Let’s Get EngagedLet’s Get Engaged

Active Community Active Community EngagementEngagement (ACE)(ACE)

Nancy Russell

The ACQUIRE Project

Global Health Council Auxiliary Meeting May 28, 2008

You will learn about the different levels of community engagement for health

You will be familiar with the ACE continuum to aide you in your project work

You will come to understand that empowerment influences health outcomes….

And more!!!

Session Objectives

Community Engagement Defined

Active Community Engagement (ACE) continuum

ACQUIRE Lessons Learned

Program implications

Moving Forward

ACE Game

Presentation Content

Community Engagement Defined

“The process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being.”

CDC, “Principles of Community Engagement”, 1997

Community Engagement

“Are we there yet?” Why do we ask this question?– Lack information– Lack control

When we are engaged in the process we have– More information– More choice– More decision making– More often

As communities are more engaged, communication moves from vertical to horizontal – From messages to dialogue to decision making

What is the ACE continuum?

A framework based on ACQUIRE experience and literature

Shows empowerment increases with each level of engagement

Shows all community engagement is valid - and levels depend on multiple factors (time, $, expectations)

ACE builds joint vision and indicators for success

Overview of ACE Continuum

Framework for planning and assessing community engagement

Three levels of Engagement

5 characteristics of Empowerment*

– Community involvement in assessment

– Access to information

– Inclusion in decision making

– Local organizational capacity to advocate

– Accountability of institutions to public

*Narayn, D, World Bank, 2oo2 and Dr. Michael Hatcher, CDC, 2007

Need to value partnerships

Be clear about the purpose of community engagement

Define terms

Collaboration and flexibility

Determine level of engagement from beginning

Clear indicators and expected outcomes

Engage and re engage

Budget for maintaining community engagement

Principles of Community Engagement

Quality client-provider

interaction

Quality client-provider

interaction

• Leadership and champions fostered • Supportive service policies promoted• Human and financial resources allocated

• Leadership and champions fostered • Supportive service policies promoted• Human and financial resources allocated

• Service sites readied

• Staff performance improved

• Training, supervision, referral, and logistics systems strengthened

• Service sites readied

• Staff performance improved

• Training, supervision, referral, and logistics systems strengthened

• Accurate informationshared

• Image of services enhanced

• Communities engaged

• Accurate informationshared

• Image of services enhanced

• Communities engaged

Fundamentalsof Care

StakeholderParticipation

““More More MoreMore More More Services People Places”Services People Places”

to into in

Data for Decision Making

Increased knowledge Increased knowledge + acceptability+ acceptability

Increased availabilityIncreased availability

Improved policy + program environmentImproved policy + program environment

DemandSupply

Advocacy

Increased Access, Quality and UseIncreased Access, Quality and Use

Gender Equity

Communities engaged

ACQUIRE Lessons Learned

Engagement moves from passive to active at each level.

Power sharing increases with each level of engagement.

ACQUIRE Lessons Learned

One, two or three levels of ACE can exist in one project.

Adopting shared language and expectations critical to partnerships

Champions are critical.

Project Lessons Learned

Empowerment outcomes emerge with health outcomes

Use of participatory processes and tools important

Moving Forward

FP/RH service delivery programs define community engagement along a continuum

Time of reduced resources can build on community linkages

Decentralization is opportunity to become less vertical in planning community interventions

The ACE framework is used to initiate discussion and build a way forward with a common vision

Let the Games the Begin!!!

ACE cards will be distributed

Each table will work as a team – or divide into teams

Review the outcomes for each level and each category of ACE on one side of the card

Choose activities from the set of labels – place a label where you think it belongs – forming an A, C or E with the filled spaces on the card

First group to form a letter will get a prize.