Guiding principles to social change-the community action cycle

"Given that the major determinants are societal, public health must be committed to societal change.
-- Jonathan Mann

In the examples given earlier, the communities followed a process known as the Community Action Cycle that draws on many of the theories and concepts of a social systems approach to individual change and social change. This approach has been defined as "a process of public and private dialogue through which people define who they are, what they want and how they can get it" (Grey-Felder and Dean, 1999, p. 15). While there are numerous models of how social change comes about, there is considerable agreement on the fundamental elements-which are also the guiding principles of community mobilization as presented throughout this website. These are:

Sustainability of social change is more likely if the individuals and communities most affected own the process and content of communication.
Communication for social change should be empowering, horizontal (versus top-down), give a voice to the previously unheard members of the community, and be biased towards local content and ownership.
Communities should be the agents of their own change.
Emphasis should shift from persuasion and the transmission of information from outside technical experts to support for dialogue, debate, and negotiation on issues that resonate with members of the community.
Emphasis on outcomes should shift away from individual behavior to social norms, policies, culture, and the supporting environment.

For years, the international development community has conceded that the very notion of "outside assistance" is problematic-and may even be a contradiction in terms. At the very least, there is general agreement that outsiders, by definition, often don't understand enough to be able to offer locally appropriate assistance. Or, to put it another way, the best outside assistance may be that which is put at the disposal of insiders. Throughout this website, we emphasize the importance of defining the role of external community mobilization program teams in relation to community groups. For the most part, this role will be focused on facilitation and accompaniment. Defining and redefining more specific roles will be one of your greatest challenges as you work with communities to help them address their changing needs as their capacity and autonomy grow.

To mobilize communities effectively, you don't need to know all the answers. In fact, it is much better to be humble and admit from the start that you're a learner among learners. But as a facilitator, it is important that you pose key questions and help participants feel safe enough to explore and develop their own questions and answers. This process requires you, your team and the communities you work with to carefully think about and plan how to proceed before you act, take the time to reflect on what you are learning and then apply what you are learning to future plans and actions.

This "how to" website, the result of decades of work in the field, is admittedly still evolving, a work in progress that can be improved upon through the exchange of ideas and experiences. We have tried not to be prescriptive but to offer general steps, tools and approaches that many effective community mobilization programs have found useful. Flexibility and a willingness to challenge assumptions, sometimes make mistakes, learn from experience and adjust your approach accordingly are all critical to the success of the effort. Effective work with communities requires not only a thorough understanding of the various phases and steps of mobilization but also a strong commitment to, respect for, and belief in the abilities and potential of the people you aim to serve.

Phase 1: Prepare to Mobilize

Community mobilization is a proven approach to development that has helped people around the world identify and address pressing health care issues. The approach not only helps people improve their health and living conditions, but by its very nature strengthens and enhances the ability of the community to work together for any goal that is important to its members.

Community mobilization is defined as a capacity-building process through which community individuals, groups, or organizations plan, carry out, and evaluate activities on a participatory and sustained basis to improve their health and other needs, either on their own initiative or stimulated by others.

STEP 1: Select a health issue and define the community

Ideally it is the community itself which selects the issue, but in the real world of international development assistance, the issue is often pre-selected by donors or other external organizations with little or no consultation with the community. Whether you choose your own health issue or have it handed to you, you will almost always be in a position to shape and define the issue with respect to the local circumstances in which you will be working.

As you select a health issue, you will also need to define the community or communities with which you will work. Community mobilization refers to "community" in its broadest sense. In the changing context of migration, urbanization and globalization, the concept of "community" has evolved significantly beyond just a group of people who live in a defined territory. Today, community also refers to groups of people who may be physically separated but who are connected by other common characteristics, such as profession, interests, age, ethnic origin, or language.

STEP 2: Put together a community mobilization team

Before you get very far into this initial preparation stage, you will need to put together the team of people who will be working with you to support the community on this project. This team may be made up exclusively of people from your own organization, or it may include members from partner or other organizations. Throughout the manual, we refer to this team as the "community mobilization program team" or "program team " for short.

STEP 3: Gather information about the health issue and the community.

You and your team will need to learn as much as you can about the people who are most affected by the health issue and the community you are planning to work with. Some of the questions you will need to gather answers to are: Who is most affected by the issue, directly, and indirectly? Why are these people the most affected? What are their socio-demographic characteristics? Where do they live? What are current beliefs and practices related to the issue?

In exploring the health issue it can also be very helpful to identify and study the people who should be affected by the issue but apparently are not; that is, people living in the same area and/or under the same conditions who have the same risk of being affected by the issue but who are healthy and doing well in spite of the presence of risk factors (known as "positive deviants").

STEP 4: Identify resources and constraints

You will need to do an inventory of the resources that will be available to the program and any constraints you may face. Resources usually fall into four categories: financial, human, material, and time. After you identify resources, you should then identify what constraints you may face and ways to eliminate, minimize or work around these constraints. For example, constraints might be that project staff do not possess the skills to do the work, that there is insufficient time to achieve the desired results through a high quality program, or that there are very limited financial or material resources.

STEP 5: Develop a community mobilization plan

A community mobilization plan is a general description of how you and your team intend to assist this particular community to mobilize around this particular issue. At a minimum, such a plan should contain: background information, the program goal, the overall objectives of the effort, the process you and the community will go through to achieve the goal and objectives, a monitoring and evaluation plan, a project management plan, and a budget.

The process mentioned above would normally be some form of the Community Action Cycle (around which this website is structured), which typically has five phases and to which we have added two. The seven phases of community mobilization are: 1. preparing to mobilize, 2. organizing the community for action, 3. exploring the health issue and setting priorities, 4. planning together, 5. acting together, 6. evaluating together, and 7. scaling up.

STEP 6: Develop your team

One of the last things you and your team will do in this preparation phase is to look again at the tasks you've set for yourselves and decide who is going to be responsible for what. Once you have done this, it will become clear as to whether your team members have the skills they need for the duties they've been assigned. If they don't, you have several choices: 1) you can add people to your team who do have the needed skills; 2) you can train people in the needed skills; or 3) you can partner with another organization who has people with the needed skills. However you decide to handle the matter, you want to approach the next stage in the community mobilization process-organizing the community for action- confident in your team members' ability to do the work you're about to embark on.