Community Empowerment Glenn Laverack

Expressions of Health ‘Think of the last time you experienced yourself as “healthy” and provide a few phrases to express the feeling and the context’. Labonte, 1993.

Expressions of Health Power-from within: Being loved; loving; belonging; happiness; confidence. Power-over: Being in control; able to the things I want/enjoy. Power-with: Giving; sharing; caring.

Power-from-within A personal power or an inner sense of self-discipline and self-esteem. Labonte, 1996

Power-Over A relationship in which one party is made to do what another party wishes them to do, despite their resistance and even if it may not be in their best interests. Starhawk, 1990

Power-with A relationship in which power-over is used carefully and deliberately to increase other people’s power-from-within, rather than to dominate or exploit them. Starhawk, 1990

Powerlessness The absence of power with the expectancy that a behaviour or action cannot determine the desired outcome. An attitude of self-blame, distrust that can create a sense of hopelessness.

"I wanted to go out and change the world". "But I couldn’t find a babysitter". Travers, K. D. (1997)

Empowerment Personal Organisational Family Community/ collective

Personal Empowerment Psychological empowerment integrates perceptions of personal control, a proactive approach to life, and a critical understanding of the sociopolitical environment. It is not individualism but an active engagement in one’s community and the sociopolitical environment. (Zimmerman, 1995)

At some stage individuals will want to address the broader, underlying causes of their powerlessness and will want to become more engaged in politically orientated activities. Passive action empowerment

Community empowerment Community empowerment is ‘a process by which disadvantaged people work together to increase control over events that influence their lives’ (David Werner, 1988). A process and an outcome often leading to social and political change.

The Continuum of Collective Empowerment 1 2 3 4 5 <-- ---------- ------------- ------- ------- ----> Action for Social & Political Change Personal action Small groups Community organisations Partnerships 13

Social change exerts influence over the nature of social behaviour or relations within society. Values and behaviours. Political change exerts influence over the actions of organizations, institutions and civil society. Policy and legislation.

The role of the practitioner The practitioner is directive, instructing communities what they should do. The practitioner plays a facilitating role, asking and assisting communities to do what they want towards self-directed goals. The practitioner plays a facilitating role to explicitly bring about social and political change, in favour of the community.

The community contribution There is evidence that community mobilisation is an effective method for promoting participation and empowering communities among a wide range of health and other non-health benefits (Rosato, 2008).

Communities Social ties and networks are a powerful determinant of health. Community-based interventions can work. Provide skills, knowledge and experience. Bridging and connecting to others. Builds capacity and helps with local program delivery. (South, 2013) Pictures from Wakefield Groundwork

Community Health Champions 15,000 + champions recruited and supported in the UK. Roles vary in intensity from talking to people as part of their daily lives through to organising community activities. Help to recruit other volunteers. (Altogether better, 2011).

The Safer Parks Scheme New Zealand Started by the City Council following complaints about crime in public parks – low patronage. Employed park wardens and honorary rangers to patrol the areas and installed exercise equipment. In collaboration with the DoC it encouraged public participation through its ‘adopt a park’ initiative. Volunteers helped to raise money and to report any problems that they encountered to the park rangers. As a result park patronage and exercise levels greatly increased-leading to improved health.

Building and measuring community empowerment

Capable communities The existence of functional leadership, established community structures, participation and the ability to mobilize resources are indicative of strong organizational and social abilities and capture the essential qualities of a ‘capable’ community. A link between the inter-personal elements such as individual control and positive relationships and the organisational aspects of community capacity and empowerment.

Building community empowerment Community participation. Problem assessment capacities. Local leadership. Resource mobilisation. Organisational structures. Links to other organisations and people. Ability to ‘ask why’ (critical consciousness). Community control over programme management. Equitable relationship with outside agents. (Laverack, 2009). 22

The Methodology Participatory- workshop approach-4 phases. Preparation (the development of a working definition & pre-testing the domains). Assessment of each domain. Strategic planning for each domain. The follow-up (re-assessment and comparison of progress).

The Descriptors for each Domain Five Qualitative statements. Least to most capacity building. Separate sheet and not numbered. Participants select/adapt one statement.

Ranking the Assessment Selected statements ranked 0 to 4. Numerical value placed into graph. Graph provides visual representation. Graph should be culturally applicable.

Organisational structures 1 2 3 4 Build organisational structures HAT has no organisational structure such as a committee structure.   Organisational structures have been established by the HAT but are not active. Organisational structures have a way to allow the involvement of all its members in decision making. Organisational structures have established links with other groups outside the HAT. Organisational structures work well with its members. HAT is committed to its own issues and the other groups that it works with.

The Empowerment Matrix Domain Assessment and rank Reasons why How to Improve Strategy Resources Build organisational structures Organisational structures have been established by the HAT but are not active. (1) Because some roles have not been clearly defined Eg. Secretary, Vice chair, Treasurer Elect vice chair, secretary, treasurer FUNDED: (Secretary) WHAT: This will be reviewed after September 2007 NOT FUNDED: (Vice Chair, Treasurer) WHAT: Elected via Secret Ballot WHO: Chair WHEN: 6/7 June 2007 @ next HAT meeting WHERE: Training Centre Time Commitment to meet (6/7 June) Venue (Training centre)

Visual Representation Spider web configuration. Comparison between domains. Comparison overtime. Comparison between communities.

Cross checking findings

Research and Development PEOPLE PRACTITIONERS POLICY MAKERS Effective approaches to engage with marginalised groups. Professional competencies to facilitate the empowerment of people at all levels. Scaling up successful bottom-up approaches. Evidence of the link between empowerment, the determinants of health and health outcomes.