Prepare To Mobilize

STEPS
  1. Select a health issue and define the community
  2. Put together a community mobilization team
  3. Gather information about the health issue and the community
  4. Identify resources and constraints
  5. Develop a community mobilization plan
  6. Develop your team

STEP 5: Develop a community mobilization plan.

Now that you and your team have a better understanding of the health issue you will be working on, the setting you will be working in, and your resources and constraints, it’s time to develop a community mobilization plan. (If you have limited prior experience with community mobilization, you may want to read the rest of the manual before developing your plan.) This plan is a general description of how you and your team intend to assist this particular community to mobilize around this particular issue. For those teams working with a donor, this plan may serve as the project proposal or the basis for it if the donor requires a different format.

The purpose of the mobilization plan you are developing is to define the overall program goals and objectives and identify a process that will help interested communities achieve them, not to determine specific community actions or activities. As you create this plan, you should always keep the two overriding goals of community mobilization uppermost in your mind:

  1. to improve the health of the community, particularly those most affected by the issue
  2. to improve the community’s capacity to address its health and other needs

At a minimum, a typical community mobilization plan should contain the following seven elements, each of which is described in detail below. A sample mobilization plan, for the Bridges (Puentes) program in Peru, appears in the tools section.

  1. background information
  2. program goal: the overall goal of the mobilization effort
  3. program objectives: the overall objectives of the effort
  4. the community mobilization process: the overall process you and the community will go through to achieve the goal and objectives
  5. a monitoring and evaluation plan
  6. a project management plan
  7. a budget

1. Background information

This section should describe the overall context for the plan, including information about the health issue, the setting, the resources and constraints, and why this particular community was selected.

PHILIPPINES: Appreciative Community Mobilization-A Strength-based Approach

"Appreciative Community Mobilization" was born out of the organizational development field's experience with "Appreciative Inquiry" which focuses on an organization's strengths and works to build on them. An appreciative methodology developed by Case Western's "GEM Initiative" using a "4-D" cycle (Discovery, Dream, Design and Deliver) was adapted by Save the Children in the Philippines to help communities improve family health by learning from and building on their positive past experiences to plan future actions. Communities strengthen their abilities to set priorities, plan, implement, monitor and evaluate their progress toward improving family health.

Situated in urban and rural communities in Iloilo, this project builds on existing community ("barangay") and local government strengths, structures and resources including local leaders, Community Volunteer Health Workers (CVHWs), the local health board, municipal and barangay budgeting processes, local committees and department of health facilities and staff. Through a strategy of "Appreciative Community Mobilization", participants aim to increase "marginalized" or priority groups' access to, and utilization of family planning and child survival services and healthy behaviors and increase their participation in community decision-making. Participants comment that they like the approach because it acknowledges and builds on their strengths, doesn't "make us wrong so that we stop talking" and helps them to realize their dreams for a healthier family and community.

VIETNAM: Local Wisdom

The foundation of the Poverty Alleviation and Nutrition Program in Vietnam (PANP) mobilization strategy is a "strength-based" approach focusing on respect, recognition, and application of positive local knowledge and practice. Targeting those who are 'positive deviant', such as those poor families keeping their children well-nourished, requires that we seek guidance from them.

The model is based on the belief that in order for development gains to be sustainable, strategies and solutions to community problems had to be identified within the community by the members themselves. Translating this idea into action helped PANP to focus on community resources, as well as needs, essential for both sustainability and scaling-up. The focus is on the discovery of community resources, both human and material. This process contrasts with the more traditional development approach that focuses on community needs as the principal basis for program development while not fully recognizing existing community resources and strengths.

Visiting poor families with well-nourished children enabled the volunteers not only to review successful parents, but also to actually observe what went into the cooking pot and the kind of child care which was provided. The 'deviant behavior' which was identified was the use of tiny shrimps and crabs, easily found in rice paddies (but initially considered inappropriate for young children), sweet potato greens, sesame seeds, peanuts, dried fish, fish sauce, and corn. The food varied by community and season but was free, or inexpensive.

2. Program goal

In some cases, the goal of the program has been predetermined in relation to global, national, or local health priorities as identified by the donor. In other situations where communities perceive a pressing need, communities themselves may define the goal. Alternatively, public health officials or others may identify a goal based on an analysis of community health indicators (e.g., frequency and severity of specific health problems and feasibility to address them).

No matter who defines it, a clearly articulated goal that can motivate the community is one of the most important keys to an effective community mobilization strategy. This does not mean that you should ignore what donors, public health officials, or program staff want to achieve but to state the goal in concrete, personal terms that people will understand and want to support.

Community mobilization goals sometimes mistakenly aim at promoting behaviors, such as “mobilizing people to vaccinate their children”, rather than emphasizing the potential benefits, such as “reducing the number of children who get sick or die from diseases that can be prevented by vaccination. The Warmi project goal, for example, was to reduce maternal and newborn deaths, while in Vietnam the project goal was to restore malnourished children to good nutritional status.

3. Program objectives

There are many resources on how to define objectives in the context of program design. Many discuss the characteristics of well-defined, “SMART” objectives—specific, measurable, attainable, result-oriented and time-limited—and these are valid and useful. When mobilizing communities, however, our role is not to define the specific objectives of the overall effort because the primary actors, the community members, will do this. Instead, the plan’s objectives will focus on general health outcomes and process objectives related to building community capacity and to the key underlying themes that we identified while learning about the community. Our aim at this point is to set a direction for the process so that facilitators can judge whether the program design is effective or whether it needs to be adjusted. For those familiar with project design, this approach to setting objectives is different because it takes the setting of specific objectives out of their hands and puts it into the hands of community members.

Those who work with donors may need to explain why it is so important for community members to define and commit to their own objectives. For example, when negotiating the approval of the Warmi project design, donors, other program staff and the project designers discussed at length why the project did not propose specific objectives with clearly identified indicators, as is expected with most proposals. Instead, the Warmi project proposal stated that the list of objectives and indicators presented in the proposal was illustrative and would be revised based on work with communities to set priorities and appropriate objectives. Fortunately, the donor was flexible and understood the rationale behind the proposal, and the project was approved with the agreement that once objectives were defined, they would be communicated to the donor.

Here are two examples of objectives, from the SECI project in Bolivia and the Bridges project in Peru.

The SECI project aimed to:

  1. Increase communication between participating communities and health service providers through the use of a community and facility-based health information system to contribute to improved health.
  2. Increase participating communities’ and health service providers’ ability to analyze and use information to address community health problems.
The Bridges project had the following objectives:
  1. Increase the utilization of public health services in selected project areas.
  2. Improve client and service provider interpersonal interactions within health services.
  3. Establish mechanisms and/or systems to improve coordination and collaboration between health services and community organizations.
The Bridges Project went on to articulate general process objectives based on the key underlying themes identified through analysis of information gathered while learning about the community. These process objectives, stated as “desired results”, follow below.

 

EXAMPLE of Underlying Themes and "Desired Results" from the "Bridges" Project in Peru

UNDERLYING THEMES DESIRED RESULTS
Power Create a more equitable balance of power between cummunities and service providers.
Respect Develop mutual respect
Self-esteem Build self-esteem (of both cummunity members and service providers)
Gender Ensure that women are active participants in the process
Quality (central theme around which to mobilize) Shift concept of quality from shift-based to "quality begins at home"...services are only one component of quality care
Rights and responsibilities Shared responsibility for health
Differing paradigms/belief systems (western medicine vs. indigenous knowledge) Acceptance of differing perspectives; dialogue to maximize benifits of positive, healthy beliefs and practices regardless of origin
Teamwork Encourage development of a team
Crircal self-reflection and objectivity Foster environment that promotes critical self-reflection and objectivity
Protagonism Foster Protagonism (communities and providers set agenda, implement, monitor, and evaluate their progress)

4. The community mobilization process--a Community Action Cycle

This website recommends structuring community mobilization efforts around the five phases of the Community Action Cycle, and adds two other phases: prepare to mobilize and scale up. Accordingly, as you and your team sit down to develop your mobilization plan, you can assume that in general this is the process you and the community will be going through as you carry out this effort.

Using the Community Action Cycle as a guide and keeping in mind the overall approach you wish to take and the strategies you outlined above, describe the basic tasks/activities you propose for each phase of the process. This does not need to be very detailed at this point, but for planning and budgeting purposes, you should consider the types of activities, who will participate (approximate numbers and characteristics) and what you hope to achieve through these activities.

In thethe Bridges example presented at the end of this phase, we see that the team proposed using participatory video as a medium to facilitate self-reflection in the "Explore" phase. This video served to communicate both parties' opinions to each other without having to confront each other directly in a potentially explosive manner, but also without "dehumanizing" the content which could have resulted had they presented it through second parties or on audio cassette. This activity supported the project strategy of getting to know each other as people to begin to develop a relationship that went beyond current poor provider-client relations while it also dealt with exploring the content of the health issue: what is quality care?

5. Monitoring and evaluation plan

Community participants will have the opportunity to develop their own monitoring and evaluation plan as part of the community action cycle process. However, the project monitoring and evaluation plan should meet your team's and your donor's needs for information. This section of the proposal should state, at a minimum, which health related outcomes will be monitored on an ongoing or periodic basis and how. Additionally, you should consider which areas of community capacity or other process outcomes you will monitor, how and when. At this point, it may be premature to specify community capacity indicators until you have worked with the community to determine which areas they would like to strengthen. However, you may want to state how you plan to work with the community to come to this agreement. We recommend that you use both qualitative and quantitative measures and a combination of participatory and external methods if possible to provide a more comprehensive picture. If you do not have the resources to afford this, you should discuss which methods you have chosen and why in relation to the overall goals of the project and in light of various "stakeholder" interests.

6. Management plan

This section of your plan should state who the members of the program team are, how they will communicate and work together, what their roles will be in relation to the project participants, and describe coordination mechanisms and institutional relationships if appropriate.

Staffing will vary according to your available resources (time and money), the number of communities and population you are trying to reach and your project strategies and activities. Experience demonstrates that it is reasonable to estimate that a team of two people can work with between ten and twenty communities, even in settings that are geographically dispersed. Teams are recommended as one person can facilitate while the other assists, observes and documents the sessions. One person can facilitate sessions alone, but this is more difficult and is not recommended, if two can possibly work together. If community capacity is such that a local person can facilitate, and this is desirable, you may be able to have one person from your team support the effort by helping to prepare the facilitator, observe, document and provide feedback to him/her.

7. Budget

Most proposals will also include a budget based on the management structure and activities proposed. It is not within the scope of this website to go into detail here on how to budget. However, as with all budgeting, you should consider the costs of personnel, equipment, materials and supplies, travel and transport, other direct costs for training, administration and other project activities not previously covered.