Step 1 - Community Engagement and Analysis Intelligence Step 1 - Community Engagement and Analysis Putting the Public at the Forefront of Public Health Nutrition Practice One of the defining features of public health nutrition (PHN) practice is its focus on populations or communities rather than individuals Engagement can take many forms and is flexible to the situation Community development approach to PHN work stems from the belief that communities have internal capacity to take action Community Engagement and Analysis

Community Engagement and Analysis

What is a Community? A community is generally defined by homogenous unity. The most commonly cited factors for defining community or population include: Geographical proximity Cultural similarity Social stratification based on common interests or characteristics Community Engagement and Analysis

Why Community Engagement? Successful preventive health interventions are greatly dependent on the participation and support of the community in which the intervention is developed and implemented. PHN practitioners act as catalysts for community action, by empowering others to develop intelligent strategies to deal with identified determinants of nutrition-related health problems. Community engagement and development is not a structured process but needs to be informed by the community itself and adapted to the context of the individual community. Community Engagement and Analysis

Who best represents a community? One of the challenges of community engagement is identifying who in the community best represents the community. Individuals with the time, energy and motivation to participate in PHN interventions may not represent or understand the issues as experienced by those most needy in the community. Beware of the dominant minority. Explore a mix of strategies to identify and engage those most affected by the issue you are dealing with. Community Engagement and Analysis

Community Development Constructs There are several constructs or methods underpinning community development: Participation – joint action between community members and health development workers Empowerment – a shift of power where community members experience more control over decisions that influence their health and lives Equity – acknowledgement of health inequalities and prioritising activities toward those who’s needs are greatest. Community organisation and collective action – mobilising a variety of agencies, institutions and groups in a community to coordinate services and programs for the united purpose of improving the health of the community Community Engagement and Analysis

Community Development Dilemmas Social support and community involvement can elicit health enhancing benefits and produce sustainable changes in the ‘upstream’ determinants of health However there can be challenges and dilemmas involved in community development work including: Funding – frequently short-term with a pre-identified focus Accountability – dual accountability (a) funding agency and (b) community Acceptability – time and resource requirements not always condoned by management/ practitioner not trusted or identified as a community member Professional attitude – considering ones self as an expert who knows what is best for the community Community Engagement and Analysis

Building Community Capital A healthy community has high levels of social, ecological, human and economic capital – collectively ‘community capital’ ‘capital’ recognises that health is a form of wealth For a community to be healthy all four forms of capital need to increase together Social and human capital make up 60% of the worlds wealth → importance of prioritising effort towards community development to produce social and human capital Community Engagement and Analysis

Capacity Building Community engagement as a strategy within a capacity building approach can thus be described as a ‘bottom-up’ approach, informed by and owned by the community. Capacity building can present challenges for health professionals because it necessarily involves health practitioners relinquishing control and working towards a role obsolescence. Capacity building can be seen as a central health promotion strategy and is a continual process that acts in parallel at each point along the public health intervention management cycle. Community Engagement and Analysis

Public health nutrition intervention management practice cycle ASSESSMENT Define needs and analyse problems Determinant analysis Evaluation ANALYSIS BUILD CAPACITY Explore strategy options Implementation Planning and prioritisation Baillie et al (2008) ACTION Community Engagement and Analysis

Community Analysis “Know thy community” is an important commandment of effective PHN intervention management. Community analysis involves reviewing demographic, health and other essential data about the community or population and how it compares to national or regional averages. This initial assessment of the community helps identify key stakeholders, target groups and provides a basis for community engagement. Once the target group is identified, develop a clear description of the target group to further focus the next steps of problem and determinant analysis. Community Engagement and Analysis