Approaches to Engaging Communities

PIYUSHA MAJUMDAR: In this section, we will be exploring different approaches to engage community in any health program, starting with explanation of SEED-SCALE model– SEED, which is an acronym for Self Evaluation for Effective Decision-making, and SCALE, which is the acronym for a System for Communities to Adapt Learning and Expand. I want you to deliberate over some of the effective approaches or tools to engage community in any public health program. Just take over it and then I’ll tell you about some of the effective approaches that we use during public health programs.

So the approaches like informing the community of policy directions of the government, consulting the community as a part of process to develop government policies, or build a community awareness and understanding. Involving the community through a range of mechanisms to ensure that issues and concerns are understood and considered as a part of the decision-making process. Collaborating with the community by developing partnership to formulate options and provide recommendation. Then comes sharing leadership or empowering the community to make decisions and to implement or manage change. The seven tasks of SEED-SCALE. As you can see in the slide, we’re going to go through with one of the cycles of community engagement from a different school of thought.

The one which you’re seeing in this slide is from future generation. It shows that there are seven tasks of SEED-SCALE. SEED-SCALE may mean different things. In a more applied sense of program design or a system management, SEED-SCALE operates as a conceptual framework for designing, implementation, monitoring, and evaluation of sustainable community-based development activities. It must, broadly speaking, yet operate as a period of change with the underlying presumption that social change is a result of enabling or redirecting human or social energy in a cyclical, yet relatively growing as opposed to the linear fashion As you can see, community process can be complex, challenging, and labor intensive.

However, there are several underlying principles that can assist health professional, researcher, policymaker, and community leader in planning, designing, implementing, and evaluating community engagement effort. So the SEED-SCALE is based on the four principles that are necessary for social change. The first principle says that you have to build from community success. So people’s energy and creativity expand as they realize that they are capable of controlling the challenge in their life. One success becomes the stepping stone for the subsequent success and generate community confidence and forward momentum. So identifying and then building on success is an approach that focused on building upon the existing strength in the community.

This is a forward-moving constructive effort that focus attention on the community asset rather than need. The second principle of SEED-SCALE is based on three-way partnership. Any community energy mobilizes by itself. Community need help from the official who can adjust policies and regulation to facilitate cooperation among factions and channel external resources. Community also needs help from the expert who can build capacity by training, introduce new ideas, and help monitor change. So community development study worldwide shows that success result when community vote from the bottom up, officials vote from the top down, and an expert vote from outside-in. So all the three roles are needed. So this kind of a three-way partnership is needed for any kind of a project.

The third principle is evidence-based decision-making. So any action is effective when grounded in objective data. Lacking such data, participant will make decision on the basis of transitory opinion. And these tend to be most influenced by whosoever talk most convincingly or whoever holds more power at the moment. The data gathering is very important, especially using the key indicator of a SEED survey. And it’s the process that can start simply and develop great sophistication over time. The fourth principle for SEED-SCALE is change in community behavior. People can come together in partnership, they can agree on objective data. But to achieve a lasting result, they must also change their behavior. So these are the four main principles of a SEED-SCALE model.

So in the slide, we are showing the seven tasks which is associated with SEED-SCALE. So starting with creating or reshaping a local coordinating community to identify the local success, then comes adapting the success from elsewhere. You have to gather the local evidence, create an action plan, and then partner each implement action, and the last one is mid-course correction to strengthen four principles. So there’s no right way of doing this process, and the steps do not always take place one after another in this order. So the forthcoming slide, we will be discussing more about the three phases. First one is planning, second is implementation or management, and third is evaluation or reflection.

We’re going to discuss the first phase of SEED-SCALE, which is the planning phase. So the main principle, which is being followed in the planning phase, is you have to be very clear about the purpose or the goal of the engagement effort and the population of the community you want to engage. You have to become knowledgeable about the community’s culture, economic condition, social network, political and power structure, norms and values, demographic trend, history, and experience with effort by outside group to engage in various program. Apart from this, you have to also learn about a community’s perception of those initiating the engagement activity then establish relationships, build trust, work with formal and informal leaders, seek their commitment in mobilizing the community.

And last among principles, you have to map and leverage on the existing program for community engagement mechanism, the program which is already running, like routine immunization campaign or HIV programs. Now, in this slide, as you can see, in the planning phase you can see there are four red rectangular boxes. So the first four activities is to be undertaken for the planning phase. So the implementation and management. So before actually doing this, there are certain principles which need to followed. We have to go to the community, establish relationships with them, build trust with them, work with formal and informal leadership, and seek commitment from the community organization and leaders to create processes for mobilizing the community.

Just remember and accept that collective self-determination is the responsibility and the right of all people in the community, and no external entity should assume it can bestow on a community the power to act in its own self-respect. We have to recognize and respect diversity and ensure that the most vulnerable are reached and engaged. Identification and mobilization of asset and strength in developing the community’s capacity and resources to make decisions and take action, then empowerment of community capacity building. It’s all about promoting the capacity of local community to develop, implement, and sustain their own solution to create a problem in a way that helps them to shape and exercise control over their physical, social, economic, and cultural environment.

Now, there are certain individual and institutional resources, such as facilities, material, skill, and economic bar. All can be mobilized for community-held decision-making in action. So community member and institution should be viewed as resources to bring about change and take action, of course, depending on the trigger for the engagement process. For example, a funded mandate was a more grassroots effort, so resources are likely to be quite varied. Although it is essential to begin by using existing resources, the literature on the capacity building and correlation stresses that engagement is more likely to be sustained when new resources and capacity are developed.

So engaging the community in making decisions about health and taking action in that arena may involve the provision of expert and resources to help community and develop the necessary capacity. Not only capacity, but also the infrastructure to analyze the situation, make decision, and take action. And in the implementation part, you have to be prepared to release control of action and intervention to the community. And just be flexible to meet the challenging needs or the changing need of the community. So these are the things that has to be kept into consideration while implementing any project. In this slide, we’re going to discuss about the last phase, which is the evaluation.

And as you can see in the circle of a SEED-SCALE task, the last part is mid-course correction for strengthening. So there are certain things which has to be done for evaluation or reflection. Share your data with the community. Tell them what you’ve collected so far or what are the things which is existing in the community, then engage them in interpreting what the findings or result mean to them and what should be a way forward for them? Then, this is the community engagement process, so partnered with the community is very necessary to create change and improve health. And last thought is the community collaboration.

Community support requires community collaboration, and community collaboration requires long-term commitment by engaging the organization and its partner. So all these things should be taken into consideration while undertaking any kind of a project or doing any kind of a community engagement activity.