COMPETENCY APPRAISAL

COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH

Definition:

COPAR is the social development approach that aims to transform the apathetic, individualistic and voiceless poor into dynamic, participatory and politically responsive community. COPAR is collective, participatory, transformative, liberative , sustained and systematic process of buildings peoples organizations by mobilizing and enhancing the capabilities and resources of the people for the resolution of their issues and concerns toward effective change in their existing oppressive and exploitative conditions. A process by which community identify its needs and objectives,develops confidence to taken actions in respect to them and in doing so, extends and develops cooperative and collaborate attitudes and practices in the community. Continuous and sustained process of educating the people to understand and develop their critical awareness of their existing conditions, working with the problem collectively and efficiently on their immediate and long-term problems , and mobilizing the people to develop their capability and readiness to respond and take action on their immediate needs toward solving their long-term problems.

Importance: 1. COPAR helps the community workers to generate community development in development activities. 2. COPAR prepares people to eventually take over the management of a development programs in the future. 3. COPAR maximizes community participation andinvolvement: community resources are mobilized for health development services.

Principles: 1. People, especially the most oppressed and deprived sectors are open to change, have the capacity to change and are able to bring out change. 2. COPAR should be based on the interest of the poorest sectors of the society. 3. COPAR should lead to self-reliant community and society.

Processes/ Methods used In COPAR

1. ACTION-REFLECTION-ACTION SESSIONS (ARAS) A progressive cycle of Action-Reflection-Action sessions (ARAS) which begins with small, local and concrete issues identified by the people and the evaluation and reflection of and on the action taken by them.
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2. Consciousness-raising Consciousness-raising through experiential learning iscentral to the COPAR process because it places emphasis on learning that emerges from concrete action which enriches succeeding actions. 3. Participatory & Mass-based COPAR is participatory and mass-based because it is primarily directed towards and biased in favour of the poor, powerless and the oppressed. 4. Group-centered COPAR is group-centered and not leader-oriented. Leaders are identified, emerge and are tested through action rather than appointed or selectedby some external force or entity. Critical Steps (activities) in COPAR

Integration- health care worker becomes one with the people in order to: Immerse himself/herself in the community Understand deeply the culture, economy, leaders, history, rhythms and lifestyles in the community. Social investigation -otherwise known as community study - A systematic process of collecting, collating, analysing data to draw a clear picture of the community. Tentative program Planning- CO to choose one issue to work in order to begin organizing the people. Ground work- going around and motivating the people on a one on basis to do something on the issue that has been chosen.

The Meeting- people collectively ratifywhat they have already decided individually. The meeting gives the people the collective power and confidence. Problems and issues are discussed. Role Play- means acting out the meeting that will take place between the leaders of the people and the government representatives. It is a way of training the people to participate to anticipate what will happen and prepare them such eventually.

Mobilization or Action- actual experience of the people in confronting the powerful and the actual exercise of the people power.
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Evaluation- the people reviewing the steps 1-7 so as to determine whether they were successfully or not in their objectives.

Reflection- dealing with deeper, ongoing concerns to look at positive values CO is trying to build in the organization. It gives the people time to reflect on the stark reality of life compared to the deal. Organization peoples organization is the result of many successive and similar actions of the people. A final organizational structure is setup with elected officers and supporting members.

Phases of the COPAR process:

1. Pre-entry Phase The initial phase of organizing process where the community organizer looks for communities to serve or help. It is the most complex phase in terms of actual outputs, activities and strategies and time spent for it. 2. Entry Phase Sometimes called immersion phase as the activities done here includes the sensitization of the people on the critical event on their life, motivating them to share their dreams and ideas on how to manage their concerns and eventually mobilizing them to make collective action on these. This phase signals the actual entry of the community worker / organizer into the community.

3. Organization-Building Phase The formation of more formal structures and the inclusion of more formal procedures of planning, implementing and evaluation community-wide activities. It is this phase where the organized leaders or groups are being given trainings (formal,informal) to develop their ASK (attitude, skills, and knowledge) in managing their own concerns/ programs. 4. Sustenance & Strengthening Phase Occur when the community organization has already been established and the community-wide underlakings. At this point , the different committees set-up in the organizations building phase are already
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expected to be functioning by way of planning , implementing and evaluating their own programs, with the overall guidance from line community-wide organization. 5. Phase Out The phase when the health care workers leave the community to stand- alone. This phase should be stated during the entry phase so that the will be ready for this phase. The organizations built should be ready to sustain the test of the community itself because the real evaluation will be by the residents of the community itself

PATTERN ORF OCCURRENCE & DISTRIBUTION Distinct pattern 1.Sporadicis the intermittent occurrence of a few isolated and unrelated cases in a given locality -cases are few and scattered 2. Endemicis the continuous occurrence throughout a period of time, of the usual number of cases in a given locality. -disease is therefore always occurring in the locality and the given level of occurrence is more or less constant through a period of time. 3. Epidemicis unusually large number of cases in a relative short period of time. 4. Pandemicsimultaneous occurrence of epidemic of the same disease in several countries.

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ENVIRONMENTAL SANITATION

Branch of public heath that deals with the study of preventing illness by managing the environment and changing peoples behaviour to reduce exposure to biological and non-biological agents of disease and injury. Study of all factors in mans physical environment, which may exercise a deleterious effect on his health well being and survival. Water sanitation Food sanitation Refuse and garbage disposal Excrete disposal Insect vector and rodent control Housing Air pollution Noise Radiological protection Institutional sanitation Stream pollution

WATER SANITATION PROGRAM POLICIES: Approved types of water supply facilities

Level I (point source)serves around 15-25 households and its outreach must not be more than 250 meters from the farthest user. The yield/discharge is from 40-140 liters per min.

Level II (Communal Faucet System/ Stand-Posts) Located not more than 25 meters from the farthest house. The system is designed to delivery of 100 households, w/ 1 faucet per 4-6 households. Level III (waterworks system/Individual house Connections)

PROPER EXCRETA AND SEWAGE DISPOSAL PROGRAM Approved types of toilet facilities
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Level1 a. Non water carriage toilet facility - No water is necessary to wash the waste into the receiving space. b. Toilet facilities - requiring small amount of water to wash the waste into the receiving space. Level2 On site toilet facilities of the water carriage type with water-sealed and flush type with septic vaut / tank disposal facilities.

Level3 Water carriage types of toilet facilities connected to septic tanks and / or to sewerage system to treatment plant.

FOOD SANITATION POLICIES Food Establishments shall be appraised as to the following sanitary conditions. o Inspection/approval of all food sources,containers,transport vehicles. o Compliance to Sanitary permit requirements for all food establishments. o Provision of updated health certificate for food handlers , cooks and cook helpers which include monitoring as to presence of intestinal parasites and bacterial infection. o DOHs Administrative order no. 1-2006 requires all laboratories to use Formalin Ether Concentration Technique (FECT) instead of the direct fecal smear in the analysis of stools of foodhandlers o Destruction or banning of food unfit to human consumption . o Training of food handlers and operators on food sanitation. o Food establishments shall be rated and classified as follows: -Class A- Excellent - Class B- very Satisfactory - Class C-Satisfactory Ambulant food vendors shall comply with the requirements as to issuance of health certificate which also include monitoring the presence of intestinal parasite and a bacterial infection. Household food sanitation are to be promoted and monitored and food hygiene education to be intensified through health education and provision of ICE materials.

FOUR RIGHTS IN FOOD SAFETY: Right source Right preparation Right Cooking Right Storage
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RULE IN FOOD SAFETY: When in Doubt, throw it out!

LAWS AFFECTING THE REPUBLIC HEALTH AND PRACTICE OF THE COMMUNITY HEALTH NURSING

1. STOCKHOLM CONVENTION ON PERSISTENT ORGANIC POLLUTIONS (POPs) - in MAY 2001, where the Philippines is a signatory and eventually ratified by the senate on FEBUARY 2, 2004 through Senate Resolution 676. -this is treaty BANS the use of POPs in households and industries. These POPs are called DIRTY DOZEN of pesticides, industrial chemicals and unintentional by products of burning: Pesticides: aldrin and dieldrin, endrin, chlordane, heptaclor, DDt, hexachlorobenzene, mirex, and toxaphene Industrial Chemicals: polychlorinated biphenyls, and Hexachlorobenzene Unintentional by products of burning: dioxins and Furans

2. R.A. 6969- Toxic Substances and Hazardous and nuclear Waste Control Act of 1990 -its implementing the rule and regulations (DAO 29) (1992) regulating the importation, use, movement, treatment and disposal of toxic chemicals and hazardous and nuclear wastes in the Philippines.

3. R.A. 8749- CLEAN AIR ACT OF 1999 -provides a comprehensive air pollution management and control program to achieve and maintain healthy air. SEC 20 BANS the use of the incineration for municipal, bio-chemical and hazardous wastes but allows the traditional method of small scale community burning.

4. R.A. 9003 Ecological Solid Waste Management Act of 2000 -it declares the adaption of a systematic, comprehensive, and ecological solid waste management program as a policy of the State. Adopts a community-based approach. Mandates waste diversion through composting and recycling. 5. R.A. 9275 Clean Water Act 2004 - this to establish waste water treatment facilities that will clean waste water before releasing into the bodies of water like the rivers and seas.
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Furthermore, it also requires LGUs to form Water Management Areas that will manage waste water in their respective areas. 6. SUPPLEMENTAL IMPLEMENTING RULES AND REGULATIONS OF CHAPTER II- Water Supply, of the Code on Sanitation of The Philippines (P.D. 856) -supplemental IRR provides the guidelines on the proper regulation of the water refilling stations. 7. SUPPLEMENTAL IRR ON CHAPTER 17 on SEWAGE Collection and Disposal and Excrete Disposal and Drainage of the Sanitation Code of the Philippines (P.D. 856) -it regulates and provides proper guidelines of LGUs and establishments involved in the desludging, collection, handling and transport, treatment, and disposal of domestic sludge from cesspools, communal septic tanks, tanks domestic sewage treatment plans/ facilities and from household septic tanks.

NURSING RESPONSIBILITIES: Actively participate in the training component of the service like in Food Handlers Class, and attend training related to environmental health. Assist in deworming activities for the school children Act as an advocate of facilitator to the families in matters of programs on environmental health in coordination with other members of rural health unit Actively participate in environmental sanitation campaigns and projects in the community Be a role model for others in the community to emulate in terms of cleanliness in the home surrounding.

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