Promoting Partnership with the Community

        Promoting Partnership with the
Community

Importance of Partnership with the Community in Health Promotion
Partnership
• A mutual search for information and solutions.
• It is a voluntary joint action or decision-making in a harmonious and supportive way, for a common goal and outcome.
• It involves all players or stakeholders at community level who, through their actions, will influence health services delivery at any of the health delivery points in the community.

       Types of Partnership
There are two types of partnerships described in this module
• The first type of partnership is between organizations providing health and health-related care in a community.
• The second type is between organizations providing health and health-related care and the community.

Importance of Partnership
• Isolated efforts have limited impact because experiences, expertise and lessons learnt are neither shared nor concentrated.
• With effective collaboration, each organization can focus on its strongest areas.
• By cooperating with interested parties, district health management teams (DHMT) may be able to provide broad-based and high quality health services to those who need them.
• The importance of developing partnership with the community in health promotion include:
o Improved community perception about health indicators
o Full community participation leading to programme acceptability, ownership and
sustainability
o Increase financial and programmatic resources
o Assists in individual and organizational networking
o More credibility and visibility of quality services in promoting health among community members and influence of advocacy efforts

Advantages of Partnership in Health Care
• When resources are scarce there is an obvious need to share the limited resources.
• Partnership makes the most efficient and effective use of resources while avoiding duplication.
• Significant health problems always have environmental, social, economic, political and legal determinants. These multiple determinants of health problems may only be addressed through combined efforts by various sectors.
• Through collaboration, organizations may identify common areas of interest and they may pursue activities in similar standards. Eventually they may develop common policies and thus increase a common sense of direction.
• Monitoring of progress is easier when efforts and technology are harmonized.
• Combined health interventions or programmes may be more responsive to specific health needs of a particular area or community than multiple isolated efforts.
• Exchange of data, information and networking may improve the approaches of individual partners and sustain the capacity of large programmes that cover many areas.
o Such exchange and sharing of information may make an organization avoid mistakes, learn from the problems and successes of others, and avoid wasteful and unnecessary activities.
o It may also benefit the design, implementation and evaluation of programmes in all kinds of fields including health, education, and home-based care.
• Maintenance of equipment may be both convenient and inexpensive when technical inputs are made compatible.
• When organizations coordinate, they can assign activities to those organizations that are best qualified to carry out those activities, thus putting an end to duplication of services.
o This should free both funds and personnel to take on new activities, thereby broadening the scope of the services provided.
• Collaboration brings greater influence.
o When all service-providers speak with one strong voice, they are much more likely to be heard, respected and answered.
• In summary, collaboration among partners builds solidarity and reduces unnecessary competition and uncertainties among stakeholders while addressing major health problems.

Identification of Areas of Partnership
Partnership between Organizations
• In order to provide clients with the best and most accessible health services possible, the community health management team (CHMT) needs to work collaboratively with other
organizations in both the public and private sectors available in the community.
• It is very important for the CHMT to coordinate all elements of health programmes in the community.

Characteristics of an Organization
• Before entering into partnership you would like to know your partner better.
• It is important to consider briefly what determines the character of an organization.

• Organizations are defined as collections of people joined together in some formal association
in order to achieve group or individual objectives.
• Organizations are characterized by:
o The purpose of the organization
o The people, who are associated with the organization, their attitudes and values, their aspirations, their experience of different types of work
o The strategies and tactics, as evidenced from plans and policies.
These strategies may relate to services provided, intended target group and area, finances and personnel
o The technology or equipment they have
o The environment in which the organization is operating
o The structure of roles and relationships, which is partially revealed in organizational charts and job descriptions, but extends to the content and form of control systems and
administrative structure.
o The culture of the organization, which consists of its shared values and beliefs.
   This culture creates special patterns of thinking and feeling within each organization.
      Large government and donor organizations may have a bureaucratic culture very different from the organizational culture of a local NGO.

Building Partnerships
• Partnerships are formed by groups of individuals that join together aiming to accomplish a common purpose
• Building effective partnership
o Key questions to ask yourself before approaching potential partners
     Who should constitute the partnership?
    Who should lead the partnership?
    How will resources be accounted for?
    How big should be the partnership?
    Should it be limited to the community/community or other levels should be involved as well?
• Within a community/or community area, there are usually many organizations that are involved in health or health-related services.

These organizations may be:
o religious organizations
o private for-profit organizations
o NGOs
o local-government organizations (water, community development and other departments)
Determine Characteristics of Organization and Patterns of Collaboration/Partnership
• Identify organizations to meet with in the area
• Write to the organization requesting them to attend a joint meeting
• State clearly in the letter that a senior staff member of the organization is requested to attend the meeting to have a dialog and exchange ideas on the organization’s strategies in health
provision, structure, resources and performance.
• During the meeting you will identify organization’s interests, similarities and differences between the organizations and identify existing or potential areas of cooperation/partnership.
• Development of networkin

o In all health care organizations, there are individuals and institutions that have
connections or channels of influence with other individuals or institutions. This leads to the development of organizational networking.
o Management has to devote time and attention to these lateral and horizontal approaches and not to concentrate only on activities within the structure of the organization.
     For example, inter-personal relationship may influence a link within organizations which were once not working together.
• Communication
o Achieving a common understanding is very crucial for the success of any partnership.
o To arrive at a common understanding, there has to be good and effective communication, where messages are conveyed with a shared meaning in a two-way manner between the parties involved.
o Often, conflict arises because of barriers to communication.
o Such barriers could be difference in perception, lack of knowledge, prejudice or bias, among others.

Elements of Effective Partnership Networking with the Community

Factors Facilitating Partnership
• Promoting partnership may be difficult and there are usually obstacles or constraints in the way.

• There are also factors that make it easier to achieve your aims.
• It is good to know what factors encourage partnership.
o Knowing those factors may help you to create the right climate for partnership and to recognize opportunities for collaboration when they arise.
• Examples of factors that promote partnership between organizations include:
o Clear purpose and commitment to inter-organizational partnership by all partners. This is sometimes called ‘political will’.
o Partnership at all levels. Partnership is easier to achieve if there is a national framework for facilitating a similar process at regional, community and community levels.
o Partnership is facilitated by decentralization.
o Decentralization provides community managers with decision-making authority over resources that facilitate partnership.
o Joint planning makes a useful contribution to partnership because planners join in efforts to identify and agree on problems, setting objectives, identification of resources, budgets,
timetables and procedures.
o Sometimes formal rules, regulations and procedures indicate where different agencies can make common use of resources such as finance, personnel and transport.
o Agencies in various sectors should review their policies and regulations to make provision for collaboration and joint decision-making procedures.

Requirement for Effective Networking with the Community
• Identification of community resource persons (village elders, traditional healers, traditional birth attendants (TBAs)
• Consolidation of existing resources
• Formation and maintenance of the network

• Clear purpose for networking
• Commitment building; need for commitment by both parties health personnel and the community
• Maintenance of networking
• Having a health facility committee among them there must be community members representing the community
• Meetings and documentations
• Plan off action for any activity which need to be done for promotion of health
• Collaborative implementation, that is, communities are part of the implementation
• Building alliances with other interested groups; incorporating other groups who have similar interest
• Advocacy
o Community members to be involved in advocacy to other members for implementation of programmes to promote health of the community

Obstacles to Partnership with the CommunityConstraints to Partnership
• If you intend to work together, it is important to foresee and identify possible problems of collaboration and seek ways of solving them.
• Problems in collaboration are related to differences in organizational structures, cultures, procedures (e.g. financial, administrative) and professional ideologies and values.

Problems Related to Organizational Purpose and Structure
• Different policy priorities held by different organizations.
o For example, interests and priorities of individual communities and local organizations are sacrificed when collaborating with large international organizations that have their own agenda.
• Establishing relationships with local partners is difficult when partners are still under central control and are lacking autonomy.
• Partnership is further made difficult when agency boundaries are different.
o A diocese may have facilities spread out over several communities and regions, while a particular DHMT is only interested in providing health facilities in its own community.
• Some organizations may view partnership as a threat to their established role or responsibility, or causing a loss of autonomy or abdication of their leadership role.
o These fears exist in every organization but they tend to be most pronounced among weak or young organizations.

Problems Related To Differences in Procedures
• Organizations operate according to their own management and planning systems and procedures that may be incompatible with those of other organizations. Such different systems include:
o Planning horizons and cycles;
o Budgetary cycles and procedures.

Strategies to Promote Partnership within the Community
Developing Coordination among Organizations in the Community
• Mapping collaborators and collaborative activities
o When many organizations are involved in improving health and health-related services, the council health management team (CHMT) may want to sort out which organization is offering what type of services and whether there is any duplication in the provision of
services.
o Identify which organizations are performing each activity or function sorted.
o The exercise of preparing the function allocation chart is most useful when
representatives of all organizations involved are present and take part to complete the chart and discuss what steps need to be taken to improve services.
o The function allocation chart will help the CHMT and partners to visualize the entire range of health services that are available in the community and use it to identify gaps and duplication of effort.
o Partner organizations will also see how they fit into the overall community health system.
o The chart is therefore an effective tool for establishing a common understanding of the complexities of coordinating health services among different organizations in the community.

How to Improve Partnership among Organizations in the Community
• In order to improve partnership among organizations in the community, there should be a meeting, propose draft agenda and suggest organizations that might send a representative to
the meeting.
• During the meeting
o Allay the fears and highlight the advantages of partnership.
o Establish working procedures of the group, such as frequency of meetings and sharing of information through reports.
o Conduct a function allocation exercise to see who is currently doing what and to identify gaps and redundancies.
o Define the key areas for coordination, and specify the desired changes and expected results.
o Record the discussions and agreements reached.
o Set a date for next meeting.

Strategies in Promoting Partnership with the Community
• Getting to know the community and the community getting to know you
• Before you can involve a community in anything, you have to know the community and vice versa
• Important things you may want to know about a community:
o Work, living standards and seasons
o Family life
o How people in a community relate to each other and their environment;
o Values, beliefs and customs
o Health attitudes, problems and practices

• Do they have places where people can meet to make decisions?
• Values, beliefs, customs and attitudes
o What beliefs are most common about the five top health problems of the area?
o Which customs (traditional practices) do people feel are harmful to human health?
o Are there any social practices or beliefs, which hinder cooperation with certain groups in the area

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