12 Assignment
12
13 Rationale for situation analysis Week 13 Assignment
13
14 Steps in situation analysis Week 14 Assignment
14
 15 Instruments used in situation Week 15 Assignment
analysis 15
16 Role of situation analysis Week 16 Assignment
16
17 Concept of advocacy Week 17 Assignment
17
18 Rationale for advocacy Week 18 Assignment
18
19 Steps in advocacy Week 19 Assignment
19
20 Processes and methods for the Week 20 Assignment
design of advocacy messages 20
21 Use of advocacy materials Week 21 Assignment
21

HOW TO GET THE MOST OUT OF THIS COURSE

In distance learning, the study units replace the university lecturer. This
is one of the huge advantages of distance learning mode; you can read
and work through specially designed study materials at your own pace
and at a time and place that suit you best. Think of it as reading from the
teacher, the study guide tells you what to read, when to read and the
relevant texts to consult. You are provided exercises at appropriate
points, just as a lecturer might give you an in-class exercise.

Each of the study units follows a common format. The first item is an
introduction to the subject matter of the unit and how a particular unit is
integrated with the other units and the course as a whole. Next to this is
a set of learning objectives. These learning objectives are meant to guide
your studies. The moment a unit is finished, you must go back and
check whether you have achieved the objectives. If this is made a habit,
then you will significantly improve your chances of passing the course.

The main body of the units also guides you through the required
readings from other sources. This will usually be either from a set book
or from other sources.

Self-assessment exercises are provided throughout the unit, to aid

personal studies and answers are provided at the end of the unit.
Working through these self-tests will help you to achieve the objectives
of the unit and also prepare you for tutor marked assignments and
examinations. You should attempt each self-test as you encounter them
in the units.

The following are practical strategies for working through this course;
1. Read the Course Guide thoroughly.
2. Organise a study schedule. Refer to the course overview for more
details.
Note the time you are expected to spend on each unit and how the
assignment relates to the units. Important details, e.g. details of
your tutorials and the date of the first day of the semester are
available. You need to gather together all these information in
one place such as a diary, a wall chart calendar or an organiser.
Whatever method you choose, you should decide on and write in
your own dates for working on each unit.

3. Once you have created your own study schedule, do everything

you can to stick to it. The major reason that students fail is that
they get behind with their course works. If you get into
difficulties with your schedule, please let your tutor know before
it is too late for help.

4. Turn to Unit 1 and read the introduction and the objectives for the
unit.

5. Assemble the study materials. Information about what you need

for a unit is given in the table of contents at the beginning of each
unit. You will almost always need both the study unit you are
working on and one of the materials recommended for further
readings, on your desk at the same time.

6. Work through the unit, the content of the unit itself has been
arranged to provide a sequence for you to follow. As you work
through the unit, you will be encouraged to read from your set
books.

7. Keep in mind that you will learn a lot by doing all your
assignments carefully. They have been designed to help you meet
the objectives of the course and will help you pass the
examination.

8. Review the objectives of each study unit to confirm that you have
achieved them. If you are not certain about any of the objectives,
review the study material and consult your tutor.

9. When you are confident that you have achieved a unit’s

objectives, you can start on the next unit. Proceed unit by unit
through the course and try to pace your study so that you can
keep yourself on schedule.
10. When you have submitted an assignment to your tutor for
marking, do not wait for its return before starting on the next unit.
Keep to your schedule. When the assignment is returned, pay
particular attention to your tutor’s comments, both on the tutor-
marked assignment form and also that written on the assignment.
Consult you tutor as soon as possible if you have any questions or
problems.

11. After completing the last unit, review the course and prepare
yourself for the final examination. Check that you have achieved
the unit objectives (listed at the beginning of each unit) and the
course objectives (listed in this course guide).

FACILITATORS/TUTORS AND TUTORIALS

There are 12 hours of tutorials provided in support of this course. You

will be notified of the dates, time and location together with the name
and phone number of your tutor as soon as you are allocated a tutorial
group.

Your tutor will mark and comment on your assignments, keep a close
watch on your progress and on any difficulties you might encounter and
provide assistance to you during the course. You must mail your e-tutor-
marked assignment to your tutor well before the due date. At least two
working days are required for this purpose. They will be marked by your
tutor and returned to you as soon as possible.

Do not hesitate to contact your tutor by telephone, e-mail or discussion

board if you need help. The following might be circumstances in which
you would find help necessary: contact your tutor if:

• You do not understand any part of the study units or the assigned
readings.
• You have difficulty with the self-test or exercise.
• You have questions or problems with an assignment, with your
tutor’s comments on an assignment or with the grading of an
assignment.

You should try your best to attend the tutorials. This is the only chance
to have face to face contact with your tutor and ask questions which are
answered instantly. You can raise any problem encountered in the
course of your study. To gain the maximum benefit from the course
tutorials, prepare a question list before attending them. You will learn a
lot from participating in discussion actively.

Good luck.
 MAIN
COURSE

CONTENTS PAGE

Module1 Community Mobilisation………………………...1

Unit 1 Concept of Community Mobilisation…………..…..1

Unit 2 Rationale for Community Mobilisation…………....6
Unit 3 Steps involved in Community Mobilisation……….12
Unit 4 Community Participation…………………………. 18
Unit 5 Rationale for Community Participation……….…...26
Unit 6 Formation and Organisation of
Development Committees……………………….….33

Module2 Community Diagnosis…………………………… 44

Unit 1 Concept of Community Diagnosis………………... 44

Unit 2 Rationale for Community Diagnosis……………….52
Unit 3 Steps in Community Diagnosis……………………..55
Unit 4 Methods for Community Diagnosis………………...58
Unit 5 Information Sought During Community Diagnosis...61

Module3 Situation Analysis………………………………......66

Unit 1 Concept of Situation Analysis……………………....66

Unit 2 Rationale for Situation Analysis………………….....69
Unit 3 Steps in Situation Analysis…………………….….....71
Unit 4 Instruments used in Situation Analysis………..……73
Unit 5 Role of Situation Analysis………………………..…75

Module 4 Advocacy…………………………………………….78

Unit 1 Concept of Advocacy………………………..……….78

Unit 2 Rationale for Advocacy………………………………81
Unit 3 Steps in Advocacy…………………………………....83
Unit 4 Processes and Methods for the Design
of Advocacy Messages…………………………..…...86
Unit 5 Use of Advocacy Materials…………………………..91
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

MODULE 1 COMMUNITY MOBILISATION

Unit 1 Concept of Community Mobilisation

Unit 2 Rationale for Community Mobilisation
Unit 3 Steps Involved in Community Mobilisation
Unit 4 Community Participation
Unit 5 Rationale for Community Participation
Unit 6 Formation and Organisation of Development Committees

UNIT 1 CONCEPT OF COMMUNITY MOBILISATION

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definition of a Community
3.2 Description of the Organisational Structure of
Community
3.3 Description of the Leadership Composition of a
Community
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Community Mobilisation has been defined as a capacity building

process through which community individuals, groups, or organisations
plan, carry out and evaluate activities on a participatory and sustained
basis to improve health and other needs on their own initiative or
stimulated by others. This process must involve the whole community,
not just the specific actors who are directly involved in the intervention
programme.

A community could be considered “mobilised” when all members feel

as though the issue is important to them and worthy of action and
support. Community mobilisation inherently involves community
engagement and partnership which are the universally-identified key
components to success. These key components include recruiting
community members to participate in needs assessments, convening
advisory boards comprised of multiple constituencies within a
community, empowering community members to carry out chosen
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

intervention strategies and evaluation endeavors, and recruiting

community members to occupy leadership positions within the
prevention effort.

Community mobilisation is important because the community itself is

ultimately responsible for and affected by situations of safety or
insecurity.
Government resources are insufficient to meet the entire health needs of
all the people. But even w h e r e G o v e r n m e n t h a s all
t h e resources a v a i l a b l e , t h e appreciation of the people and
their willingness to use the seresources must be aroused for the fullest
exploitation of and benefit from deployed resources. Community
mobilisation is directed at stimulating people to be aware of what they
can do by and for themselves to improve their health and solve some of
their health problems. In any case, we should take a look at the
objectives as indicated below.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• define a community
• describe the organisational structure of a community
• describe the leadership composition of a community.

3.0 MAIN CONTENT

3.1 Definition of a Community

The World Health Organisation (1978) stated that a community consists

of people living together in some form of social organisation and
cohesion. Its members share in varying degree political, economic,
social and cultural characteristics, as well as interests and aspirations
including health. Communities vary widely in size and socio-economic
profile, ranging from clusters of isolated homesteads to more organised
villages, towns and cities. Olise (2007) defined a community as a group
of people living in a defined area and sharing some common interest.
Examples are towns and villages.

A community can be homogenous that is consisting of people sharing

the same culture e.g villages or heterogeneous that is consisting of
people sharing different culture e.g urban cities.

You can see the different ways a community is defined. Each of these
definitions expresses the idea of living together in a specified area and
sharing things in common.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

"Community" is important within a public health context. Research

demonstrates that:

• Prevention and intervention take place at the community level.

• Community context is an important determinant of health
outcomes.

However, the lack of a commonly accepted definition of community

results in different collaborators forming contradictory or incompatible
assumptions about community. This often undermines their ability to
evaluate the contribution of the community in achieving in December
2001; the American Journal of Public Health published the results of
research to define community within a public health context (MacQueen
et al. 2001).

Researchers identified core dimensions of "community," as defined by

people from diverse groups. Five core elements emerged:

• locus
• sharing
• action
• ties, and
• diversity

A common definition of community emerged:

A group of people with diverse characteristics who are linked by social
ties, share common perspectives, and engage in joint action in
geographical locations or setting (MacQueen et al. 2001).

3.2 Description of the Organisational Structure of a

Community

Organisational structure of a community refers to how a community is

made up as well as who is at what position otherwise known as the
leadership structure.

The structure is as follows:

1. Village Head (Paramount Ruler)

2. Village Council (Chiefs)
3. President/Chairman (Community Development Committee)
4. Influential leaders
5. Members of the Community (the people)
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

This structure enables community mobilises to know where to start from

in the communities in their mobilisation processes.

3.3 Description of the Leadership Composition of a

Community

There are different group of leaders in the community. They include:

Formal Leaders
These are the first class individuals otherwise knowna s ceremonial
leaders in the community who are elected, appointed or chosen to rule
the community e.g. traditional rulers namely Chiefs, Ezes, Obas, Emirs,
Districts heads and village heads. They are entitled to remuneration
from government.

Informal Leaders
These leaders are unofficially installed but nominated and recognised by
members of the community to lead them in their day to day activities.
For example women leaders, market women leaders, youth leaders, men
leaders etc.

Opinion L e a d e r s

These are persons authorised a n d recognised b y constituted

authorities to give opinions on various matters concerning the
community. They are appointed to hold offices especially in public
bodies and organisations. For example; chairmen of councils, councilors,
pastors, Imams etc. Opinion leaders constitute the leadership
composition of a community. They represent a cross-section of the
community in matters of decision making.

SELF-ASSESSMENT EXERCISE

List the types of leaders in the community

4.0 CONCLUSION

In this unit you have learned that a community is a group of people

living in an area and that the organisational structure of the community
starts from the traditional rulers downwards. You also know the
leadership composition of the community. This unit also defined
community mobilisation as a process of creating awareness on the
community on health issues.

5.0 SUMMARY
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

This unit has focused on the definition of a community, its

organisational structure and leadership composition. It also emphasised
on definition of community mobilisation as a process of creating
awareness. Unit two will discuss the rationale for community
mobilisation.

6.0 TUTOR-MARKED ASSIGNMENT

1 a. Define the term community.

b. Describe the organisational structure of a community.

7.0 REFERENCES/FURTHER READING

Kyari, U. M. U. (2002). Introduction to Primary Health Care for

Beginners in Community Health Nigerian Experience. Zaria:
Sankore Educational Publishers.

Gbefwi, N. B. (2004). Health Education and Communication Strategies:

A Practical Approach for Community Based Health
practitioners and Rural HealthWorkers. Lagos: West African
Publisher.

Federal Ministry of Health (2004). Operational Training Manual and

Guidelines for the Development of Primary Health Care
System in Nigeria. Abuja.

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications.

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo
Publishers.

WHO/UNICEF (1978). Primary Health Care Report of the International

Conference on Primary Health Care AlmaAta USSR, 6-12
September 1978.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 2 RATIONALE FOR COMMUNITY MOBILISATION

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definition of Community Mobilisation
3.2 Goals of Community Mobilisation
3.3 Rationale for Community Mobilisation
3.4 Key Tasks Involved in Community Mobilisation
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Rationale for community mobilisation simply means the fundamental

reasons or ideas behind community mobilisation. Since community
mobilisation is an important activity in health care delivery it must have
some rationale behind it. In this unit, we are going to be discussing the
importance of community mobilisation and its key elements.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• define community mobilisation

• state the goals of community mobilisation
• discuss the rationale for community mobilisation
• discuss the key tasks involved in community mobilisation.

3.0 MAIN CONTENT

3.1 Definition of Community Mobilisation

Federal Ministry of Health (FMOH) (2004) defined community

mobilisation as a means of encouraging, influencing and arousing
interest of people to make them actively involved in finding solutions to
some of their own problems. Community Mobilisation is getting people
involved and committed to achieving goal. Onuzuluike (2004) defined
community mobilisation as process of assisting people to become more
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

aware of their community, take an in-depth look at that community,

identify the felt needs as well as their needs, have belief or faith that
something can be done to relieve these needs and that most of there
sources to achieve these are within the competence of the community,
possess a desire and a willingness to use such resources to ensure the
continued existence and improvement of their community. Gbefwi
(2004) stated that community mobilisation involves creating awareness
on health conditions and allowing for a common solution in the
community.

It is an ideal method for developing decision-making skills,

communication, co-operation and self reliance. Community
mobilisation simply implies putting a community in a state of readiness
for action. It requires time, patience and understanding on the part of the
health workers in order to achieve success. This is not a one time
activity, but rather, a continuous exercise, which should constitute an
integral aspect of efforts, aimed at initiating health action by the people
them selves. You will observe thatin the different definitions of
community mobilisation the focus has been on creating awareness for
the community to take decision involving some of their health
problems.

Community mobilisation has been defined as a capacity building process

through which community individuals, groups, or organisations plan,
carry out and evaluate activities on a participatory and sustained basis to
improve health and other needs on their own initiative or stimulated by
others (Howard-Graham, 2005). Mobilisation increases the participatory
decision-making processes by bringing diverse stakeholders to the
table. It enables those people who may not normally be involved in the
decision making process to be a part of the project. Mobilisation also
fosters strong relationships between Federal governments, local
governments, businesses and community members.

Community mobilisation strengthens and enhances the ability of

communities to work together to achieve goals that are important for
that community. Community mobilisation is not something that is done
over night, but it is a process that requires time and commitment from
all parties involved. The key to successful mobilisation efforts is
making sure that communities are in the driver’s seat during the
process. Mobilisation is not something that happens to the community
rather it is something that the community does. One of the primary
goals of mobilisation is to make sure mobilisation efforts are community
driven. This allows a community to solve its problems through its
own efforts which is the key to having sustained outcomes within a
community.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.2 Goals of Community Mobilisation

• Increase community, individual, and group capacity to identify

and satisfy needs
• Increase community level decision-making
• Increase community ownership of programs
• Bring additional resources to the community
• Build on social networks to spread support, commitment and
changes in social norms and behaviours

3.3 Rationale for Community Mobilisation

A community mobilisation approach is valuable because it empowers

people’s rights to participate and to determine their own future. It
enables groups to create local solutions to local problems. These local
solutions will be more sustainable than external solutions that do not fit
well with the local situation, culture and practices. When communities
define the problem, set common goals and work together on their own
programs, to achieve the goals, the communities change in ways that
will last after the project ends (Florida Department of Health, 2016).

The discussions on the rationale for community mobilisation are as

follows:

The rationale is that when people are actively mobilised and committed
in taking part in matters concerning them and their health right from the
planning stage, they will take part in the implementation and evaluation
processes.

It has been proved that when health projects are initiated from outside,
nobody is interested in taking good care of such facilities but when the
people are involved in such projects greater care is taken by the
community.

It is known that mobilisation activity depends on sensitisation

through adequate flow of information. Therefore, instead of any Health
Agency to present the community with ready-made solutions on all the
health problems, the community is encouraged to take a look at its own
problems and find solutions to some of them using its own resources
and local organisation. However, outside assistance may be provided
through advice, materials and finance.

It is observed that rural or community development/health programmes

that do not recognise the initiatives and the ingenuity of the people are
unlikely to achieve its stated objectives. Thus, community mobilisation
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

is therefore expedient for the stated objectives of any health programmes

in the community to be achieved.

One of the rationales for community mobilisation is that it establishes

cordial relationship and understanding between the health workers and
the community in areas of traditional beliefs and cultural values.

Community mobilisation enables t h e c o m mu n i t y to d e v e l o p

l i n k w i t h different organisations. This inter-sectoral collaboration
assists the community in times of need. The rationale for community
mobilisation also include the idea of teaching the community how to
solve some of their health development programmes within themselves
and not always waiting for Government to do everything for them.

From the above stated facts you can understand the rationale or the idea
behind community mobilisation i n health care delivery as it is pre-
requisite for community involvement and commitment towards health
programmes in the community.

3.4 Key Tasks Involved in Community Mobilisation

• Developing an ongoing dialogue with community members

regarding health issues

• Creating or strengthening community organisations aimed at

improving health

• Assisting in creating an environment in which individuals can

empower themselves to address their own and their community’s
health needs

• Promoting community members’ participation in ways that

recognise diversity and equity, particularly of those who are most
affected by the health issue

• Working in partnership with community members in all phases of

a project to create locally appropriate responses to health needs

• Identifying and supporting the creative potential of communities

to develop a variety of strategies and approaches to improve
health status

• Assisting in linking communities with external resources to aid

them in their efforts to improve health
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

• Committing enough time to work with communities or with a

partner who works with them.

SELF-ASSESSMENT EXERCISE

Define community mobilisation.

4.0 CONCLUSION

In this unit you have learned what the rationale for community
mobilisation is in the promotion of community health. Community
mobilisation enables the community members to be aware of the
problems, know the impact and take part in strategies drafted out in the
intervention. It makes them willing to change and allow the
sustainability of the interventions provided.

5.0 SUMMARY

This unit focused on the rationale for community mobilisation and that
when people are involved in health programmes there is commitment,
objectives are achieved, facilities are protected and the people become
self-reliant in initiation and problem solving.

6.0 TUTOR-MARKED ASSIGNMENT

State, at least, three rationales for community mobilisation.

7.0 REFERENCES/FURTHER READING

Akinsola, H. A. (1993). A-Z of Community Health and Social Medicine

in
Medical and Nursing Practice with special reference to
Nigeria.Ibadan: 3 AM communications.

Federal Ministry of Health, (1996). Curriculum for Community Health

Officers, Lagos.

Federal Ministry of Health. (2004). Operational Training Manual and

Guidelines for the Development of Primary Health Care
System in Nigeria, Abuja.

Forida Department of Health, (2016). What is Mobilisation?

https://www.myctb.org/wst/floridacommunityprevention/Mobilisation/d
efault.aspx. Accessed 13/01/17
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Gbefwi, N. B. (2004). Health Education and Communication Strategies:

A practical Approach for Community Based Health practitioners
and Rural Health Workers. Lagos: West African Publisher.

Howard-Graham, L. (2005). Demystifying Community Mobilisation:

An Effective Strategy to Improve Maternal and Newborn
Health. Storti C. (ed.) Pp. 1-32.

Kyari, U. M. U. (2002). Introduction to Primary Health Care for

Beginners in Community Health Nigerian Experience. Zaria:
Sankore Educational Publishers.

Olise P. (2007). Primary Health Care for Sustainable Development:

Abuja: Ozege Publications.

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo Publishers.

Peter O. (2006). Principles and Practice of Primary Health Care.

Onitsha: Noble Publishers.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 3 STEPS IN COMMUNITY MOBILISATION

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Steps involved in Community Mobilisation
3.2 Graphical Rrepresentation of the Ccommunity
Mobilisation Cycle
3.3 Information to be provided before the Community
Mobilisation
3.4 Success Factors
3.5 The Dos and Don’ts for Community Mobilisation
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

You must have at this juncture understood theconcept of community

Mobilisation. Consequently, in order to mobilise communities there are
steps that should be taken togain entry into a community. It should be
noted that no one can develop a model of community Mobilisation steps
that would have rigid application in all parts of a country as large and
diverse as Nigeria. However, the following steps represent a minimum
that could be adapted for communities irrespective of whatever setting
one finds oneself.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• describe the steps involved in community mobilisation

• graphically illustrate community mobilisation
• describe the information to be provided before the community
mobilisation
• discuss the success factors
• recount the dos and don’ts for community mobilisation.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.0 MAIN CONTENT

3.1 Steps Involved in Community Mobilisation

In order to mobilise a community, the following steps are necessary:

i) Know the community

ii) Make initial contact with the community leaders
iii) Communicate intentions to the leaders
iv) Acquaint yourself with the cultura land social protocols of the
community
v) Arrange meetings with the community leaders and community
representatives.
vi) Develop an agenda for the meeting with the other health workers
vii) Attend the meeting
viii) Explain purpose of the meeting in a nacceptable language
ix) Request them to convey the message to other community
members and bring feed back to subsequent meetings.
x) Encourage questions and participation from the audience to
clarify all issues before meeting disperses, including actions to be
taken before the next meeting;
xi) Decide with participants the time, date and venue of next
meeting.
xii) Have as many meetings as necessary until a consensus is arrived
at.

Minkler and Wallenstein, (eds.) (2003) summarised the steps for

community Mobilisation as follows:

i. stakeholder recruitment
ii. identifying underlying conditions, as identified by community
stakeholders
iii. community assessment
iv. development of a community plan (along with outcome
measurements)
v. development of an evaluation
vi. plan implementation
vii. evaluate
viii. repeat!
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.2 Graphical Representation of The Community

Mobilisation Cycle

Fig. 3.1 Source: Florida Department of Health, (2016)

3.3 Information to be Provided before Community

Mobilisation

There are some critical questions about the community mobilisation

strategy that need to be answered (based on the results of the formative
research) before proceeding with a mobilisation effort. Planning and
implementing successful community mobilisation initiatives requires
answering some important questions: These questions include:

I. What is the goal? (Described in terms that motivate citizens)

ii. Who is the community? (Those most affected by and interested in
the issue)
iii. Where is the community now? What resources does it have?
What needs or issues are pressing?
iv. Where does the community want to go? What needs and
opportunities does the community most want to pursue? When the
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

community gets where it wants to be, how will the community be

measurably better?
v. What strategies and activities will move the community from
where it is to where it wants to be? What resources can be Mobilised to
address these priorities?
vi. How will results be assessed?
vii. Who is stimulating the process? (Outside of or inside the
community)
viii. Who will be facilitating the process? (Community member?
Community Based Organisation (CBO) staff/volunteer? Health system
worker?Local NGO staff?InternationalPrivate Voluntary Organisation
(PVO) staff?Government worker outside health system?)
ix. What support structure exists for facilitators? (Training,
facilitation materials, monitoring/supervision, logistics and
transport)
x. What external and internal resources are potentially available to
contribute to the effort?
xi. What laws, policies, and governance structures are in place to
support or limit CM efforts?
xii. To what extent do people have experience participating in
community action? Who is included? Who is left out? Why?
xiii. If the effort is externally supported, how long is the donor’s
timeframe? Is it realistic? What is the potential for longer-term
community ownership and sustainability?

Without answers to these strategic questions, community mobilisation is

likely to involve many activities, but not meet community needs or
achieve important results.

3.4 Success Factors

A review of the programs that have been implemented to date suggests

that the primary ingredients of a successful community mobilisation
program using maternal and newborn health as an example consist of the
following:

i. program staff including: a program manager, team of facilitators

(one or two selected from a community, or, more likely, a team of
two to cover approximately 10 communities);
ii. trainer(s)
iii. transport budget, depending on where facilitators and managers
are based and may include means of transport (e.g., bicycles or
motorcycles) if facilitators need to travel longer distances
iv. budget for developing training and educational materials (e.g.,
training manuals, picture cards, booklets, audio-video aids)
v. media budget (for radio shows, street drama, and other media)
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

vi. training budget (depends on distance to training site, number of

days, and number of participants and existing skills/knowledge of
trainees); and
vii. Other direct costs associated with office expenses.

These success factors can still be applied to other areas in health.

3.5 The Dos and Don’ts for Community Mobilisation

The Dos
i. Do it with the community help
ii. Use community expertise
iii. Understand ethnic and cultural differences of communities and
build
on ethnic and cultural diversities
iv. Include others in the planning process
v. Develop community partnerships

The Don’ts
i. Do it all for the community
ii. See professionals as the experts
iii. Deny ethnic and cultural differences of a community
iv. Plan mobilisation efforts alone
v. Focus solely on individual efforts

SELF-ASSESSMENT EXERCISE

Minkler and Wallenstein (2003) summarised community mobilisation in

_______ number of steps?

4.0 CONCLUSION

In this unit, you have learned the steps to be taken before entering a
community to mobilise the people towards health actions. At this point
you should be able to enumerate the steps.

5.0 SUMMARY

This unit has brought to bear the steps necessary for community
mobilisation which include knowing the community, establishing
contacts with leaders and holding meetings to arrive at consensus on
how to tackle health issues in the community. Unit four will deal with
community participation

6.0 TUTOR-MARKED ASSIGNMENT

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

List the steps involved in community mobilisation.

7.0 REFERENCES/FURTHER READING

Ibet-Iragumina, M. W. (2010). Fundamentals of Primary Health Care.

(Rev.ed.) Port Harcourt: Minson Publishers.

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo
Publishers.

FMOH. (1996). Curriculum for Community Health Officers. Lagos.

Federa lMinistry of Health (2004). Operational Training Manual and

Guidelines for the Development of Primary Health Care System in
Nigeria. Abuja.

Florida Department of Health, (2016). What is Mobilisation?

https://www.myctb.org/wst/floridacommunityprevention/mobilis
ation/default.aspx. Accessed 13/01/17

Kyari, U. M. U. (2002). Introduction to Primary Health Care for

Beginners in Community Health Nigerian Experience. Zaria: Sankore
Educational Publishers.

Gbefwi, N. B. (2004). Health Education and Communication Strategies:

A practical Approach for Community Based Health Practitioners and
rural health workers, Lagos: West African Publisher.

Olise, P. (2007).Primary Health Care for Sustainable Development

Abuja: Ozege Publications.

Peter, O. (2006). Principles and Practice of Primary Health Care.

Onitsha: Noble Publishers.

Egwu, I. N. (2000). Primary Health Care System in Nigeria. Theory,

Practice and Perspectives. Lagos: Elmore Publishers.

Onuzulike, N. M. (2004). Health Care Delivery System.

Owerri: Achugo Publishers.

Peter O. (2006). Principles and Practice of Primary Health Care.

Onitsha: Noble Publishers.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Cheetham, N. (2002). Community Participation. What is it? Transitions:

Community Participation vol. 14, No. 3:1-10.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 4 COMMUNITY PARTICIPATION

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Explanation of the Concept of Community Participation
3.2 What is Community Participation?
3.3 Beneficiaries of Community Participation Approach
3.4 Major Characteristics and Skills Necessary to Facilitate a
Community Participation Approach
3.5 Major Challenges of Community Participation Programs
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Community participation is a proven approach to addressing health care

issues and has been very useful in HIV prevention in the United States
and in development globally, in projects ranging from sanitation to child
survival, clean water, and health infrastructure. However, the quality of
participation varies from project to project. Moreover, despite the failure
of many health programs designed without the participation of target
communities, some professionals continue to question the value of
community members' participating in program design, implementation,
and evaluation. The next unit will discuss the importance of community
participation in addressing the reproductive and sexual health of
adolescents (Cheetham, 2002).

One of the fundamental Principles of Primary Health Care is the

participation of the community at all stages of development. For
communities to be intelligently involved, they need to have easy access
to the right kind of information concerning their health situation and
how they themselves can help to improve some of them. below.

2.0 OBJECTIVES

By the end of this unit, you wil be able to:

• explain the concept of community participation

• define community participation
• describe the beneficiaries of community participation approach
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

• enumerate major characteristics and skills necessary to facilitate a

community participation approach
• discuss the major challenges of community participation
programs.

3.0 MAIN CONTENT

3.1 Explanation of the Concept of Community Participation

Fig.4.1

Community participation differs from community mobilisation but

could be interwoven with community involvement. A WHO study
(WHO, 1991) suggested that participation can be interpreted in three
ways:

• Participation as contribution,
• As organisation and
• As empowerment.

When a community participates in programs by contributing labour,

cash or materials, this is contributive participation. Participation as
organisation means creation of appropriate structure which facilitates
participation. Empowering participation occurs when people develop the
capability to solve their problems without waiting for help from outside.
However, in order not to make this concept cumbersome, community
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

participation maybe used interchangeably with community involvement.

Furthermore, the definition of community participation will make the
concept more explicit.

3.2 What is Community Participation?

WHO (1978) defined community participation as “the process by

which individuals and families assume responsibility for their own
health and welfare and for those of the and develop the capacity to
contribute to their and community’s development” By knowing
(understanding) their circumstances better, they are then motivated to
solve their common problems because they will therefore become agents
(participants) of their own development. The role of the Health Agencies
therefore is to explain relevant health issues, advice and provide
necessary information and technology to find solutions to the problems.

You will realise that this definition is quite explicit because that a lot of
components that make community participation expedient and a
necessary tool for health development in the community.

However, there is no single definition of participation by communities

but an agglomeration of definitions varying mostly by the degree of
participation. The continuum on the next page provides a helpful
framework for understanding community participation. In this
continuum, "participation" ranges from negligible or "co-opted"—in
which community members serve as token representatives with no part
in making decisions—to "collective action"—in which local people
initiate action, set the agenda, and work towards a commonly defined
goal (Macqueen et al. 2001).

Community participation occurs when a community organises itself and

takes responsibility for managing its problems. Taking responsibility
includes identifying the problems, developing actions, putting them into
place, and following through (Advocates for Youth, 2001).

3.3 Beneficiaries of Community Participation Approach

Community participation has many direct beneficiaries when carried out

with a high degree of community input and responsibility. Everyone
benefits when participating in the activities. For example, adults and
youth might participate in village committees to improve services.
Everyone might watch a play or video and learn from presentations
about local programs. Youth benefit from improved knowledge about
contraception and HIV/AIDS or from increased skill in negotiating
condom use, and other community members’ benefit, too. A truly
participatory program involves and benefits the entire community,
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

including youth, young children, parents, teachers and schools,

community leaders, health care providers, local government officials,
and agency administrators. Programs also benefit because trends in
many nations towards decentralisation and democratisation also require
increased decision making at the community level.

3.4 Major Characteristics and Skills Necessary to Facilitate a

Community Participation Approach

Promoters of community participation need to be able to facilitate a

process, rather than to direct it. Facilitators need to have trust the
community's members, their knowledge and resources. A facilitator
should be willing to seek out local expertise and build on it while
bolstering knowledge and skills as needed.

According to Cheetham (2002), key characteristics and skills required to

Mobilise community participation include:

i. Commitment to community-derived solutions to community-

based problems
ii. Political, cultural, and gender sensitivity
iii. Ability to apply learning and behaviour change principles and
theories
iv. Ability to assess, support, and build capacities in the community
v. Confidence in the community's expertise
vi. Technical knowledge of the health or other issue(s) the project
will address
vii. Ability to communicate well, especially by actively listening
viii. Ability to facilitate group meetings
ix. Programmatic and managerial strengths
x. Organisational development expertise
xi. Ability to advocate for and defend community-based solutions
and approaches (NIH, 1995; Howard-Grabman and Snetro…).

3.5 Major Challenges of Community Participation Programs

Community participation also poses important challenges. The two

major challenges are as follows:

i. Evaluating Participation
ii. Scaling up Participatory Models

i. Evaluating Participation
A challenge for program planners is how to evaluate community
participation. For example, what should be evaluated (health outcomes,
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

participation levels, improved capacities, or some combination of these)

and how will they be evaluated? While measuring health outcomes
(such as birth rates or sexual health knowledge, attitudes, and behaviors
in a particular age group) may be fairly straight forward, it will be
important for community participation programs also to identify and
measure indicators of participation (Cheetham, 2002).

One of the goals is to achieve participation. Whether planners want to

measure changes in community self-efficacy or changes in local
capacity to identify and solve problems, it is important to define these
objectives clearly and to develop appropriate tools for measuring
progress toward the objectives. Qualitative tools (or some combination
of qualitative and quantitative) may be most appropriate to assess the
subjective quality of "participation," but indicators of participation and
ways of assessing it should be defined by the community, and
community members should decide and carry out the evaluation
(Cheetham, 2002).

ii. Scaling Up Participatory Models

Funding bodies often indicate interest in programs that have potential
for "scaling up." Community participation programs present some
obstacles to "scaling up" due to their deliberately and intensely local
nature. As a program develops and matures, program planners may face
the challenge of "scaling down" the intensity of community participation
in order to "scale up" the project without compromising its participatory
nature and results (Cheetham, 2002).

SELF-ASSESSEMENT EXERCISE

List one of the objectives of the Primary Health Care.

4.0 CONCLUSION

In this unit, we discussed the concept and definition of community

participation. I hope you had fun! Community participation is a very
important strategy in efforts to work with youth to improve their sexual
and reproductive health. Community participation is a strategy that
respects the rights and ability of youths and other community members
in designing and implementing programs within their community.
Community participation opens the way for community members
including youths to act responsibly. Whether a participatory approach is
the primary strategy or a complementary one, it will greatly enrich and
strengthen programs and help achieve more sustainable, appropriate, and
effective programs in the field (Cheetham, 2002).
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

You should at this point be able to discuss the relationship between

community involvement and participation (considering that they are
interwoven).The concept differs from community mobilisation in some
direction. Also you should be able by now to define comfortably, the
term community participation.

5.0 SUMMARY

This unit has emphasised on community participation as an organised

means of empowering the community with increasing control over
project activities such that it develops the collective capacity for their
implementation and management for better healthcare for the people. It
is advisable that every community must participate in any form towards
adequate healthcare delivery in the community. Community
Participation encourages community members to solve some of their
health problems on their own.

6.0 TUTOR-MARKED ASSIGNMENT

1. Explain the concept of community participation.

2. Define the term community participation according to WHO.

7.0 REFERENCES/FURTHER READING

Ibet-Iragumina, M. W. (2010). Fundamentals of Primary Health Care.

(Rev.ed.) Port Harcourt: Minson Publishers.

Minkler, M. & Waller stein, N. (Eds.) (2003). Community Based

Participatory Research for Health. San Francisco: Jossey-Bass.

Obionu, C. N. (1996). Primary Health Care for Developing Countries.

Enugu:, Exodus Productions.

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo
Publishers.

WHO (1978). Primary Health Care Report of the International

Conference on
Primary Health Care Alma-Ata USSR,6-12 September,1978
Switzerland.

Bhatnagar, B. et al. Participatory Development and the World Bank.

[World Bank Discussion Paper] Washington, DC: The World
Bank, 1992.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Macqueen, K. M. et al. What is community? An evidence-based

Definition for Participatory Public Health. Am J Pub Health
2001;91:1929-1938.
Cornwall A. Training handout. [s.l.], 1995.

Advocates for Youth. UN Published Data from the Burkina Project.

Washington, DC: 2001.

National Institutes of Health (NIH). Theory at a Glance: A Guide for

Health Promotion Practice. Bethesda, MD: National Institutes of
Health, National Cancer Institute, [1995].

Howard-Grabman, L., Snetro, G. How to Mobilise Communities for

Health and Social Change. Baltimore, MD: Johns Hopkins
University Center for Communication Programs, forthcoming.

Cheetham, N. (2002). Community Participation. What is it? Transitions:

Community Participation vol. 14, No. 3:1-10.

Egwu, I. N. (2000). Primary Health Care System in Nigeria. Theory,

Practice and Perspectives. Lagos: Elmore Publishers.

Onuzulike, N. M. (2004). Health Care Delivery System. Owerri:

Achugo
Publishers.

Peter, O. (2006). Principles and Practice of Primary Health Care.

Onitsha: Noble
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 5 RATIONALE FOR COMMUNITY

PARTICIPATION

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Rationale for Community Participation
3.2 Importance of using Community Participation Approaches
in Adolescent Reproductive and Sexual Health Programming
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Since you have acquired an overview of the concept of community

participation, let us at this juncture take a look at the rationale for
community participation in health care delivery. Rationale for
community participation in health care delivery simply means the basic
reasons or ideas behind community participation. The need for
community participation cannot be overemphasised. Community
mobilisation will be more sustainable than external solutions that do not
fit well with the local situation, culture and practices. When
communities define the problem, set common goals and work together
on their own programs, to achieve the goals, the communities change in
ways that will last after the project ends.
Mobilisation strengthens and enhances the ability of communities to
work together to achieve goals that are important for that community.

Community mobilisation is not something that is done overnight, but it

is a process that requires time and commitment from all parties
involved. The key to successful mobilisation efforts is making sure that
communities are in the driver’s seat during the process. Mobilisation is
not something that happens to the community; it is something that the
community does. One of the primary goals of mobilisation is to make
sure mobilisation efforts are community driven. This allows a
community to solve its problems through its own efforts which is the
key to having sustained outcomes within a community.

In planning health programmes, the following steps are taken into

consideration:
i. Need Assessments
ii. Identification of target audience
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

iii. Definition of the objectives and desired outcome

iv. Content and subject matter
v. Identification of training tools, activities and outpost
vi. Budget and inputs
vii. Publicity
viii. Implementation
ix. Evaluation and assessment
x. Reporting

Community mobilisation or participation is ensured before the above

steps are taken. It is required especially for the first stage which is the
needs assessment.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• discuss the rationale for community participation/mobilisation

• explain the importance of using community participation
approaches in adolescent reproductive and sexual health
programming.

3.0 MAIN CONTENT

3.1 Rationale for Community Participation

The discussions on the rationale for community participation are as

follows:

I. Community participation ensures the participation of local people in

identifying their needs.
ii. The rationale includes the possibilities of the community setting their
priorities, planning and implementing health programmes in
the community.
iii. Community participation helps to make the community at large
aware of their health needs and problems as well devising
means to solve some of their problems.
iv. Members of the community meet with health care providers to decide
jointly on remedial actions and cooperate with health officials
in carrying out health programmes and campaigns.
iv. Community participation encourages inter-sectoral collaboration
because the community as their acceptance for the end product
of all essential elements and principles of primary health.
Therefore, community participation foster multi-sectoral
collaboration.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

v. Community participation ensures costs sharing. Health care

programmes are viewed as accessible and affordable
programmes. Consequently, funding should be shared by the
government and community members as this promotes
successfulimplementation of the health care programmes.

You can adduce from the facts above that community participation is
important in the achievement of health services coverage and objectives.

Even though some authors have contested that participation makes no

difference, the usefulness of community participation has been well
documented in the literature. Involving stakeholders and empowering
community participants in programs at all levels, from local to national,
provide a more effective path for solving sustainable resource
management issues (Chamala, 1995). Community participation
enhances project effectiveness through community ownership of
development efforts and aids decision-making (Kelly and Van
Vlaenderen, 1995; Kolavalli and Kerr, 2002). Price and Mylius (1991)
also identified local ownership of a project or program as a key to
generating motivation for ecologically sustainable activities. Community
participation also leads to dissemination of information amongst
community members, particularly local knowledge that leads to better
facilitation of action (Price and Mylius, 1991; Stiglitz 2002).
Community participation results in learning and learning are often a pre-
requisite for changing behaviour and practices (Kelly, 2001).
The four affirmations that summarize the importance of community
participation in development as identified by Gow and Vansant (1983)
include:

i. People organise best around problems they consider most

important.
ii. Local people tend to make better economic decisions and
judgments in the context of their own environment and
circumstances.
iii. Voluntary provision of labour, time, money and materials to a
project is a necessary condition for breaking patterns of
dependency and passivity.
iv. The local control over the amount, quality and benefits of
development activities helps make the process self-sustaining
(Botch way, 2001).

White (1981) identified a number of beneficial reasons for community

participation in projects as follows:

i. More work is accomplished with community participation.

ii. Services can be provided more cheaply.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

iii. Community participation has an intrinsic value for participants:

• it is a catalyst for further development;
• it encourages a sense of responsibility.
• it guarantees that a felt need is involved
• it ensures things are done correctly.
• It uses valuable indigenous knowledge; frees people from
dependence on other peoples’ skills; and makes people
more conscious of the causes of their poverty and what
they can do about it.

Policies that are sensitive to local circumstances will be more likely to

be successful in their implementation through the involvement of the
local community (Curry (1993). Again, communities that have a say in
the development of policies for their locality are much more likely to be
enthusiastic about their implementation (Curry, 1993). It has been found
that participation has a role in enhancing civic consciousness and
political maturity that makes those in office accountable (Golooba-
Mutebi, 2004).
Importance of Using Community Participation Approaches in
Adolescent Reproductive and Sexual Health Programming

To showcase the importance of community participation, we use

adolescent reproductive and sexual health programming as an example.
Youth do not live in a vacuum, independent of influences around them.
Rather, social, cultural, and economic factors strongly influence young
people's ability to access reproductive and sexual health information and
services. To improve young people's sexual and reproductive health,
therefore, programs must address youth and their environment. In order
to address youth adequately and appropriately, programs should be
designed and implemented with the meaningful involvement of youth.
To address youth's environment, planners must acknowledge that
community and families significantly influence youth(Cheetham,2002).

Programs that ignore the influence of community and family in the lives
of young people are, in fact, creating a nearly impossible situation i.e.
asking young people to change their world on their own. It is unfair to
ask youth to change their beliefs and behaviours without also providing
community support for these changes. Especially when reproductive and
sexual health issues are controversial and/or taboo, it is critical to bring
other community members into the process so that they, too, can support
healthy change (Cheetham, 2002).

If implemented properly, community participation can be effective for a

number of reasons shown below:
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

i. Communities have different needs, problems, beliefs, practices,

assets, and resources related to sexual health. Getting the
community involved in program design and implementation helps
ensure that strategies are appropriate for and acceptable to the
community and its youth.
ii. Community participation promotes shared responsibility by
service providers, community members, and youth themselves for
the sexual health of adolescents in the community.
iii. When communities "own" adolescent sexual health programs,
they often Mobilise resources that may not otherwise be
available. They can work together to advocate for better
programs, services, and policies for youth.
iv. Community support can change structures and norms that pose
barriers to sexual health information and services for youth and
can increase awareness regarding youth's right to information and
treatment.
v. Community participation can increase the accountability of
sexual health programs and service providers.
vi. Participation can empower youth within the community.

SELF-ASSESSMENT EXERCISE

List the beneficial reasons for community participation in projects

according to White (1981).

4.0 CONCLUSION

In this unit, you learnt the rationale for community participation in the
dispensation of health care delivery. At this point you should be able to
enumerate the rationale for community participation.

5.0 SUMMARY

This unit has emphasised on the rationale for community participation in

health care delivery. Community participation in health care delivery
identifies needs, set priorities and ensures planning and implementation
of healthcare programmes.

6.0 TUTOR-MARKEDASSIGNMENT

List three rationales for community participation.

7.0 REFERENCES/FURTHER READING

Botchway, K. (2001). Paradox of Empowerment: Reflections on a Case

Study from Northern Ghana. World Development 29: 135-153.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Chamala S. (1995). Overview of Participative Action Approaches in

Australian Land and Water Management. In: Participative
Approaches for Land Care. Keith K. (Ed.) Pp. 5-42. Brisbane:
Australian Academic Press.

Claridge, T. (2013). Importance of Community Participation.

http://www.socialcapitalresearch.com/designing-social-capital-sensitive-
participation-methodologies/importance-participation.html.
Retrieved 10th January, 2017
Curry, N. (1993). Rural Development in the 1990s: Does Prospect Lie in
Retrospect? In: Rural Development in Ireland: A Challenge for
the 1990s. Greer J. (ed.) Aldershot: Avebury.

Golooba-Mutebi, F. (2004). Reassessing Popular Participation in

Uganda. Public Administration and Development in Press.

Gow, D. & Vansant, J. (1983). Beyond the Rhetoric of Rural

Development Participation: How can it be done? World
Development 11: 427-443.

Ibet-Iragumina, M. W. (2010). Fundamentals of Primary Health Care.

(Rev.ed.). PortHarcourt: Minson Publishers.

Kelly K. & Van Vlaenderen H. (1995). Evaluating Participation

Processes in Community Development. Evaluation and Program
Planning 18: 371-383.
Kelly, D. (2001). Community Participation in Rangeland Management:
a Report for the Rural Industries Research and Development
Corporation. (RIRDC: Barton ACT).

Kolavalli, S. & Kerr, J. (2002). Scaling Up Participatory Watershed

Development in India. Development & Change 33: 213-235.

Onuzulike, N. M. (2004). Health Care Delivery Systems. Owerri:

Achugo Publishers.

Price, S. & Mylius, B. (1991). Social Analysis and Community

Participation.

Stiglitz, J. E. (2002). Participation and Development: Perspectives from

the Comprehensive Development Paradigm. Review of
Development Economics 6: 163-182.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Storey, D. (1999). Issues of Integration, Participation and Empowerment

in Rural Development: The Case of LEADER in the Republic of
Ireland. Journal of Rural Studies 15:307-315.

White, A. (1981). Community participation in water and sanitation:

concepts, strategies and methods. IRC: The Hague.

Peter, O. (2006). Principles and Practice of Primary Health Care.

Onitsha: Noble Publishers.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 6 FORMATION AND ORGANISATION OF

DEVELOPMENT COMMITTEES

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Description of the Various Development Committees
3.2 Title of the Committee
3.3 The Role of Donors, Policy Makers, and External
Organisations
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Development committees are important because prior to the

establishment of primary healthcare in Nigeria, decisions and actions
relating to health were unilaterally taken by Government Agencies on
behalf of the communities Primary Healthcare (PHC) emphasises the
importance of full and active involve men to fall communities to ensure
the success of PHC in accordance with the Alma-Ata declaration of
1978. Hence, the communities are empowered to manage in a
coordinated manner, the health programmes of their people at all times.
In order to strengthen and sustain the management process, the
communities are empowered to participate and effect this management
process; the bottom up concept of planning from the village to the
federal level must be applied. It’s important to establish and sustain
functional and effective development committees at all levels to achieve
health for all. This strategy emphasises on health by the people.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

* describe the various development committees

* mention the title of the committee
* list the composition of the committee
* the terms of reference/responsibilities/roles of the committees
* elaborate the role of donors, policymakers, and external
organisations.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.0 MAIN CONTENT

3.1 Description of the Various Development Committees

It is important to establish and sustain functional and effective

development committees at all levels to achieve health for all. The
Development Committees at the various levels must choose members
who reside in the community, understand and speak the local language,
know and share the community’s culture, attitudes and beliefs, are
respected and willing to contribute selflessly to community programmes.

3.2 Titles of Committees

Village Development Committee (VDC) or Community Development

Committee (CDC).

a. Composition of the VDC/CDC Committee

i. A respectable person elected by the committee members as

chairman
ii. An elected literate member of the village/community shall serve
as secretary.
iii. Representative of religious groups
iv. Representative of women’s group/associations
v. Representative of occupational/ professional groups
vi. Representative of Non-Governmental Organizations (NGOs)
vii. Representative of Village Health Workers (VHWs) and
Traditional Birth Attendants (TBAs)
viii. Representative of the disabled
ix. Representative of Youths
x. Representative of Traditional Healers
xi. Representative of patent medicine stores owners
xii. A trusted member of the committee will serve as the Treasurer

b. Role And Responsibilities of the Village Development

Committee (VDC) or Community Development Committee
(CDC)

The committee shall:

i. Identify health and health related needs in the village/community

ii. Plan for the health and welfare of the community
iii. Identify available resources (human and material)within the
community and allocate as appropriate to PHC programme.
iv. Supervise and implementation of PHC work plan
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

v. Monitor and evaluate the progress and impact of the

implementation of health activities
vi. Mobilise and stimulate active community involvement
inthe implementation of developed health plans.
vii. Determine exemptions for drug payment and deferment; but
provide funds for the exemptions/deferments.
viii. Determine the pricing of drugs to allow for financing of other
PHC
Activities.
ix. Supervise all account books,(monies at hand should be deposited
in a bank within 24hours or 72hours at weekends).
x. Supervise and monitor quantity of drug supply
xi. Select appropriate persons within the community to be trained as
Village Health Workers (VHWs/TBA) for PHC, AIDS /STD and
other programmes.
xii. Supervise the activities of Village Health Workers and
Traditional Birth Attendants; including review of monthly record
of work;
xiii. Remunerate in cash or kind, the Village Health Workers for
his/her work in the community;
xiv. Agree with the Village Health Worker the number of hour
she/she should work per day;
xv. Establish a village health post, where there is none already;
xvi. Ensure that VHW/TBAK its are stocked to top-up level for drugs.
xvii. Liaise with other officials living in the village to provide health
care and other development activities;
xviii. Provide necessary support to VHW for the provision of
healthcare services;
xix. Forward local community health plan toward level.

c. Operational Guidelines

In following the above terms of reference, the committee shall:

i. Meet once every month;

ii. Record minutes of meetings;
iii. Minutes of meetings shall be signed by the Chairman and
Secretary after adoption at subsequent meetings
iv. Comply with the quorum set for starting meetings;
v. The Treasurer should record and keep all monies;
vi. The Treasurer should record all expenditures;
vii. Where there is a Bank Account ,signatories will be the
Committee Chairman and Treasurer, and if necessary the
Secretary;
viii. Send minutes of meetings to Ward Development Committee
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

2. Ward Development Committee (WDC) A:

a. Composition of the Committee

Composition of the WDC is as follows:

The head shall be elected by members.

Wards head or Autonomous Clan head (Chairman), but where no such

person exists, the most respectable village head or any other person
selected may serve as Committee Chairman. In such a case, the
appointment o Chairman should be left entirely in the hands of
Committee members;

i. The WDC consist of representative from each VDC in the

village.
ii. The chairman shall be elected by members.
iii. The secretary of the committee shall be electedby the members.
iv. The Wards Community Development Officer ,if available

The committee can where necessary co-opt members of health related

sectors such as Secondary School Principals and Primary School
Headmasters Agric-Extension Workers PHCN/Water Works Staff,
NGOs. At least 20% of membership will be women and they should be
given effective post such as Head of Health facilities in the area.

b. Roles and Responsibilities of WDC Committee

The Ward Committee will:

i. Identify health and social needs and plan for them.

ii. Supervise the implementation of developed work plans.
iii. Identify local human and material resources to meet these needs.
iv. Forward for health /community development plans (village,
facility and Wards levels) to LGA.
v. Mobilise and stimulate active involvement of prominent and
other local people in the planning, implementation and evaluation
of projects.
vi. Take active role in the supervision and monitoring of the Wards
Drug Revolving Fund/B.I.
vii. Raise funds for community programmes when necessary at
village, facilities and Wards levels.
viii. Provide feedback to the rest of the community on how funds
raised are disbursed.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

ix. Liaise with government and other voluntary agencies in finding

solutions to health, social and other related problems in the
Wards.
x. Supervise the activities of the VHWs/TBAs, CHEWs;
xi. Monitor activities at both the health facilities and village levels;
xii. Oversee the functioning of the Health facilities in the Wards;
xiii. Provide necessary support to VHWs/TBAs;
xiv. Ensure that a Bank account is opened with is liable bank. The
signatories will be as given by the NPHCDA guidelines on the
Ward Health Systems document.
xv. Monitoring equipment and inventory of monthly intervals.
xvi. Ensure the proper functioning of the Health Facility using a
maintenance plan.

c. Operational Guidelines of WDC Committee

The Committee shall:

i. Meet monthly;
ii. Record minutes of meetings;
iii. Recommend that minutes of meetings be signed by the Chairman
and Secretary after approval at the next meeting;
iv. Monitor drug revolving at the Ward/Facility level;
v. Ensure that NHMIS forms are correctly filled and submitted
ontime;

vi. Give feedback of data collected at LGA PHC Management

Development Committee meetings;
vii. Comply with the quorum of members set for starting the meeting;
viii. Authorise the Treasurer to record and keep all monies;
ix. Authorise the Treasurer to spend money only after approval by
Committee;
x. Instruct the Treasurer to record all expenditure;
xi. Chose where applicable, the ward referral centre to serve as the
meeting venue and
xii. Secretariat of the Ward Development Committee;
xiii. Advise, where there is a Bank Account, signatories to be the
Committee Chairman and Treasurer and if necessary, the
Secretary;
xiv. Send minutes of meetings to Local Government Area Committee.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3. The LGA Primary Health Care Management Committee

Each LGA should have a LGAPHC Management Committee.

The objective of this committee is to provide an overall direction for

Primary Health Care in the LGA.

a. The Composition of the LGA PHC Management Committee

i. The Chairman of the LGA (Chairman)

ii. Supervisory Councilor for Health (member)
iii. The LGA Secretary;
iv. LGA PHC Coordinator (Secretary);
v. A representative of CHO Training Institutions.
vi. Principal of School of Health Technology.
vii. Representative of health-related occupational
groups/associations;
viii. The Chief (or most senior) Community Health Officer in the
LGA;
ix. The Community Development Officer for the LGA;
x. The Medical Officers of the secondary health facility
xi. Chairman of Ward Development Committee
xii. Ward heads
xiii. Representatives of International Organizations having PHC
programmes in the LGA;
xiv. Heads of other health-related departments in the LGA
(Education, Agriculture, Works, etc);
xv. Representatives of NGOs;
xvi. Representatives of Women/Youth Groups;
xvii. Representatives of Religious Groups;

b. Terms of Reference

The Terms of Reference of the LGA PHC Management Development

Committee shall be to:

i. Provide overall direction for PHC including endemic,

communicable diseases (HIV/IDS/STD, TB, Malaria,
Onchocerciasis, etc)
ii. Plan and manage PHC Services in the LGA
iii. Health Manpower Development for the LGA
iv. Provide the Operational Guideline for the LGA
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

4. Local Government Area PHC Technical Committee

There should be a PHC Technical Committee at the LGA level.

a. Composition

i. LGAPHC Coordinator–Chairman
ii. All Assistant PHC Coordinators
iii. Program Managers in the LGA.

b. Roles and Responsibilities

i) Plan and budget for implementation of activities of PHC

department and present same to the LGA PHC Management
Development Committee;
ii) Identify training needs for Health Workers and make proposals to
th LGA PHC Management Development Committee;
iii) Design minimum acceptable performance standard for
monitoring LGA PHC Services and develop monitoring
indicators.
iv) Monitor activities of health workers;
v) Design supervisory checklist for LGA PHC services;
vi) Identify health related needs of communities within the Local
Government Area;
vii) Plan for mobilisation of local and external resources to enhance
PHC Activities;
viii) Provide feedback to committees at all levels;
ix) Monitor drug revolving fund for the health services at the LGA
level;
x) Discuss PHCM’S report and take appropriate action;
xi) Give feedback of data collected at LGA PHC Management
Committee meeting/facility staff/community.
xii) Review progress of PHC in the LGA and evaluate their
indicators.

c. Operational Guidelines

In carrying out the above functions, the committee shall:

i) meet monthly;
ii) Record minutes of meetings;
iii) Adopt minutes of meetings and ensure that the Chairman and
Secretary sign them;
iv) Comply with the quorum set for starting meetings.
5. The State PHC Implementation Committee
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

a. Composition

i. Commissioner for Health–Chairman

ii. Permanent Secretary Health
iii. Director of Primary HealthCare–Secretary
iv. Representatives of Health-related Ministries
v. Representatives of Women’s Associations
vi. Representatives of Extra-Ministerial Department
vii. Representatives of International Agent
Viii. Local Government Areas Chairmen
ix. Representatives of Religious Groups
x. Representative of the Directorate of Local Government
xi. Chairman of LGA Service Commission
xii. Any other member as maybe deemed appropriate.
xiii. Director of LGA Affairs.

b. Terms of Reference

The Committee shall:

i. Review PHC implementation plans as developed by the LGAs in

the State;
ii. Provide necessary materials, technical, financial, and other
support to LGAs in the implementation of the plans;
iii. Commission periodic assessment surveys of the progress made in
PHC Implementation and its impact on the quality of lives of the
people;
iv. Receive reports of PHC activities in the LGAs through the State
PHC Coordinator and give feedback to LGAs.
v. Liaise with other State Ministries and Federal officials operating
in the State for the enhancement of PHC services;
vi. Collaborate with NGOs and other International Agencies through
the Federal Ministry of Health and National Primary Health Care
Development Agency (NPHCDA) for necessary support and
assistance ;and
vii. Monitor and evaluate LGA activities at all levels in conjunction
with the NPHCDA.

3.3 The Role of Donors, Policy Makers, and External

Organisations

Here, we want to use maternal and newborn health as an example to

illustrate the role of donors and policymakers in community
mobilisation. The role of donors and policymakers in community
mobilisation for maternal and newborn health is to ensure that programs:
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

i. Integrate community mobilisation into the broader national or

regional health plan.
ii. Prioritise communities with the highest mortality and that could
benefit most.
iii. Hire implementing organisations with proven experience and
expertise in community mobilisation and maternal and newborn
health.
iv. Engage communities as full partners in planning, implementation,
and evaluation.
v. Have sufficient financial support; have realistic timelines; are
supported by policies that promote community participation.
vi. Establish links to external assistance within the health and other
sectors.
vii. Establish mechanisms to coordinate the work of all implementing
agencies and communities to ensure that perspectives at all levels
are taken into account as strategies and materials are developed,
to maximise program learning and use of resources.

External assistance is most effective when it starts from where people

are and facilitates a process through which interested community
members, especially the most vulnerable, identify and implement
strategies and approaches that will reduce mortality within their local
context. Additionally, external facilitators may share valuable
information with community members on effective strategies, practices,
and experiences to complement Local knowledge, making for better
informed community decision-making and planning (Howard-Graham,
2005).

To play these roles successfully, external organisations must establish

relationships with communities built on respect and trust, with faith in
the ability of community members to identify and resolve their
challenges in the most appropriate way in the local cultural setting.
Ideally, community mobilisation will work together with other,
complementary program strategies (mass media, services strengthening,
and policy advocacy) rather than on its own. For example, Home Based
Life Saving Skills (HBLSS) training may be offered to interested
communities that have limited access to health services; community
members may participate in the development and dissemination of
educational messages and materials; and community members may help
design health facilities and health protocols that take into account their
perspectives on quality care (Howard-Graham, 2005).

SELF-ASSESSMENT EXERCISE
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Enumerate the composition of PHC Technical Committee at the LGA

level.

4.0 CONCLUSION

In this unit, we have discussed the various development committees

including their titles, composition and responsibilities. Consequently,
you should be able to discuss the various committees, their parameters
and characteristics.

5.0 SUMMARY

Primary Health Care emphasizes on the importance of full involvement

by all communities to ensure health by the people. In order to achieve
this strategy it is expedient to establish functioning and effective
development committees at all levels from the Village, Ward, LGA and
State. This unit really focused on the titles, composition and
responsibilities of all the five committees such as: the Village
Development Committee (Community Development Committee),Ward
Development Committee (WDC), the State PHC implementation
committee, Local Government Area PHC technical committee and The
LGA Primary Health Care management committee.

6.0 TUTOR-MARKED ASSIGNMENT

1 List three members of the Community Development Committee.

2. Enumerate five responsibilities of the Community Development
Committee.
3. Enumerate two terms of Reference of the LGA Primary Health
Care.
Management Committee.
4. List five members of the State PHC Implementation Committee.

7.0 REFERENCES/FURTHER READING

Abosede, O. A. (2003). Primary Health Care in Medical Education in

Nigeria. Lagos: University of Lagos Press.

Community Health Practitioners Registration Board of Nigeria (2006),

Curriculum for Higher Diploma in Community Health Abuja,
Mitral Press.

FMOH (2004) Operational Training Manual and Guidelines for the

Development of Primary Health Care System in Nigeria, Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Howard-Graham, L. (2005). Demystifying Community Mobilisation:

An Effective Strategy to Improve Maternal and Newborn Health.
Storti C. ed. Pp. 1-32.

Ransome-Kuti, O, Sorungbe, A. O. O., Oyegbite, K. S. & Bamisaiye, A.

(1993). Strengthening Primary Health Care of Local Government
Level; The Nigerian Experience. Lagos: Academy Press.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

MODULE 2 COMMUNITY DIAGNOSIS

Unit 1 Concept of Community Diagnosis

Unit 2 Rationale for Community Diagnosis
Unit 3 Steps in Community Diagnosis
Unit 4 Methods for Community Diagnosis
Unit 5 Information Sought During Community Diagnosis

UNIT 1 CONCEPT OF COMMUNITY DIAGNOSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Meaning of Diagnosis
3.2 Definition of Community Diagnosis
3.3 The Community Diagnosis Process
3.4 Types of Health Needs
3.5 How is Community Diagnosed?
3.6 Characteristics of Indicators
3.7 Classification of Health Indicators
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

In order to provide the necessary health services for a community, health

care providers must be able to identify the prevailing health issues or
problems and determine their priorities. In spite of the fact that health
care facility is available, it is advisable to continue to reassess the health
situation in the community and plan services that are appropriate to the
priority health problems of the community health workers must possess
the requisite skills for diagnosing the health problems of the community.

This unit will enable you to understand the concept of community

diagnosis. Before we do this, let us have a view of what you should
learn in this unit as indicated in the objectives below:

2.0 OBJECTIVES

By the end of this unit, you will be able to:

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

• explain the meaning of diagnosis

• define community diagnosis
• discuss the types of health needs in the community
• define the community diagnosis process
• enumerate the types of health needs
• describe how community diagnosis is carried out
• list the characteristics of indicators
• highlight the different classes of health indicators.

3.0 MAIN CONTENT

3.1 Meaning of Diagnosis

Diagnosis simply means to determine the nature of something e.g.

disease .It is a statement of the result of findings. Family Medical
Compassion defined diagnosis as the process whereby a particular
disease or condition is identified after analysis and consideration of the
relevant parameterie .symptoms, physical manifestation, results of
laboratory tests etc. Parker (1985) stated that the diagnosis of a disease
in an individual patient is a fundamentalideainmedicine. It is based on
signs and symptoms and the making of inferences from them. When this
is applied to a community it is known as community diagnosis.

3.2 Definition of Community Diagnosis

Kyari (2002) defined community diagnosis as a process of finding out

about the health needs of the community. The focus of community
diagnosis is on the identification of the basic health needs of the
community. FMOH (2004) defined community diagnosis as an
organised process involving identified needs, resources, wants,
constraints, problems, and disease patterns, physical, social, cultural and
demographic characteristics of the community. In community diagnosis,
the entire community is regarded as a patient requiring community
diagnosis and treatment. Community diagnosis generally refers to the
identification and quantification of health problems in a community as a
whole in terms of mortality and morbidity rates and ratios, and
identification of their correlates for the purpose of defining those at risk
or those in need of health care.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.3 The Community Diagnosis Process

The Community Diagnosis Process is a means of examining aggregate

and social statistics in addition to the knowledge of the local situation, in
order to determine the health needs of the community.

3.4 Types of Health Needs of a Community

i. Felt Needs
These needs are those identified by the community itself which
require solutions for example shortage of water supply, poor
roads etc.

ii. Identified Needs

These are health needs which members of the community are not
aware of and are identified during the process of community
diagnosis for example pattern of disease occurrence etc.

3.5 How Is The Community Diagnosed?

Community analysis is the process of examining data to define needs

strengths, barriers, opportunities, readiness, and resources. The product
of analysis is the community profile.To analyse assessment data is
helpful to categorise the data.

This may be done in the following ways:

i. Demographic
ii. Environmental
iii. Health resources and services
iv. Health policies
v. Socioeconomic
vi. Study of target groups.

Community is diagnosed using health indicators. Indicators of health are

variables used for the assessment of community health.

3.6 Characteristics of Indicators

i. Validity: they should actually measure what they are supposed to

measure.
ii. Reliability and objectivity: the answers should be the same if
measured by different people in similar circumstances.
iii. Sensitivity: they should be sensitive to changes in the situation
concerned.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

iv. Specificity: they should reflect changes only in the situation

concerned.
v. Feasibility: they should have the ability to obtain data needed
vi. Relevant: they should contribute to the understanding of the
phenomenon of interest.

3.7 Classification of Health Indicators

1. Mortality indicators
2. Morbidity indicators
3. Disability rates
4. Nutritional status indicators
5. Health care delivery indicators
6. Utilisation rates
7. Indicators of social and mental health
8. Environmental indicators
9. Socio-economic indicators
10. Health policy indicators
11. Indicators of quality of life
12. Other indicators

1. Mortality Indicators

Mortality or death rates are the traditional measures of health status.

They are widely used because there are ready available. For example,
death certificate is a legal requirement in many countries.

Mortality indicators include the following:

i. Crude death rates

ii. Specific death rates: age/disease
iii. Expectation of life
iv. Infant mortality rate
v. Maternal mortality rate
vi. Proportionate mortality ratio
vii. Case fatality rate
2. Morbidity Indicators

Morbidity indicators are morbidity rates or disease rates. Data on

morbidity are preferable, although often difficult to obtain.

Examples of morbidity examples are:

i. Incidence and prevalence

ii. Notification rates
iii. Attendance rates: out-patient clinics or health centers.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

iv. Admission and discharge rates

v. Hospital stay duration rates

3. Disability Indicators

Disability indicators are disability rates. Examples are as follows:

i. Number of days of restricted activity

ii. Bed disability days
iii. Work/School loss days within a specified period.
iv. Expectation of life free of disability

4. Nutritional Indicators

Examples of nnutritional indicators are:

i. Anthropometrics measurements
ii. Height of children at school entry
iii. Prevalence of low birth weight
iv. Clinical surveys: Anaemia, Hypothyroidism, Night blindness

5. Health Care Delivery Indicators

Health care delivery indicators reflect the equity and provision of health
care.

Examples are as follows:

i. Doctor / Population ratio

ii. Doctor / Nurse ratio
iii. Population / Bed ratio
iv. Population / per health center

6. Utilisation Indicators

Utilisation indicators are health care utilisation rates which show the
extent of use of health services. It indicates the proportion of people in
need of service who actually receive it in a given period or year.

Examples are as follows:

i. Proportion of infants who are fully immunised in the 1st year of

life ii. immunisation coverage.
iii. Proportion of pregnant women who receive antenatal care
(ANC).
iv. Hospital-beds occupancy rate.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

v. Hospital-beds turn-over ratio

7. Social/Mental Health Indicators

Indicators of social and mental health are indirect measures of health

status. Often, valid positive indicators do not often exist so in direct
measures are commonly used. Examples are as follows:

i. Suicide & Homicide rates

ii. Road traffic accidents
iii. Alcohol and drug abuse.

8. Environmental Indicators

Environmental health indicators reflect the quality of environment.

Examples include:

i. Measures of Pollution
ii. The proportion of people having access to safe water and
sanitation facilities
iii. Vectors density

9. Socio-economic Indicators

Socio-economic indicatorsare not direct measures of health status. They

are used for the interpretation of health care indicators. Examples are as
follows:

i. Rate of population increase

ii. Per capital Gross Net Profit (GNP)
iii. Level of unemployment
iv. Literacy rates - females
v. Family size
vi. Housing condition e.g. number of persons per room
vii. Age

10. Health Policy Indicators

Health Policy Indicators assesses the aallocation of adequate resources.

Examples are:

i. Proportion of GNP spent on health services.

ii. Proportion of GNP spent on health related activities.
iii. Proportion of total health resources devoted to primary health
care
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

11. Other Indicators

Other health indicators include:

i. Indicators of quality of life.

ii. Basic needs indicators.
iii. Health for all indicators.

SELF-ASSESSMENT EXERCISE

Define community diagnosis according to FMOH.

4.0 CONCLUSION

In this unit you have known about the meaning of diagnosis and that in
the definition of community diagnosis the focus is on identification of
health needs. You have also classified these health needs as felt and
identified needs, defined the community diagnosis process, enumerated
the types of health needs, described how community diagnosis is carried
out, listed the characteristics of indicators as well as discussed the
different classes of health indicators.

5.0 SUMMARY

Community diagnosis is the process of working with the community

member to find out about the needs of the community. These needs
include those already identified by the community itself (felt needs) and
others identified during the process (identified needs). It also includes
finding out information about the structure, the people, association’s
resources and other characteristics of the community. Community
diagnosis helps us to identify the important health problems and diseases
in a community and how we can present them with suitable health
programmes. Community diagnosis is carried out using health
indicators; some are direct indicators while some are indirect indicators.

6.0 TUTOR-MARKED ASSIGNMENT

1. Explain the term diagnosis.

2. What are the various definitions of community diagnosis?.
3. Differentiate between felt needs and identified needs, with one
example in each case.

7.0 REFERENCES/FURTHER READING

Abosede, O. A. (2003). Primary Health Care in Medical Education in

Nigeria. Lagos: University of Lagos Press.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

FMOH (2004). Curriculum for Community Health Officers Lagos,

Nigeria.

Salama R. (nd). Community Analysis. Community Medicine. Egypt:

Suez Canal University.

Egwu, I. N. (2000). Primary Health Care Theory, Practice &

Perspective. Lagos: Elmore Publishers.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 2 RATIONALE FOR COMMUNITY DIAGNOSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Goals of Community Diagnosis
3.2 The Rationale for Community Diagnosis
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

The previous unit has exposed you to the concept of community

diagnosis; therefore it will be necessary also for you to know the
rationale for community diagnosis. Rationales are basic ideas behind an
activity. Thus, for you to have an in-depth knowledge of the subject
matter the rationale must be stated clearly for you to grasp.

According to Eng. and Blanchard (1990) it appears that conducting a

needs assessment is a necessary component of program planning, but the
information is not sufficient for designing sustainable interventions. An
action-oriented community diagnosis procedure has been developed
over several years to identify normative and comparative needs
determined by service agencies as well as expressed and perceived
needs experienced by clients; assess community conditions contributing
to collective competence as well as the barriers and gaps contributing to
disease and illness; and increase collective competence of communities
and agencies to collaborate in defining problems and needs.

2.0 OBJECTIVES

At the end of this unit, you should be able to:

• identify the goals of community diagnosis

• State the rationale for community diagnosis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.0 MAIN CONTENT

3.1 Goals of Community Diagnosis

The aims of community diagnosis are to:

i. Analyse the health status of the community

ii. Evaluate the health resources, services, and systems of care
within the community
iii. Assess attitudes toward community health services and issues
iv. Identify priorities, establish goals, and determine courses of
action to improve the health status of the community
v. Establish an epidemiologic baseline for measuring improvement
over time.

3.2 The Rationale for Community Diagnosis

The rationales for community diagnosis are as follows:

i. Community diagnosis provides realistic information specific to a

community for which definite relevant plans are made in order to
solve problems.
ii. It makes the Community to be self-reliant and enables the people
to have their initiatives.
iii. Community diagnosis enables the people to identify their health
needs and use resources in a culturally and acceptable manner to
promote their health.
iv. It helps to identify constraints which can be addressed in the
planning process of any health programme in the community.

SELF-ASSESSMENT EXERCISE

List the goals of community diagnosis

4.0 CONCLUSION

In this unit you have learned the rationale for community diagnosis and
it is expected that you can state clearly the rationale for community
diagnosis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

5.0 SUMMARY

In order to achieve success in the delivery of adequate and effective

health care and for health facility to be utilised information about the
health status and infrastructure in the community must be understood. It
is therefore important to discuss the rationale for community diagnosis
which include the provision of realistic information relevant to Solve
health problems using identified resources, in a culturally and acceptable
manner.

6.0 TUTOR-MARKED ASSIGNMENT

State, at least, two rationales for community diagnosis.

7.0 REFERENCES/FURTHER READING

FMOH. (1996). Curriculum for Community Health Officers, Lagos.

Kyari, U. M. (2002). Introduction to Primary Health Care for Beginners

in
Community Health. Zaria: Sankore Educational Publishers.

Eng, E. & Blanchard, L. (1990). Action-oriented Community Diagnosis:

A Health Education Tool. Int Q Community Health Education.
1990 January 1;11(2):93-110. doi: 10.2190/W8MU-5H9X-
PQW1-LV38.

NwaforR, O. (2008). Health Management. Enugu: Beloved Computer

Services.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT3 STEPS IN COMMUNITY DIAGNOSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Steps in Carrying Out Community Diagnosis
3.2 Steps in Community Health Assessment Development
Process
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

In this unit, emphasis will be led on the necessary steps involved in

diagnosing a community. In order to carrying out community diagnosis
steps must be followed as a pre-requisite for community cooperation.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• explain the steps in community diagnosis

• discuss steps in community health assessment development
process.

3.0 MAIN CONTENT

3.1 Steps Involved in Carrying Out Community Diagnosis

In the process of community diagnosis the following steps are

necessary:

i. Make entry through the LGA into the community.

ii. Identify boundaries of the community.
iii. Make a sketch map of the community using established symbols
e.g. rivers, schools, markets and other important landmarks or
obtain a sketch map of the community from the Local
Government Office.
iv. Make a list of resources available in the community e.g.
industries, markets, churches, mosques, healthcare facilities and
personnel, organisations e.g. transport unions, non-government
organisations.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

v. Make a list of cultural practices and attitudes affecting health e.g.

those that are useful, harmful and harmless.
vi. Describe social customs and important festivals of the
community.
vii. Make a list of infrastructures in the community, e.g. electricity,
water supply, means of transportation etc.
viii. Collate information from the community.
ix. Conduct interviews and survey of social groups in the
community.
x. Write report using Federal Ministry of Health format.
xi. Give feedback to the LGA/State/ FMOH.

3.2 Steps in Community Health Assessment Development

Process

Assessment, planning models and frameworks, identifies ten steps in the

community health assessment development process (Department of
health, (DOH, 2006)). They are:

i. Establish the assessment team.

ii. Identify and secure resources.
iii. Identify and engage community partners.
iv. Collect, analyse, and present data.
v. Set health priorities.
vi. Clarify the issue.
vii. Set goals and measure progress.
viii. Choose the strategy.
ix. Develop the community health assessment document.
x. Manage and sustain the process.

SELF-ASSESSMENT EXERCISE

List the 10 steps in the Community Health Assessment development

process as indicated by Department of Health, (2006).

4.0 CONCLUSION

In this unit you have learned about the steps involved in carrying out
community diagnosis you should at this point be able to state the steps
for community diagnosis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

5.0 SUMMARY

This unit focused on the description of the steps involved in carrying out
community diagnosis. The steps should be followed starting with
making entry in the community and carrying othe activities.

6.0 TUTOR-MARKED ASSIGNMENT

1. List the first three (3) steps involved in community diagnosis.

7.0 REFERENCES/FURTHER READING

Community Health Practitioners Registration Board of Nigeria (2006).

Curriculum for Diploma in Community Health. Abuja: Miral
Press.

DOH (2006). 10 Steps in Community Health Assessment Development

Process. https://www.health.ny.gov/statistics/chac/10steps.htm,
Accessed 16/1/17.

National Primary Health Care Development Agency (2005). Briefing

Manual on Primary Health Care Services for NYSC Health
Professionals. Amawbia, Lumos Nig. Ltd.

FMOH (2004). Operational Training Manual and Guidelines for the

Development of Primary Health Care system in Nigeria. Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 4 METHODS FOR COMMUNITY DIAGNOSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Description of the methods used in community diagnosis

3.1.1 Observation
3.1.2 Interview
3.1.3 Focused Group Discussion
3.1.4 Review of Existing Records
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

This unit will focus on the various methods used in community

diagnosis.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

* describe the methods used in Community diagnosis

* explain Observation
* define Interview
* explain Group discussion
* discuss review of existing records.

3.0 MAIN CONTENT

3.1 Description of the Methods used in Community

Diagnosis

Every activity has methods of achieving its goals. There are different
ways of gathering information for community diagnosis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

These includes:

i. Observation,
ii. Interviews,
iii. Group discussion and
iv. review of existing records.

3.1.1 Observation

It is very important to determine the disease that affect the community

through observation and physical examination, because some diseases
are not easily recognised in the community e.g. Anaemia, dental caries
malnutrition, diabetes. In observation you observe their surroundings,
living conditions ,eating habits and life pattern to avoid wrong
impression. In observation also you are to use your eyes to see and also
hear some relevant information with your ears.

3.1.2 Interview

The act of interviewing, involves communicating with somebody e.g.

household heads, mothers. These are people who play important role in
the community in decision making on health matters or issues. You
should create a good rapport with the person so that he/she will feel free
to talk with you and give you the correct information about what you
need. The interview maybe face to face (verbally) or through
questionnaire (filling a prepared form).

3.1.3 Focused Group Discussion

Focused group discussion, unlike interview, is held with groups of

people and not an individual. It is useful in getting information on health
needs of the community that is what they feel as their most pressing
problems.

3.1.4 Review of Existing Records

Useful information can be obtained by reviewing existing records

particularly when trying to determine the population of a community,
the health facilities sand the health personnel as well as disease pattern
in the area. This information can be obtained from existing records.
These records maybe found in the:

i. Local Government Area office or in the health statistics

department;
ii. Reports on nutritional status surveys, basically, monitoring of
health status in the communities to determine the incidence of
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

mal nutritional diseases and proper treatment. This survey report

is important in community diagnosis;
iii. Maps: the map of the area is required for community diagnosis
iv. Reports by private organizations: NGOs and others could
produce useful reports on health status to assist in community
diagnosis; and
v. Research records of disease pattern: The incidence and pattern of
diseases in the area can help community diagnosis. These can
also be obtained from past records or research.

SELF-ASSESSMEENT EXERCISE

List the four methods of community diagnosis.

4.0 CONCLUSION

In this unit, you have known the various methods used in collecting
information for community diagnosis. At this juncture, you should be
able to describe the various methods.

5.0 SUMMARY

This unit has focused on the description, explanation and discussion on

the various methods used in community diagnosis which include
observation, interview, group discussion and review of existing records.

6.0 TUTOR-MARKED ASSIGNMENT

1. Discuss interview as a method in community diagnosis.

2. Explain the term focused group discussion

7.0 REFERENCES/FURTHER READING

Akinsola, H. A. (1993). A–Z of Community Health and Social Medicine

in Medical and Nursing Practice with Special Reference to
Nigeria. Ibadan: 3AM Communications.

Egwu, I. N. (2000). Primary Health Care Theory, Practice &

Perspective. Lagos: Elmore Publishers.

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 5 INFORMATION SOUGHT DURING

COMMUNITY DIAGNOSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Geography of the Area (Map)
3.2 Epidemiological Information Needed for Community
Diagnosis
3.3 Demographic Information Needed for Community
Diagnosis
3.4 Socio-Economic Conditions of the Community
3.5 Factors Affecting Health in the Community
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

When services are to begin in a community there is the tendency to have

a careful assessment of existing situations and relevant pieces of
information in the community that will enhance the planning of
interventions or health actions. This unit will help you to understand the
important information you will need for community diagnosis. In order
to discuss this subject properly, it will be necessary to have a view of
what you should learn in this unit, as indicated in the objectives stated
below.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• discuss the geography of the area (map)

• explain the Epidemiological information needed
• discuss the Demographic information needed
• state the socio-economic conditions
• state the factors that affect health in the community.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.0 MAIN CONTENT

3.1 Geography of the Area

The major aspects that relate to this idea are mainly based on them of
the area, which will also include major settlements, seasons, type of
vegetation and location in relation to other communities.

In order to carry out community diagnosis in a Community or Local

Government Area the use of maps is necessary. Oxford Advanced
Learner’s Dictionary 6th Edition defined Map as a drawing or plan of
the earth’s surface or part of it, showing countries, towns etc.

Ibet-Iraquinma (2006) defined Map as a flat representation of a place

including villages, Towns, Local Government Area, State and Country
on a paper in a diagrammatic form. Maps enables one to obtain
information about the topography of the area which include physical
features of a place for example terrain, mountains, rivers, streams,
vegetation seasons etc. It also ensures the identification of target areas,
shows distances to various facilities and settlements as well as to locate
population, and proximity of one settlement to another. The Local
Government Area map including that of towns and villages could be
obtained from the Chairman or the Local Government Council Area
office. If such a map is not available efforts should be made to initiate
the drawing of such a map.Using the characteristics of a map.

3.2 Epidemiological Information Needed for Community

Diagnosis

Akinsola, (1993) defines Epidemiology as the study of the pattern of

distribution of disease in human populations and the factors which
influence the distribution. The information required in this context will
include types of diseases and infections prevalent in the community,
their magnitude and distribution by sex, age, ethnicity, seasonal
variations and other dynamics.

Below are some of the necessary Epidemiological factors to take

cognisance of:

i. Disease: Nature and patterns of occurrence of illness in the

community.
ii. Occurrence: Sources of the disease and how it occurs in the
community.
iii. Frequency: Concerned with the estimation of amount of disease
or the condition of occurrence either during a given period of
time or at a particular time.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

iv. Distribution: The pattern produced by the disease in terms of time

it occurred per(a)person:-Male, Female (b) Place:-Temperate,
Tropical
v. Population: Group of individuals, community with common
characteristics.
vi. Dynamism: Progress of the disease in the population in terms of
changing pattern Over a period of time.
vii. Determinants: Variables affecting the frequency and Dynamism
of the disease in a community e.g .age, sex and Nutritional
factors.
viii. Population at Risk: Total number of community members in the
population tohave likelihood (Risk) of developing the diseases or
health problems.
ix. Morbidity: Degree of damage or effect caused by the disease in
the population of the community
x. Mortality: Percentage of death caused by the disease in the
population in a Community.

3.3 Demographic Information Needed for Community

Diagnosis

Demographic information required for community diagnosis will

involve the distribution of the population by sex, age, ethnic and
religious groups as this will determine how many people that will later
require specific adequate and effective services. The basic information
about the demographic profile of the committee is as follows:

• Population Size: Total number of people in the community.

• Population Growth: Rate of increase in population of the
community.
• Immigrant: Population of those people coming into the
community from other country
• Emigrants: Population of those persons moving outside the
community.
• Death Rate: Total number of death in a population of a
community.
• Birth Rate: Total number of birth in a population of a community.
• Sex: Gender quality of the community populace male or female.
• Age: Years of birth for individual community member.

3.4 Socio-Economic Conditions of the Community

These areas include occupations, income level, housing types, and living
conditions, educational level, source and nature of water supply and
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

others. These aspects of the Socio-economic status of the community

will be explored for community diagnosis to be carried out.

3.5 Factors that Affect Health in the Community

There are certain factors in the community that are detrimental to the
health status of the members of the community such as environmental
sanitation, personal hygiene, attitudinal and behavioral factors, customs
and beliefs.

Obionu, (2001) defined environmental sanitation as the process of

taming the environment so that it does not constitute hazard to man.
When the environment is not kept dirty,it becomes hazardous to man
and affect the health status of the community.

Ibet-Iragunima, (2006) defined Personal hygiene as all those personal

factors which influence the health and wellbeing of an individual. The
factors include lack of cleanliness, exercise, diet, alcoholism, smoking
and others influence the health of man. The way of life of the people
(culture) and their inclination to certain things (beliefs) also affect them
even their lifestyles. The areas of food, female circumcision and
perceptions about the values of health as well as illness behaviour
should be given priority attention.

4.0 CONCLUSION

In this unit, you have learned about the necessary information that will
be sought during community diagnosis. It includes map of the area,
epidemiology, and demographic and factors affecting health. You
should at this point be able to state the information to be sought during
the process.

5.0 SUMMARY

This unit has focused on the type of information to be sought during

community diagnosis. They include information about population, birth,
deaths, age, sex, geographical characteristics, and disease patterns,
environmental and cultural factors.

6.0 TUTOR-MARKED ASSIGNMENT

1. List six demographic information needed during community

diagnosis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

2. Enumerate three factors that affect the health status of the

community.

7.0 REFERENCES/FURTHER READING

Akinsola, H. A. (1993). A–Z of Community Health and Social Medicine

in Medical and Nursing Practice with Special Reference to
Nigeria. Ibadan: 3AM Communications.

FMOH (1996). Curriculum for Community Health Officers, Lagos.

Hornby, A. S. (2000). Oxford Advanced Learner’s Dictionary of Current

English (6th ed.). Oxford University Press.

Ibet – Iraqunima, M. W. (2006). Fundamental of Primary Health Care.

Port Harcourt: Paulimatex Printers.

Obionu, C. N. (2001). Primary Health Care for Developing Countries.

Enugu: Delta Publications.

Nwafor, R. O. (2008). Health Management. Enugu: Beloved Computer

Services.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

MODULE 3 SITUATION ANALYSIS

Unit 1 Concept of Situation Analysis

Unit 2 Rationale for Situation Analysis
Unit 3 Steps in Situation Analysis
Unit 4 Instruments Used in Situation Analysis
Unit 5 Role of Situation Analysis

UNIT1 CONCEPT OF SITUATION ANALYSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Explanation of the Concept of Situation Analysis
3.2 Definitions of Situation Analysis
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

In order to determine the ability of the health services to respond to the

problems existing in the area a careful assessment of the health situation
in the community is important. Information is collected from various
sources in the Wards/Local Government Areas to be covered. Thus,
situation analysis will determine the actual status of health in a given
community. This unit will enable you to understand the concept and
definitions of situation analysis. Before, we go further; it will be
expedient to have a view of what you will learn in this unit, based on the
unit objectives below.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• explain the concept of situation analysis

• define the terms situation analysis.

3.0 MAIN CONTENT

3.1 Explanation of the Concept of Situation Analysis

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Situation Analysis consists of a comprehensive inventory of health

facilities in the LGA, their distribution, the category of personnel and
other existing infrastructure. No health program can be adequate and
effective without the personnel in the system carrying inventory of what
is on ground. Therefore, Situation Analysis is a pre-requisite for
effective health services in the any area. The idea is to tackle the
problems identified during community diagnosis.

3.2 Definitions of Situation Analysis

FMOH (1996) defined Situation Analysis as the process of finding out

the actual status of health in a given community.

Ransome-Kuti, (1993) defined Situation Analysis as the process of

determining the ability of the health services to respond to the problems
identified through community diagnosis.

Ibet–Iragunima, (2006) defined Situation Analysis as the ability to find

out the health status of the community and the available personnel and
infrastructure to meet their needs.

The above definitions have emphasised on the health status of the

community in which case certain structure will be in existence or will be
required for them to maintain good health status.

4.0 CONCLUSION

In this unit, you have learned about the concept and definitions of
Situation Analysis as finding out the health status of a community. You
should at this juncture be able to explain the concept and definition of
Situation Analysis.

5.0 SUMMARY

This unit has focused on the concept of situation Analysis as a pre-

requisite for any health intervention in the community. It has also
defined Situation Analysis as the process of determining the health
status of the community. Unit two will build on this in discussing the
rationale for Situation Analysis.

6.0 TUTOR-MARKED ASSIGNMENT

1. Discuss the concept of Situation Analysis.

2. Define the term Situation Analysis.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

7.0 REFERENCES/FURTHER READING

FMOH, (1996). Curriculum for Community Health Officers. Lagos.

Ibet-Iragunima, M. W. (2006). Fundamentals of Primary Health Care.

Port Harcourt: Paulimatex Printers.

Ransome-Kuti O., Sarumgbe, A. O. O., Oyegbite, K. S. & Bamisaiye,

A. (1992). Strengthening Primary Health Care at Local
Government Level. The Nigerian Experience. Lagos: Academy
Press Ltd.

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 2 RATIONALE FOR SITUATION ANALYSIS

CONTENTS

1.0 Introduction
2.0 Objective
3.0 Main Content
3.1 Enumerating the Rationale for Situation Analysis
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Rationale for situation analysis simply means the fundamental reasons

or ideas behind the process of Situation Analysis. Since Situation
Analysis is a necessary condition for adequate health intervention in the
communities, it must have rationale. This unit will help you to
understand as well as state the rationale for situation analysis.

2.0 OBJECTIVE

By the end of this unit, you will be able to:

• enumerate the rationale for Situation Analysis.

3.0 MAIN CONTENT

3.1 Enumerating the Rationale for Situation Analysis

The rationales for Situation Analysis are as follows:

1. To determine the effectiveness of the health services and to

respond to the problems found in the Community or Local
Government Area.
2. To provide complete inventory of health facilities in the Local
Government Area or Community.
3. To identify the distribution of health facilities in the Community.
4. To identify category and number of personnel in the facilities.
5. To provide information on the type and adequacy of services
provided in all the facilities.
6. To provide information on the number of settlements in each
Community or Local Government Area.
7. To identify the availability of certain basic infrastructure that affect
health e.g. roads,electricity,telephones,portablewatersupply,schoolsetc.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

8. To provide a complete overview of health services, their strength

and weaknesses,health-relatedproblemsandinfrastructure.

4.0 CONCLUSION

In this unit you have learned the rationale for situation analysis. You
should at this point be able to enumerate the rationale for situation
analysis.

5.0 SUMMARY

This unit is based on the rationale for situation analysis and these
include determining the effectiveness of the services in the area,
distribution, availability as well complete overview of the problems and
infrastructure. Unit three will dwell on the information sought in
situation analysis.

6.0 TUTOR-MARKED ASSIGNMENT

State three (3) rationales for situation analysis.

7.0 REFERENCES/FURTHER READING

Kyari, U. M. U. (2002). Introduction to Primary Health Care for

beginners in Community Health: Nigerian Experience. Zaria: Sankore
Educational Publishers.

NDHCDA (2005). Brief Manual on Primary Health Care Services for

NYSC Health Professionals. Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 3 INFORMATION SOUGHT FOR SITUATION

ANALYSIS

CONTENTS

1.0 Introduction
2.0 Objective
3.0 Main Content
3.1 Information Sought for Situation Analysis
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Information is a necessary tool for planning any intervention or health

actions. In order to conduct situation analysis specific information will
be required for the success of the exercise. This unit will help you to
understand the necessary information required for this important
process.

2.0 OBJECTIVE

By the end of this unit, you will be able to:

• state the information sought during Situation Analysis

3.0 MAIN CONTENT

3.1 Information Sought for Situation Analysis

In the process of carrying out situation analysis, the following

information is necessary:

1. Information on LGA and Community.

2. Population by District/Wards
3. Information on LGA Health Budget
4. Health facility by type
5. Health Personnel category, number and location.
6. School population and type.
7. Socio-economic status (income level, occupation)
8. Public Utilities and Services
9. LGA PHC activities
10. LGA logistic support etc.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

These information are needed for situation analysis process to achieve

its rationale.

4.0 CONCLUSION

In this unit, you have learned the necessary information to be sought in

the process of situation analysis. You should be able to state the
information required for situation analysis.

5.0 SUMMARY

This unit has focused on the information required for situation analysis.
In determining the health needs of the local government area or
community, adequate consideration must be given to the situations in
the community. This is based on the collection of relevant information
about health facilities, personnel and other infrastructure in the
community.

6.0 TUTOR-MARKED ASSIGNMENT

Enumerate at least five (5) information sought for Situation Analysis

7.0 REFERENCES/FURTHER READING

Abosede, O. A. (2003). Primary Health Care in Medical Education in

Nigeria. Lagos: University of Lagos Press.

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications.

WHO (1978). Report of the International Conference on Primary Health

Care, Alma Ata USSR 6-12 September, 1978.

NPHCDA (2004). Operational Training Manual and

Guidelines the Development of Primary Health Care System in
Nigeria, Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 4 STEPS IN CONDUCTING SITUATION

ANALYSIS

CONTENTS

1.0 Introduction
2.0 Objective
3.0 Main Content
3.1 Identification of the Steps in Conducting Situation
Analysis
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

In an attempt to conduct situation analysis certain steps are required for

easy access to the local government areas and communities. This unit
will expose you to the necessary steps for this exercise.

2.0 OBJECTIVE

By the end of this unit, you will be able to:

• Identify the steps in conducting Situation Analysis

3.0 MAIN CONTENT

3.1 Identification of the Steps in Conducting Situation

Analysis

This process involves the following:

1. Contacting the Local Government Area Office.

2. Contacting the village development committee;
3. Obtaining the instrument to be used from the Federal Ministry of
Health;
4. Training the Interviewers;
5. Practice role-playing with the instruments;
6. Arranging for snacks and transportation for the interviewers;
7. Assign individuals and provide them with materials;
8. Collating data from the field; and
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

9. Writing report using FMOH format.

10. Give feed back to the community and other health workers.
11. Submit report to LGA/State/FMOH

4.0 CONCLUSION

In this unit you learned the steps involved in conducting situation

analysis in the local government area or community. At this point, you
should be able to identify the steps necessary in conducting situation
analysis.

5.0 SUMMARY

This unit has emphasised on the necessary steps in conducting Situation

Analysis which includes contacts with LGAs, communities training
individuals and assigning task to them as well as writing reports on the
exercise for the improvement of the health status of the communities.
Unit five will describe the instruments used for this exercise.

6.0 TUTOR-MARKED ASSIGNMENT

List the steps involved in conducting Situation Analysis

7.0 REFERENCES/FURTHER READING

FMOH. (2004). Operational Training Manual and Guidelines for the

Development of Primary Health Care system in Nigeria. Abuja.

NPHCDA. (2005). Brief Manual on Primary Health Care services for

NYSC Health Professionals. Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 5 INSTRUMENTS USED IN SITUATION ANALYSIS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Description of the Instruments used in Situation Analysis
3.2 Form H
3.3 Form C
3.4 Form F
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

For situation analysis to be effectively conducted certain instruments

have been established for this purpose by the federal ministry of health.
This unit will acquaint you with the instruments useful for this exercise.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• describe the instruments used in situation analysis

• explain Form H
• discuss Form C
• explain Form F.

3.0 MAIN CONTENT

3.1 Description of the Instruments used in Situation Analysis

There are specific instruments designed for this exercise. They include
Form H for household, Form C for children and Form F for married
women under 50years and women who have never been pregnant.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.2 Explanation of Form H

Form H: This is called household questionnaire. These forms contain the

list of all members of the household – their demographic characteristics
and also documented illness episode for the past months.

3.3 Discussion on Form C

Form C: It is the children questionnaire. It focuses on children, their

immunization status, their diarrhea episode and what was used for
treatment or to cure them. Information from this form gives an in-depth
understanding of the health problem in each Local Government Area
and it also gives information on health knowledge and health-
seekingbehaviour. The questionnaire also provides a list of illnesses that
are prevalent in the community or Local Government Area.

3.4 Explanation of Form F

Form F: This is the female questionnaire for female, married or

unmarried under fifty (50) years and women who have never been
pregnant. This questionnaire probes into the number of children each
woman in the household had dead or alive. It also inquires into what
material health services the woman had during her last pregnancy.

4.0 CONCLUSION

In this unit, you have learned what the instruments used in situation
analysis are such a s Forms H, C and F. the forms have also been
described. You should at this juncture be able to discuss or explain any
of the Forms.

5.0 SUMMARY

This unit has focused on the description of the instruments used in

situation analysis. The instruments include For ‘H’ to collect household
information, Form ‘C’to collects child information and Form ‘F’to
collect information on female married and under fifty (50) years and
women who have never been pregnant.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

6.0 TUTOR-MARKED ASSIGNMENT

1. Briefly explain the following:

(a) Form‘H’
(b) Form‘C’
(c) Form‘F’

7.0 REFERENCES/FURTHER READING

CHPRBN (2006). Curriculum for Higher Diploma in community Health

Abuja. Miral Press.

EgwuI, N. (2000). Primary Health Care system in Nigeria: Theory

Practice & Perspective. Lagos: Elmore Publishers.

Ransome-Kuti, O., Sorungbe, A.,O.,O., Oyegbite, K.,S. & Bamisaiye,

A. (1992). Strengthening Primary Health care at Local
Government Level: The Nigerian Experience. Lagos: Academy
Press Ltd.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

MODULE 4 ADVOCACY

Unit 1 Concept of Advocacy

Unit 2 Rationale for Advocacy
Unit 3 Steps in Advocacy
Unit 4 Processes and Methods for the Design of Advocacy
Messages
Unit 5 Use of Advocacy Materials

UNIT 1 CONCEPT OF ADVOCACY

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Concept of Advocacy
3.2 Definition of Advocacy
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

This unit examines the concept and definitions of advocacy. It basically

involves soliciting support for any programme at the Local Government,
State and Federal Levels. This unit will assist you to understand
Advocacy and its components.

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• explain the concept of Advocacy

• define the term Advocacy.

3.0 MAIN CONTENT

3.1 Concept of Advocacy

Much needs to be done to maintain effective communication strategy for

advocacy as regards to any programme. At the policy level, there is very
little awareness on the part of some policy makers about certain
programmes especially a regards the irrational and benefits.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Consequently, advocacy greetings and visits are necessary for the

achievement of some major objectives of such programmes.

3.2 Definition of Advocacy

FMOH (2005) defined Advocacyas a process ofsensitizing with

subsequent followup of policymakersandotherstoarousetheirinterest
soastogetthem committedtoprogrammesespeciallyPHC programmes.

Olise, P. (2007) stated that advocacy is also the process of creating

awareness concerning any programme among policy makers and others
inorder to solicit their support and commitment.

You will discover that in these definitions emphasis is laid on

sensitization, creating awareness and arousing interest of people so as to
be involved in health programmes. It is not one day activity but a
continuous process.

4.0 CONCLUSION

In this unit, you have learned what concept and definition of advocacy
meant. The idea of Getting people committed to a programme and
creating awareness among policy makers and others on health issues.

You should at this point be able to explain the idea behind Advocacy.
Also you should be able by now to define Advocacy as a mean or
process of sensitisation of people.

5.0 SUMMARY

This unit has focused on the concept of Advocacy and definition of

Advocacy. It explain that there is need to interact with people as well
create awareness and sensitise them towards health progress so as to
achieve the objectives of Health Services.

Advocacy meetings are organised for Community leaders including

government functionaries, councilors, local government chairman,
traditional rulers, governors, presidents, legislators, permanent
secretaries, and directors commissioners of health etc.

6.0 TUTOR-MARKED ASSIGNMENT

1. Explain the concept of Advocacy.

2. Define Advocacy.

7.0 REFERENCES/FURTHER READING

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

FMOH. (2005). Brief Manual or Primary Health Care Services for

NYSC Health Professionals. Abuja.

Ibet-Iragunima, M. W. (2006). Fundamentals of Primary Health Care.

Port Harcourt: Paulimatex Printers.

FMOH. (2004) Operational Training Manual and Guidelines for the

Development by Primary Health care system in Nigeria. Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 2 RATIONALE FOR ADVOCACY

CONTENTS

1.0 Introduction
2.0 Objective
3.0 Main Content
3.1 Discussion of the Rationale for Advocacy
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

Rationale simply refers to fundamental reasons or ideas behind an

activity. Since Advocacy is a very important strategy to achieve the
objectives of any programmes especially health interventions the
rationale should be explicit for people to understand. It should however
be borne in mind that for us to discuss more on this unit you will take a
look at the objectives indicated below.

2.0 OBJECTIVE

By the end of this unit, you will be able to:

• discuss the rationale for advocacy

3.0 MAIN CONTENT

3.1 Discussion on the Rationale for Advocacy

Advocacy is necessary for acquainting policy makers of their role and

responsibility in relation to identified health goals. This will usually
include explanations why such roles are important. When policy makers
understand their roles and underlying reasons, they will be better
disposed to provide the support and the help required from them.

In view of the facts stated above one can adduce that Advocacy is
necessary for the implementation of any health programme or any other
programme.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

4.0 CONCLUSION

In this unit, you have learned about the rationale for advocacy as in
equanon (necessary condition) for the execution of any programme. At
this point you should be able to discuss or explain the rationale for
advocacy.

5.0 SUMMARY

This unit emphasised on the rationale for advocacy as a pre-requisite for

programme implementation. Advocacy is arousing interest of people to
support any programme. It aims to achieve programme objective and the
rationale are concise.

6.0 TUTOR-MARKED ASSIGNMENT

Explain the rationale for Advocacy.

7.0 REFERENCES/FURTHER READING

Olise, P. (2007). Primary Health Care for Sustainable Development.

Abuja: Ozege Publications.

Ransome-Kuti, O. S., Orungbe, A. O. O., Oyegbite, K. S. & Bamisaiye,

A. (1992). Strengthening Primary Health Care at Local
Government Level: The Nigerian Experience. Lagos: Academy
Press Ltd.

FMOH (2004). Operational Training Manual and Guidelines for the

Development of Primary Health Care System in Nigeria. Abuja.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 3 STEPS IN ADVOCACY

CONTENTS

1.0 Introduction
2.0 Objective
3.0 Main Content
3.1 Steps in Advocacy
4.0 Conclusion
5.0 Summary
6.0 Tutor-MarkedAssignment
7.0 References/FurtherReading

1.0 INTRODUCTION

This unit involves making initial contacts or visits to policy makers and
discussing the objectives of the programmes in order to get the people
fully involved.

2.0 OBJECTIVE

By the end of this unit, you will be able to:

• list the steps in Advocacy

3.0 MAIN CONTENT

3.1 Steps in Advocacy

In order to carry out a successful Advocacy, there is the need to follow

concrete steps to have contacts with policy makers and other groups that
are relevant in the implementation of programmes especially health
programmes .In order to follow the steps we must note the focus groups
bo that the Local Government, State and Federal Levels.

A. Focus Groups of Advocacy at the LGA level

1. The Chairman
2. The Secretary
3. The Supervisory Councilor for Health

4. The LGA PHC Co-ordinator (MOH)

5. The LGA PHC Committee
6. Traditional Rulers etc.

Steps in Advocacy at the Local Government level

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

1. Make initial visit to LGA/Policy Makers.

2. Discuss with the LGA functionaries, the following:
(a) Objective of the Programme;
(b) The responsibility of the LGA, NGOs, communities and
individuals;
(c) Explain the National Health Policy as its relates to PHC
Programme.
(d) The need for proper implementation of the programme;
and
(e) Formation of management committees at various levels.

B. Focus Groups for Advocacy at the State Level

1. The State Governor

2. House of Assembly Members
3. Commissioner for Health and others.

Steps in Advocacy at State Level

Make initial visit to the governor and other policy makers and discuss
intentions and objectives of the programme as well as for them to launch
the programme.

C. Focus Groups for Advocacy at the Federal Level

1. The President
2. Members of the National Assembly
3. Chief Executives of Federal Government Agencies and
Parastatals.

Steps in Advocacy at the Federal Level

Make initial visit to the President, Ministers and members of the

National Assembly as well as other important in the system. Solicit for
the launching of the programmes as well as expatiating on the objectives
of the programmes and its relationship to the national Policy.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

4.0 CONCLUSION

This unit has exposed you to the focus groups at the different levels for
advocacy and the specific steps at each level. At this point, you should
be able to list the steps in advocacy.

5.0 SUMMARY

This unit has focused mainly on the steps to be adopted in ensuring that
initiators of programmes solicit for support from policy makes in order
for the programmes to be vibrant and successful.

6.0 TUTOR-MARKED ASSIGNMENT

1. List the steps in Advocacy at the Local Government level.

2. Enumerate the focus group for Advocacy at the Federal Level.

7.0 REFERENCES/FURTHER READING

NPHCDA. (2005). Briefing Manual on Primary Health Care Services

for NYSC Health Professionals. Abuja.

CHPRBN. (2006). Curriculum for Higher Diploma in Community

Health. Abuja: Miral Press.

Abosede, O. A. (2003). Primary Health Care in Medical Education in

Nigeria. Lagos: University of Lagos Press.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 4 PROCESSES AND METHODS FOR THE

DESIGN OF ADVOCACY MESSAGES

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Identification of the Processes and Methods for the Design
and Advocacy Messages
3.2 Discussion on the Processes and Method for the Design of
Advocacy Messages
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

The processes of designing Advocacy messages involve a series of

things that are done in order to achieve results of advocacy. Since
advocacy is a means of seeking support to ideas, the methods to be used
should be in the mainstream of activities. It will be necessary for
individuals, groups or organisations to formulate concrete action plans
to enable advocacy yield results. This unit will help you understand the
processes and methods for the design of advocacy messages. Before we
do this, let us have a view of what you should learn in this unit, as stated
in the objectives

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• identify the processes and methods for the design of advocacy

messages
• discuss the methods for the design of advocacy messages
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

3.0 MAIN CONTENT

3.1 Identification of the Processes and Methods for the

Design Advocacy Messages

The most likely processes and methods to be used by individuals, groups

or organisations to design advocacy messages are as follows:

1. Invitation of key policy makers to take part in selected activities

2. Strategic alliances among like–minded initiatives
3. Joint/collaborative activities
4. Media (TV, Print, Electronic, Radio)
5. Field Visits
6. Brainstorming
7. Lecture
8. Symposium
9. Lobbying

3.2 Discussions on the Processes and Methods for the Design of

Advocacy Messages

Methods for the design of advocacy message are synonymous with

methods used in health education. These methods are strategies and/or
processes through which information is presented to the target during
advocacy.

1. Invitation of Key Policy–makers to take part in selected

activities:
Advocacy part in selected activities: Advocacy messages should
occupy the mainstream of the activities. Many organisations do
this by inviting key policy makers to take part in selective
activities such as training events and workshops, and often
inviting them to open and or close the events. Basically there is
the need to prepare and use a combination of specific tools and
approaches.

2. Strategic Alliances among Like-Minded Initiatives: In line

with the overall advocacy strategy and for results to be achieved,
strategic alliances among like-minded initiatives should be
encouraged. This alliance which involves people of like-minds
could form a growing alliance especially when it involves
members of the target group. This will create a greater impact
too.

3. Joint/Collaborative Activities: Joint activities with members of

the target audience could enhance Advocacy through a working
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

process. In collaborative activities, ideas of the advocates

gradually become cleaver to all involved, ensuring deeper
knowledge of the programme by the target audience. To convince
senior officials in government, NGOs, and other relevant
organisations of approaches behind any programme, there need to
participate in interesting programme activities

4. Media (TV, Print, Electronic, Radio) the use of various media,

experiences and other programmes can be shared with members
of the target audience. When the main target audience consist so
factors in policy making the media will probably be printed
material and electronic media to enable policy makers understand
the ideas behind the intended programme.

5. Field Visits: This involves the target group being taken out to
visit some programmes/events that need to be carried out
concerning the intended programmes. This is ideal for developing
policy makers’ attitudes and decision making on the intended
programme.
6. Brainstorming: This is a critical examination of ideas, problems,
situations and appraisal of issues between the
campaigners/advocates and the target audience or policy makers

7. Lecture: This involves a straight forward discussion, a pre-

planned structured scheme delivered as a topic in a session. Here,
the Advocates talk to the target audience about the intended
programme including its objectives

8. Symposium: This involves presentation of papers on relevant

facts about the intended programme to the target audience in a
venue. The idea is to express the full aspects of the intended,
programme for the public to buy the idea and support its
implementation.

9. Lobbying: This is a process of convincing individuals or

members of the public on the need to support the intended
programme. Lobbying and advocating with external institutions,
organisations and people provide a weightier support base to
convince or influence positively towards the intended
programmme that needs implementation.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

4.0 CONCLUSION

In this unit, you have learned the processes and methods for the design
of Advocacy messages. You have realised that the messages can be
passed to target audience through some methods like alliances,
collaborative activities, field visits and lobbying.

Advocacy methods can only succeed only where there is commitment

on the campaigners or those who are to use it. The people must believe
in the issue that is the subject of their campaigns, even when they lose,
let the loss be a reference point for hard work and not a setback.
Conclusively, no matter the amount of preparation before deciding to
use any of these methods, remember that the unexpected might happen
but always have hope and believe in our potential success.

You should at this point be able to identify processes and methods for
the design of advocacy messages. Also, you should be able to discuss
the various methods for the design of advocacy messages.

5.0 SUMMARY

This unit has focused on the processes and methods for the design of
advocacy messages by groups or organisations to enable policy makers
support and ensure the implementation of the programme. The processes
and methods include invitation to policy makers, collaborative activities,
field visits, brainstorming, symposium lobbying and others

6.0 TUTOR-MARKED ASSIGNMENT

1. Identify at least five methods for the design of Advocacy

messages
2. Discuss the following Advocacy methods
(a) Brainstorming
(b) Field visit
(c) Lobbying

7.0 REFERENCES/FURTHER READING

Abosede, O. A. (2003). Primary, HealthCare in Medical Education in

Nigeria. Lagos: University of Lagos Press.

CHPRBN (2006). Curriculum for Higher Diploma in Community

Health. Abuja: Miral Press.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Keck, M. E. & Sikkink, K. (1998). Activists Beyond Borders: Advocacy

Networks in International Politics. Baltimore: MD Cornel
University Press.

Jernugan, D. H & Wright, P. (1996). Media Advocacy: Lessons from

Community Experiences Journal of Public Health Policy Vol. 17.
N03:306-330.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

UNIT 5 USE OF ADVOCACY MATERIALS

CONTENTS

1.0 Introduction
2.0 Objectives
3.0 Main contents
3.1 Identification of Advocacy Materials
3.2 Use of Advocacy Materials
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Reading

1.0 INTRODUCTION

In order for effective Advocacy to take place some materials

including information, communication and audio–visual aids are
necessary. These materials are essential because, in order for an
individual to accept or adopt a new behaviour he must pass through
some stages which the materials must address. This unit will help us to
understand the uses of the materials for advocacy which was partly
discussed n unit four.

However, before we go further, let us take a look at what you should

learn in this unit as indicated in the unit objectives below:

2.0 OBJECTIVES

By the end of this unit, you will be able to:

• identify advocacy materials

• state the uses of Advocacy materials.

3.0 MAIN CONTENT

3.1 Identification Advocacy materials

Advocacy materials and processes include information, communication,

education, audio-visuals, flip charts, reference books and journals. These
materials help to enhance advocacy messages in order to achieve the
objectives of the intended programmes and satisfy the desires of the
advocates.

3.2 Uses of Advocacy Materials

PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

Exposure to advocacy materials is necessary for conviction and

acceptance of the intended program me by the target audience.

Advocacy materials are useful for:

1. Creating awareness
2. Motivating people and promote desired changes in behaviour of
the target audience
3. Advocacy materials educate and inform people
4. They explain the need for change
5. Advocacy materials carry information that is easily understood,
remembered and retained for future use.

4.0 CONCLUSION

In this unit, you learned about advocacy materials and their usage. The
materials include audio-visuals and their uses and understanding of the
initiated programme. You should at this point be able to identify the
materials. Also you should be able by now to state he uses of the
advocacy materials.

5.0 SUMMARY

This unit emphasised on the identification of advocacy materials and

their uses. The Advocacy materials include information, education,
communication, audio- visuals, reference books, journals and others.
The uses of Advocacy materials are creating awareness, motivation,
explanation of ideas and changes as well as education.

6.0 TUTOR-MARKED ASSIGNMENT

1. Identify three Advocacy materials.

2. Enumerate three uses of Advocacy materials.
PHS 322 COMMUNITY MOBILISATION AND PARTICIPATION

7.0 REFERENCES/FURTHER READING

Abosede, O. A. (2003). Primary Health Care in Medical Education in

Nigeria. Lagos. University of Lagos Press.

Douglas Oronto Lecture Note Nigeria: Using a Variety of Advocacy

tools in the Niger Delta. Port Harcourt.