COMMED 3

SY 2008 -2009
 FCM3
The Doctor as a Manager and
Social Mobilizer
5 STAR M.D. HEALTH PROVIDER

SOCIAL
MANAGER MOBILIZER

Lasallian

RESEARCHER EDUCATOR
 Lowest
In
Social
hierarchy
BIOPSYCHO
-SOCIAL
PERSON

Highest in
Organismic
Hierarchy
BIOMEDICAL
 BIOPSYCHOSOCIAL
BIOMEDICAL
FAMILY and COMMUNITY
BASIC/CLINICAL
MEDICINE
A M C T O O F C N C B
O E I R R
T A O A U I
L L S G G M T L O
O E L S A A M
I I T S
M C S U N N M O U P
S U E S L U
S N R H
L S Y
Y N E E
E
S I R
S
T T E
E Y
M
ORGANISMI S
C hierarchy SOCIAL
Hierarchy
COMMUNITY HEALTH DEVELOPMENT PROCESSES

CO PAR

SOC MOB
WHY

Critical recognition
characterized by a sense of
urgency that something must
be done to improve the
identified health problem
Beginnings
Social mobilization...
term used by the United
Nations International Children's
Emergency Fund (UNICEF) to
describe a comprehensive
planning approach that
emphasizes
a) political coalition building
and
b) community action

(UNICEF 1993, Wallack 1989).

Source: Communication Initiative 2001 website
Beginnings
Definition 1:
Process of bringing together all
feasible and practical inter-sectoral
social allies to
- raise people's awareness of and
demand for a particular
development program,
- assist in the delivery of resources
and services and
- strengthen community
participation for sustainability
and self-reliance.

Source: Communication Initiative 2001 website

Beginnings
A successful mobilization must be built on:
a) the basis of mutual benefits of
partners and
b) a decentralized structure.

…the more interested the partners are,

the more likely that a project of social
mobilization can be sustained over time.

…does not require partners abandon their

own interests and perceptions on a given
issue
but are willing to coalesce around a certain
problem
WHAT
Definition 2: Deliberately planned strategy

* Uses various channels to elicit actions

* Among those who can contribute to the
solution of a problem,
* more particularly
Changing the specific behavior of
members of a society who can
contribute to the achievement of a
definite goal

(UNICEF)
 WHAT

Assures sustainability by providing a

framework for action linking- up various
sectors at all levels
i.e. Community,
Subnational- Municipal,
Provincial,
Regional), National and
International.
WHAT
Definition 3 .
Social mobilization is a process that
enables people in different sectors and
at various levels of society to engage in
dialogue, negotiation and collective
action.

Purpose of social mobilization: bring

together organizations, policymakers
and communities to forge a collective
identity and to work toward a goal.

(Social Mobilization for Safe Motherhood website)

WHAT

Social development is linked to

concerted public action. No matter
how valid and worthy the cause, little
progress is made in achieving it until
a ground swell of public support is
built and diverse sectors of society
become actively involved in the
process of change. - James Grant,
UNICEF
(Source: Safe Motherhood)
 WHAT
Definition 4

WHO HOW FOR

WHAT

People taking Action towards a Common

Good

(WHO /WPRO Social Mobilization for Health

Promotions)
WHAT WHO – How – For What

PEOPLE- range of players

* decision / policy makers, opinion

leaders, religious, professionals,
commerce/ industry,non- government
orgs, community, individuals

* all relevant segments of society

community to national to international
 INTERNATIONAL
NATIONAL
DEPARTMENT
REGIONAL OF HEALTH

LOCAL GOVERNMENT
UNITS
GOVERNOR
PROVINCIAL
PHO/Hospital

MAYOR
MUNICIPAL RHU

BARANGAY
BHS
 2o 3o
Primary Care
RH/MC
PH
RHU MH DH
BHS
Private Clinics

BARANGAY
REFERRAL SYSTEM

SELF-CARE Agriculturist
LGU Engineer
Teacher

Municipal-District-Provincial-Regional-National
WHAT Who – HOW – For What

* Planned action
* Deliberate strategy
* Broad scale movement
* Engage people’s participation
* Interrelated and complementary
efforts
* Dialogue, negotiation and consensus
for mobilizing action,
* Take into account people’s felt needs
WHAT Who – How – FOR WHAT

* Achieving a specific goal for

common good
* Create an enabling environment
effect positive behavior and social
change
* Successful transformation of
development goals into social action
(Unicef)
HOW
PROCESS FRAMEWORK
Recognize critically a health
problem
- participatory research,
community surveys, dialogues,
barangay assemblies and
information from experts.

2. Determine factors affecting the

identified health problem with
key decision maker
HOW
PROCESS FRAMEWORK
3. Describe the desirable action from
these key contributors at various
levels
a- Policy/ Program Decision-
Making
b- Allocation of Resources
c- Delivery of Services

4. Plan, carry out and assess the

desirable action for the desired
changes.
Commed 1: (HEALTH EDUCATION)

Commed 3

(HEALTH ADMINISTRATION)
 Appropriate
       messages should be
designed for a particular audience based
on a particular problem.

            
 Use of various mechanisms and forms of
communication

        

One-way communication: information

dissemination and agenda- setting.
 Education uses appropriate modes of
teaching and learning;

Develops skills, attitudes and values to help

people manage the environment that affects
their situation.
Calls for greater use of popular media – people’s
theatre, folk songs, cultural competitions, social
gatherings, community debates etc.
 Develop competencies of the community,
health sector workers and those of
the other sectors

in undertaking the identified tasks

from
resource sharing to
provision of specific health
procedures.
 EXAMPLE: TRAINING FOR LOCAL
GOVERNANCE
ISSUE
UNICEF’s experience in promoting a childfriendly
approach to local governance… through
development of four essential tools:

1) the Local Development Plan for Children,

2) the Local Investment Plan for Children,
3) the Local Legal Code for Children and
4) the Local Annual State of the Children Report

In addition, emergency preparedness and response

is best handled at local level
Build the community’s capability for
problem-solving, decision making and
collective action
while developing and strengthening its
own networks
Individuals HOUSEHOLDS Barangay
Families
Babie
s Better Off Management
Child
boy/gir Bgy Council
l Health Committees
Mediu
Teens m
boy/girl Service Providers
Poor THP / BHW
Adult
Men/Wome
Poores
n
Older t Of
People
Men/Wome Poor
Organizations
n

Barangay Managed Health Care

…Implementation required to identify
and utilize village communication
networks, train field workers, locate and
mobilize opinion leaders, activate link
persons, establish rotating peer group
discussions, provide information and
supplies at meetings .

“ Communication initiative Social Mobilization

Mobilization of communities should
focus on building confidence, trust and
respect, increasing knowledge base,
and enabling community members to
participate, and become more
proactive with regard to their own
health behavior.”
 Improve
o   the implementer’s efficiency in
advocating and mobilizing action (Monitoring)

Determine the effectiveness of the program

(Evaluation)
o       Organization of information into arguments
used to persuade or convince a specific group of
people to take necessary action on a specific
goal.

o    Involves the generation and utilization of

reliable information to help national leaders,
policy makers, and decision makers to help adopt
necessary policies or programs.
 CONSIDERATIONS IN ADVOCACY
1. Study the key actors, particularly their
needs
2. Establish mutual trust – cite mutual
benefits, substantiate arguments with
good examples

3. Provide positive reinforcement to sustain

collaborative work
 
 HOW
Some Adverse Characteristics of
Stakeholders

Community NGO’s GO’s

Apathy, Apathy, Indifference/

prejudice – result Indifference - lukewarm
of past sad result of past sad response
experiences experience

Over Tolerance of Authority

dependence over dependency Conscious
domineering
attitude
 HOW
Some Adverse Characteristics…
Community NGO’S Government Orgs

Wait and see, Impatience to

timidity, lack self accommodate
confidence and act on
inquiry/ request

Indifference to Inadequate Arrogance,

initiate contact preparation of aggravate
and follow – up community community’s
‘ningas cogon’; leaders before timidity/ lack of
manana habit, visit to GO/ NGO self confidence
neglect of offices Parochial
appointments; context ‘Padrino’
 HOW
Some Adverse Characteristics…
Community Non-government Government Orgs
Orgs
Lack of knowledge of agencies Unclear ,
assistance / procedures to avail of complicated
services procedures,
delay in
processing, loss
of papers, wrong
information to
clients
Lack personnel/
logistics
 HOW TOOLS

ONE WAY TWO WAY

Interpersonal Face to face
meetings, visits,
conferences,
“events”
Newsletters, Correspondence
publications
Radio, TV, E mails,
websites; telephones
DVD
HOW TOOLS
“EVENTS ORGANIZING”
Big Bang: Launching activities by high
ranking officials
Big Visit: Visits by national/
international leaders
Little Bang: “Kapihan”

“Having Champions”
- NID
- Kilatis Kutis Kit : Toni
Rose Gayda
HOW “Yosi Kadiri, Sangkap Pinoy, Kilatis Kutis,
Oplan Alis Disease”

Four Basic rules in

communication strategies.
3.Know the culture of your
audience
4.Do not overload people with
Data
People’s Preference for
Testimony (Statistic of One)
6.Know the issue – roots of
problem
7.Be as specific as possible in
your call to action.
Few basic things that the
private sector looks for in
any partnership...

First, they want control of

their own resources
Second .. is imagination and
creativity.
Third… They look for a
program’s potential benefit
and advantage to
themselves

Let’s DOH IT!

Dr. Juan M.
Flavier
 HEALTH PROVIDER
SO WHAT

SOCIAL
MANAGER MOBILIZER
PERSON

RESEARCHER EDUCATOR
 SO WHAT

Implications to Health Worker

2. Acceptance of concept of Total Health
3. Effective communication among and
within agencies
3. Shared ownership and responsibilities for
health program
4. Capacity for joint planning,
implementation and evaluation of
health development program
5. Capacity to make effective and assertive
presentation of programs to decision
Decision makers have to be aware that
an Abundance of Resources and
Technology does not guarantee good
health
it is up to governments to create an
enabling environment in which civil
society can participate.
Measures that encourage such an
environment include legal recognition,
tax incentives, and agreement on the
ground rules for accountability and
transparency, and participation in
decision making. (Social Mobilization ,
Aids)
 Social Mobilization EPI
ACTION LEVELS

International: LGU – local funds

Policy/ Program HEALTH
WHO - technical WORKERS –
UNICEF: refs, cold training/ service
boxes delivery
ROTARY – vaccines Traditional/religious
National leaders – IEC, CO
Executive Order BHW - service
DOH resources Parents – children
 LOOK BACK LOOK FORWARD

WHAT IS WHAT WILL BE

WE ACT NATIONAL

Regional
WE SEE
INTERNATIONAL
Provincial

I SEE Municipal

Barangay
Time 0 Time N
EXAMPLE:CONTROL OF
IODINE DEFICIENCY

ASSESSMENT INDICATORS
BY LEVELS
 I. Policy/ Political Level
Formulated Policy/ Legislative Action
- Comprehensive development policy;
documented health status goals of children
and mothers among stated prioritites
- Health policy; intersectoral and community
involvement strategy objective

Public Agenda Setting

- Appropriate media, modern and traditional
for specific audiences

Resource commitment
- Approved budget items in national plan
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
 II. Bureaucratic/ Technical Level
National Plan of Action
Guidelines that recognize inter and intra-sectoral
collaboration

Designated Responsible Officers

Communication, advocacy, negotiation, community
organizing and development skills

Proper Orientation and Training

Manpower resources and skills

Advisory committee, Implementing committees

International Council for the Control of Iodine Defiency

http://iccidd.server295/.com/pages/technical resources
 II. Bureaucratic/ Technical Level
Technical Resources
Information System
Monitoring and Evaluation
Media and message
Production of Information Materials
Interpersonal Communication
Audience Response
Sustainability
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
 III. Professional, Civic and Social Levels
Organized and Demonstrated
Intersectoral Support: Commerce,
Industry, Agriculture, Education, Media,
Sports Culture
Alliances
Professional support from NGOs,
religious civic groups, women’s
organiztions
Collaborations
International Council for the Control of Iodine Defiency
http://iccidd.server295/.com/pages/technical resources
 IV. Community Level

Assessment of Community Status

Support of Government and Traditional
Leaders
Community decision input and participation
- identified community groups/
organizations
- community specific goals

International Council for the Control of Iodine Defiency

http://iccidd.server295/.com/pages/technical resources
 IV. Community Level

Training
Physical and Financial Support of
Government and Traditional Leaders
Evaluation

International Council for the Control of Iodine Defiency

http://iccidd.server295/.com/pages/technical resources
 V. Family / Individual Level

Capacity Required
Social and Technical Support
Behavioral Action

International Council for the Control of Iodine Defiency

http://iccidd.server295/.com/pages/technical resources
EXAMPLES: CONTENT
TB IN
THAILAND
TOBACCO FRAMEWORK
Our message is simple. We can break free

Individuals can break free

by stopping smoking, if necessary with the
help of smoking cessation programs.

Families can break free

by parents setting an example for their
children.

Communities can break free

by supporting legislation and ordinances of
local governments that ban smoking in
public places and ban advertising.
Our message is simple. We can break
free.

The media can break free

by insisting that the issue of tobacco
control is one that belongs to the
arena of public policy.

The Department of Health and the

World Health Organization are
committed to supporting smoking
cessation programs that are
Countries can break free

by supporting national legislation such as SB

1554: STOP FOR HEALTH ACT (STOP TOBACCO
AND OTHER PRODUCTS FOR HEALTH) that will
restrict the legitimate use and sale of tobacco
in the interest of public health through WHO's
INTERNATIONAL FRAMEWORK CONVENTION
FOR TOBACCO CONTROL (FCTC).

Together we can break free from this epidemic

of addiction and disease.

Support this signature campaign by

signing up now!
Concerned with the ill effects and evil
threats of tobacco use and its
advertisements as well as the
conspicuous sale of cigarettes to
minors, we are affixing our
signatures hereunder to manifest our
pleadings to our legislators and other
authorities
– to enact a law that would prohibit
cigarette and other tobacco product
advertisement and its sale to
minors; and
 - to support Senator Flavier's bill
1554: Stop for Health Act (Stop
Tobacco and Other Products for
Health) and the international
framework convention on
tobacco control (FCTC). …

or its equivalent in Filipino: "Warning"

Cigarette Smoking is Dangerous to your
Health". ...
 EXAMPLE:
Social Mobilization
FOR/ OF CHILDREN
UNICEF ANNUAL REPORT 2003
MAP OF PROGRAMMES FOR
ADOLESCENT PARTICIPATION DURING
CONFLICT AND POST-
CONFLICTSITUATIONS
Sept 2003 UNICEF
The project activities
2. Begin with a child-led process of risk
mapping and community mobilization.
Groups of 8-10 children (7-12 years of
age) and youth (12-18 years of age) draw
a map of their village and locate the
places that are dangerous or where
accidents happen to children.

2. Then they choose the top two risks to

young people and.
present their findings
to village adults by means of a role play,
which typically evokes keen interest and
animated discussion.
The project activities

3. Adults and young people who show

strong interest in helping and who
represent different groups in the
community then form a CWBC.

4. Initially, the CWBCs focus on

reducing physical risks such as
open wells, landmines,
.
or lack of
public latrines for women.
5. With additional experience and
training, however, they also address
emotional and social risks such as
stigmatization, hopelessness, or
continued association
of young people with a local
commander.

6. The CWBCs also monitor children’s

wellbeing and risks by means of a
Child Protection
. and Monitoring Tool
developed by Save Alliance with input
from many partners.
Critical allies on the ground, especially in
efforts
1) to reach the hard to reach,
2) improve district performance,
3) leverage resources
4) achieve optimum coordination

o Local governments,
o Non-governmental organizations,
o Traditional and religious leaders, and
o Civil society organizations
Progress for Children, Report Card on ImmunizationNo.3 Sept
2005

1990 2
003
FILM-MAKERS
Wilmot a young Liberian boy describes the impact of
war on children at a UN Security Council Meeting on
Children and Armed Conflict. At the conclusion of the
meeting, the Security Council committed to
redoubling its efforts to protect children, affected by
armed conflict, condemned the targeting or
 Due
2008

3.Social mobilization and long

term political sustainability of the
Social Determinants of Health
agenda, which is being organized
through an extensive civil society
lead process
PHM advocates people's health
issues at 59th WHA
health issues at 59th WHA
A delegation of People's Health
Movement (PHM) activists attended the
59th World Health Assembly of the World
Health Organization in Geneva in order to
advocate relevant issues. They threw their
support behind a proposed global
framework on essential health research
and development
Health : physical,
mental and social
well –being
Not merely the
absence of disease
A LEVEL OF HEALTH THAT PERMIT PEOPLE TO
LEAD SOCIALLY AND ECONOMICALLY
PRODUCTIVE LIVES
5 STAR M.D.

EDUCATOR

FCM 1
5 STAR M.D.

RESEARCHER EDUCATOR

FCM 2 FCM 1
 HEALTH PROVIDER
5 STAR M.D.

MANAGER SOCIAL MOBILIZER

FCM 3 FCM 3

RESEARCHER EDUCATOR

FCM 2 FCM 1
 5 STAR HEALTH PROVIDER

M.D.
SOCIAL
MANAGER MOBILIZER

DLS
DLS

RESEARCHER EDUCATOR
HOW
Social Mobilization in CM3
Recognize critically a problem
- affecting CM3

2. Determine factors affecting the

identified problem with key decision
maker

3. Describe the desirable action from

these key DECISION MAKERS at
various levels
a- CHANGE IN Policy/ Program
b- PROVIDE Resources (SPECIFY material,
human, funds etc)
c- PROVIDE SERVICES – training, manage,
HOW
Social Mobilization in CM3
L DECISION Desired Component to be
evel MAKER Action used to get
from desired action:
Decision Describe/ specify
1 Maker

4
HOW
PROCESS FRAMEWORK
4. PLAN , carry out and assess the
desirable elements for the desired
changes. (random assignment of 5
groups)
- Community Organizing
- Information, Education,
Communication
- Training
- Advocacy
- Monitoring and Evaluation

REPORT BY – 4:00 P.M.