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| A NETWORKING AND LEARNING PROGRAMME ON HEALTH COMMUNICATION FOR DEVELOPMENT | ||||||
| [Health communication] |
Building capable communities: promoting and evaluating community capacity |
Further information Building capable communities
Community capacity section of John Snow International website
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Full report: Exchange lunchtime discussion 16 March 2004 Glenn Laverack, author of Health Promotion Practice: Power and Empowerment, introduced the "domains approach" which encourages "top-down" health and development programmes to prioritise and assess the development of a community's capacity. Discussion of the domains approach raised several key questions:
How does a community know it needs empowering? Laverack acknowledged that we always start somewhere, often with the agendas of bilateral agencies or NGOs. But an analysis of how power works in top-down health and development programmes underpins the domains approach, which enables communities to take more control in programme planning and evaluation. A community of practice or interest is assumed rather than a community defined by its geographic location. Discussion participants agreed on the fundamental tension between top-down programmes, which distribute most of the world's health and development resources, and the development ethos of giving people the responsibility to tackle key issues and improve their lives. Laverack emphasised that the domains approach offers one way to bridge the gap between what health and development workers say and know about the importance of capacity development, and the disempowered situation of many communities engaged in programmes. Seeing capacity development as a process as well as a set of outcomes is key to the approach. Who decides what a community needs? This key question was raised by several discussion participants. Lavarack explained that the domains approach offers a systematic way to represent bottom-up needs within top-down programmes: an assessment stage asks communities to focus on nine areas (domains) where individuals and groups have most opportunity to mobilise themselves for greater control over their lives. A set of workshops result in visual representations of a community's strengths and weaknesses which form a basis for strategic planning and a reference point for ongoing evaluation. (See Evaluating community capacity [PDF] for full details of the methodology, or Introduction to the domains approach for a quick overview.) Good facilitation is essential for the assessment stage - the facilitators must understand the political, cultural, and economic context of both the community and the programme for the domains approach to work. Other ways of assessing needs such as Participatory Rapid Assessment (PRA) and less intrusive methods were noted by discussion participants, who were in agreement that programmes had to find out what communities want right at the beginning. How can community empowerment be better accommodated in top-down programming? Set realistic timescales There is obvious conflict between the usual three to five years of programme funding and the time it takes - perhaps 10 to 15 years - to bring about sustainable change. This is one of the contradictions the domains approach seeks to tackle with ongoing, community-led evaluation. Acknowledge the success of bottom-up approaches Laverack raised the fundamental question of why we have top-down programmes when we know they don't work, saying that 98% of money is distributed through top-down programmes even though 95% of them fail. Several discussion participants echoed Laverack's criticisms of top-down programmes and referred to alternative participatory approaches that community and church groups have been using for over 100 years. In practice, bottom-up and top-down approaches merge, although successful bottom-up approaches are by necessity flexible and small-scale. Participants acknowledged that in all so-called participatory approaches there is a danger of a community being co-opted by a programme's top-down agenda. However the domains approach makes some of the power issues more systematically visible. Acknowledge power relationships Be up front about the gap between the discourse on capacity development and the practice, and prioritise an understanding of the community's cultural context. Employ local staff Laverack referred to the pressure Indian and Vietnamese governments are now putting on programmes to employ staff who are nationals of the country where the programme takes place. How can monitoring and evaluation of community capabilities be used to strengthen programme design? Evaluate the process as well as the outcomes Even though indicators can be difficult to develop, the community and programme staff need to ask themselves at all stages how has this helped to increase community capacity? The domains approach applies a rigorous qualitative approach to answering this question.
See lunchtime discussions for summaries of previous discussions. |
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