Organize the Community for Action

Be careful not to pre-empt the community

Some CM teams have decided prior to the orientation meeting how they would like the community to work with them, such as by forming a health committee or selecting community volunteer health workers, even though these entities may not have existed previously in the community. The CM team then uses the orientation meeting to put this pre-selected strategy into effect by having those present elect or appoint committee members or volunteer workers who will assume responsibility for the CM program and serve as the community’s formal liaison with the team. This strategy may be effective in some situations, such as when community members are highly aware of their health needs and see the value in establishing such mechanisms.

But in many situations, this may not be the case. The volunteer health worker may be selected because the external organization (e.g., NGO, MOH) has made this a necessary condition for accessing external resources the community may need or want. However, if community members had done their own analysis of the particular health issue, their needs, and resources, they might have developed other more appropriate means of addressing their health needs. Or they may have determined that a health committee was indeed the most appropriate mechanism.

When communities do not see the need for a health committee or volunteer health workers, they do not support them. While it may be more convenient for outside organizations such as yours to work through committees, unless the community sees the need for such entities, these committees and/or volunteers will often have limited impact and are more likely to cease functioning when external assistance is withdrawn.

At the same time, when health committees, community health volunteers, or other groups already exist, it is important not to limit the orientation about the CM health issue only to these groups. You should, rather, involve these people in helping you put together an orientation for the wider community. You should also remember that while health committees and volunteer workers have considerable experience working in the community and well-developed social and political networks that can be very valuable to any community mobilization effort, they won’t necessarily be interested in the particular CM health issue you have chosen. A health committee established to increase vaccination coverage, for example, may or may not be particularly concerned about increasing access to family planning services. And you should, therefore, be careful not to limit your orientation meeting just to this group.

In short, while conventional wisdom advises working through existing community structures and organizations, and there often are good reasons to do so, this strategy may not be the best, particularly if these groups are not at all representative of the people who are most affected by and interested in the issue. (See Useful Tools I and II at the end of this phase for more information about the community orientation.)

Objectives and content of the orientation meeting