Community Engagement: A Process of Learning and Change

2. Community Engagement:A Process ofLearning and Change Prepared by Noni MacDonald MD FRCPc, Professor Pediatrics, Dalhousie University Healthy Child Uganda: winners healthy home competition 2 2012

3. Objectives Following this lecture, the participants will be able to Define communities Describe the rationale for community engagement Describe ladder of citizen engagement Describe 3 major processes in engagement Summarize evaluation tools for assessing engagement Outline the 10 coreprinciples of effective community engagement Adapted from Canadian Policy Research Networks metapraxis.ca/site/ywd_metapraxis/assets/pdf/Engagement_Framework__synopsis.pdf 3 2012

4. What are “Communities”? May mean- groups of people with similar problems e.g mothers with babies under 5y geographic related: village, township, country e.g all who live in south west Uganda health care workers in a region churches or hospitals or clinics media-radio, newspapers;social media-twitter Healthy Child Uganda 4 2012

5. Why is Community Engagement Important for Health ? Community needs to be involved in: defining health issues working to improve health design / running of health projects To share knowledge learned: relevant leaders appropriate members Help to shape community health care: disease prevention health promotion acute and/or chronic care 5 2012

6. What does Engagement Mean? Citizen engagement meaningful involvement of individual citizens in policy or program development. citizens are "engaged" when they play an active role in defining issues, considering solutions, identifying resources/priorities for action "meaningful involvement" should take place at all variety of stages of a project research, planning, or implementation www.cihr-irsc.gc.ca/e/41592.html 6 2012

7. Engagement:Ladder of Citizenship Participation MR Community Entry not=Community Engagement Arnstein, Sherry R. "A Ladder of Citizen Participation," JAIP 1969;35:216-224 7 2012

8. From Control and Power to Partnership- Learning a New Paradigm 8 2012

9. Engagement …….. About learning, changes, commitment not about power and control Always about an outcome or commitment INTERACTIVEprocess Adaptive process About listening, rephrasing to ensure understand what is being said, repeating, checking open ended questions 9 2012

10. Engagement is Dynamic Opportunity for community for learning and change Any change or transition evokes a natural emotional reaction Community engagement means working so people and the community do not fear change NEM • People own what they help create • - own the change 10 2012

11. Engagement …….. Three equally important processes Sharing Information Encouraging exploration of choices and option 3. Closing the feedback loop http://www.scdc.org.uk/national-standards-community-engagement/10-national-standards/ 11 2012

12. Sharing Information One Way -Listening Multi Way -Dialogue Two Way -Discussion 12 2012

13. Encouraging Exploration of Choices and Options What has been learned about the problem: what are the options? what are the benefits with each? what are the risks with each? how should the decision be made ? by whom? what are the barriers to implementation? 13 2012

14. Exploring Choices Suggest/ Explore Make choices/ Reconcile Validate or Test Divergent/ Generative Conversations Convergent/ Deliberative Conversations 14 2012

15. Closing the Feedback Loop Putting agreed to option into action Providing support for those carrying out the action Testing and modifying action if needed Assessingimpact of action over time Dialogue with community over learnings and outcomes Evaluation 15 2012

16. Evaluation Process Outcomes Adapted from Source: Abelson, Julia & Gauvin, François-Pierre Gauvin, Assessing the Impacts of Public Participation: Concepts, Evidence, and Policy Implications. CPRN (2006). http://www.cprn.org/doc.cfm?doc=1405&l=en Representativeness Inclusivity Participation rate Fairness Process flexibility Transparency Interaction Deliberation, etc. • Policy/decision influence • Public views incorporated into decision-making • Effect on public support • Participants’ values/opinions changed • Conflict resolution 16 2012

17. 10 Core Principles of Community Engagement Begin by listening Attend to people’s leading concerns Reach and listen beyond usual community leaders Frame issues for deliberation Provide the right type and amount of information Modified from Source: Public Agenda – Centre for the Advancement of Public Engagement (www. publicagenda.org) 17 2012

18. 10 Core Principles of Community Engagementcont’d Help people move beyond wishful thinking Expect obstacles and resistances Create multiple, varied opportunities for dialogue and deliberation Respond respectfully and conscientiously to people’s involvement Build long-term capacity- not about us.. it’s the community ! 18 2012

19. Community Participation Ladder Collaboration Collective Action Co-learning Cooperation Consultation Compliance Co- option 19 2012

20. Community Engagement Communities- maybe main locus for change in knowledge translation Efforts to engage community early reap major benefits Be sensitive to culture of local community: language, values, options, timing, setting etc DA DA 2012

21. 21 2012

22. Communities:Uganda, Kenya, Tanzania Strategies to reach and engage in MicroResearch… urban, rural……. your thoughts …….. NEM NEM Healthy Child Uganda 22 2012