drph (unimas) dho betongoutcome • weaknesses rectified • vhp programme was extended to more...

CommunityEmpowermentinHealthDrJohnnyPangkasDrPH(UNIMAS)

DHOBetong

BetongStateComplex

THE17SUSTAINABLEDEVELOPMENTGOALS

OverviewofpresentaFon

• Overview• Approach• Benefits• ValuesandDimensionofCommunityEmpowerment•  ExamplesofStudies•  Sharing• Conclusion

DefiniFon

• CommunityempowermentreferstotheprocessofenablingcommuniFestoincreasecontrolovertheirlives.

• "CommuniFes"aregroupsofpeoplethatmayormaynotbespaFallyconnected,butwhosharecommoninterests,concernsoridenFFes.

DefiniFon

• WHOdefinesempowermentas“aprocessthroughwhichpeoplegaingreatercontroloverdecisionsandacFonsaffecFngtheirhealth”

• WorldBankdefiniFon:processofincreasingcapacityofindividualsorgroupstomakechoicesandtotransformthosechoicesintodesiredacFonsandoutcomes.

WallersteinN(2006).Whatistheevidenceofeffec0venessofempowermenttoimprovehealth?Copenhagen,WHOregionalofficeforEurope(HealthEvidenceReportNetwork.

• CommunitydefiniFon•  AcommondefiniFonofcommunityemergedasagroupofpeoplewithdiversecharacterisFcswhoarelinkedbysocialFes,sharecommonperspecFves,andengageinjointacFoningeographicallocaFonsorseZngs.

•  Empowerment•  CommunityempowermentreferstotheprocessofenablingcommuniFestoincreasecontrolovertheirlives

CommunityEmpowerment

HealthPromoFonh[p://www.who.int/healthpromoFon/conferences/7gchp/track1/en/

Green&Mercer.AmericanJournalofPublicHealth|December2001,Vol91,No.12

History

•  1978,WHO’sAlmaAltafirstarFculatedthegoalsofcommunityparFcipaFonandequity

•  ExtensiontoempowermentintheO[awaCharter• UnitedNaFonMDG,women’sempowermentandhealthintervenFons

ParFcipaFon• CommunityparFcipaFoncreatesa‘sociallearning’processwherebyprofessionalsandlocalpeoplelearnfromeachotherandbuildworkingpartnershipsforsustainableimprovements.

Thantzelal

Theissues

• DispariFes,• socialexclusion• absolutepoverty


Theissues

•  LimitaFonsofhealthprofessionalsinimprovinghealth•  SelfCare(SC)andcommunityparFcipaFon•  Selfcare

•  LaypersonfuncFonsonhis/herbehalfinhealthpromoFonandprevenFonandindiseasedetecFonandtreatmentatthelevelofprimaryhealthresourceinthehealthcaresystem

KhanidiraKumarBhuyan,BMCPublicHealth2004

RaFonales

• HealthisessenFalforhumansurvivalandcapability

• CommunityparFcipaFon–efficientandcosteffecFve

•  Increaseskillsandknowledgeofpeople

Thantzetal2013,MalaysianJournalOfPublicHealth

AzwarA.TherolesofprimarycarephysicianinAchievingMDGS.JMAJ.52(6):375-379.

Approach

•  Empowermentenhanceindividualcompetenceandselfesteemwhich,inturn,increasepercepFonsofpersonalcontrolwhichhasadirecteffectonimprovinghealth.

•  IndividualacFon–smallmutualgroups–organizaFons–socialandpoliFcalacFons.

• CommunityorganizaFons–opportunityforthememberstogainskillsandcompetenciesnecessarytoallowthemtomovetowardsachievinghealthoutcomes

Community Analysis

•  Community analysis involves reviewing demographic, health and other essential data about the community or population and how it compares to national or regional averages.

•  This initial assessment of the community helps identify key stakeholders, target groups and provides a basis for community engagement.

•  Once the target group is identified, develop a clear description of the target group to further focus the next steps of problem and determinant analysis.

Bhuyan2004.BMCPublicHealth

Approach

LowndessandPrache[,2008

ContraCosta,HealthServices

CollaboraFonwithotheragencies

• Districtoffice• Localcouncil• PoliFcalleaders• NGOs• Otheragencies

CommunityDevelopmentValues

• Recognisingtheskills,knowledgeandexperFseLearning• ChallengingdiscriminaFonandoppressivepracFcesEquality• InvolvementofpeopleintheissuesParFcipaFon• WorkingtogethertoidenFfyandimplementacFonCo-operaFon• Humanrights,meettheirneedsandgreatercontroloverdecisionmakingprocessSocialjusFce

DimensionsofCommunityEmpowerment

•  Increasepeople’sknowledgeandskillsConfident• PromoteequalityandopportunityInclusive• BringpeopletogetheraroundcommonissuesOrganised• PromotepartnershipCo-operaFve• EncourageandequipcommuniFestotakepartInfluenFal

Benefits

•  Improvementinpeoplehealth• Moreefficientuseofresources•  Findingnewwaystodeliverservices

Capacitybuilding

•  Community engagement as a strategy within a capacity building approach can thus be described as a ‘bottom-up’ approach, informed by and owned by the community.

•  Capacity building can present challenges for health professionals because it necessarily involves health practitioners relinquishing control and working towards a role obsolescence.

•  Capacity building can be seen as a central health promotion strategy and is a continual process that acts in parallel at each point along the public health intervention management cycle.

Expectedoutcomes•  AWorldHealthOrganizaFon(WHO)EuropepublicaFononcommunityparFcipaFoninlocalhealthandsustainabledevelopment10:12-13summarisestheraFonaleto:

•  increasedemocracy,asparFcipaFonisbothabasicrightandanessenFalelementofciFzenship

•  combatsocialexclusionbygivingpeopleavoice,especiallymarginalisedpopulaFons•  empowerindividualsandcommuniFesandenablethemtogainmorecontrolovertheirlives

•  mobilisecommunityresourcesandenergy•  developholisFcapproaches•  aiddecision-makinganddesignmoreeffecFveservicesthroughbe[erlocalintelligence

•  ensurecommunityownershipandulFmatelythelong-termsustainabilityofprogrammes

Gregson,RachelwithCourt,Liz(2010).BuildinghealthcommuniFes:Acommunityempowermentapproach.

Expectedoutcomes

•  Evidentinbe[erhealthandimprovedservices• Non-healthprofessionalsencouragetoworkoutwhatbeenhealthymeansmeanttothem

• ReducFonofhealthcarecost

CommunityEmpowermentStudies

• AcommunitybasedintervenFonthrough1stop-centreforhealth:AcommunityempowermentapproachinMalaysia

•  ReduceNCDriskfactors•  107people,PantaiPeringgitCommunity•  Conductedby10volunteers•  Obesityreduced•  ReducedBP• WalkingFmefor5KMalsoreduced.

GenevaHealthForumArchive

• Communityempowerment–asuccessfulmodelforprevenFonandnoncommunicablediseasesinIndia–theChenaiUrbanPopulaFonStudy

•  AsiadColony•  EducaFononbenefitsonphysicalacFviFes–publiclecturesandmassvideo•  Result–increasedinnumberofpeopleinvolvedinphysicalacFviFes•  IncreaseinnumberofpeoplewhowalkthreeFmesaweek

CommunityEmpowermentStudies

Movanetal(2006).Communityempowerment–asuccessfulmodelforprevenFonofnoncommunicablediseasesinIndia–theChennaiUrbanPopulaFonStudy.JAssocPhysicianIndia

Village Health Promoters

TheProgramme

• Community-basedhealthprogramme•  IniFatedbySarawakHealthDepartmentin1983tohelpachieveHealthForAll

•  Improvesaccesstoprimaryhealthcareinunder-servedareas

• AchievedthroughVillageHealthPromotersorVHP

•  Serve as entry points through which we can build smart partnerships & encourage communities to take responsibility for their own health

The Concept

Belikau longhouse, Kapit

TheEvaluaEon•  TwomajorevaluaFonsdonesofar,bothincollaboraFonwithInsFtuteforMedicalResearch:

•  FirstevaluaFonin1985–1986

•  SecondevaluaFonin2000-2001

Outcome •  Weaknesses rectified •  VHP programme was extended to more

villages throughout Sarawak

Conclusion of evaluation •  VHP programme is still relevant, especially in the

remote areas in Sarawak •  Some changes in focus needed to keep it in tandem

with current health scenarios

WKKConference

KOSPEN

Saringan kesihatan

41

lokaliti

42

Workplace

KELABWARGAEMAS,KKSPAOH

DENGUECONTROLACTIVITIES

BAKAS–GravityFeed

PANELPENASIHATKLINIK

OTHERACTIVITIES

THANKYOU

SEGULAISEJALAINUJUPENGERAI

drph (unimas) dho betongoutcome • weaknesses rectified • vhp programme was extended to more...

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