Prepare To Mobilize

STEP 1: Select a health issue and define the community.

One of the first things that happens in any community mobilization effort is the selection of a health issue around which the community will eventually mobilize. Ideally it is the community itself which selects the issue, but in the real world of international development assistance, the issue is often pre-selected by donors or other external organizations with little or no consultation with the community. The typical user of this manual is likely to be in the position of implementing a program around an issue chosen by someone else. Whether you choose your own health issue or have it handed to you, you will almost always be in a position to shape and define the issue with respect to the local circumstances in which you will be working. In that context, there are a number of things to keep in mind about choosing a health issue.

Defining the issue is an important part of selection. How the issue is defined will depend not only on the problem itself, but must also take into account how the issue is perceived by the community and externally. Program managers need to consider the political, cultural, and social context in which they intend to work to ensure that the definition of the issue is appropriate to the setting. For example, in some settings family planning programs and adolescent reproductive health programs may meet with resistance by politically powerful groups. Some of these programs have decided to broaden their definition of the issue to include a wider array of reproductive health issues or to integrate family planning into general family health services. Others may opt to address the issue head on and plan their approach accordingly.

Another thing to consider is whether the health problem is a symptom of a much deeper issue and whether you choose to mobilize around the symptom or the underlying themes. For example, women’s health problems may be a reflection of women’s low status in the community. Will you mobilize communities around women dying or the value of women? There are ways to build both into a program design, but you must first articulate the issue.

Finally, you may want to consider whether defining an issue too broadly would overwhelm community members to the point where they start to feel they could not possibly achieve related goals and therefore decide not to participate. A well-defined focus on the main goal of the effort is critical at this stage and throughout the community mobilization process. In general, if you have limited time and resources, community mobilization is more effective when the issue is more narrowly focused. A narrow focus, however, does not mean that community-generated strategies and activities to address this issue will necessarily be limited.

Some questions to consider in selecting a health issue… Is the definition of the health problem appropriate given the cultural, political and social context? Is there an underlying/deeper issue behind the problem? Is the definition of the health issue too broad given the timeframe and resources available?

Defining A Community
To Mobilize Or Not To Mobilize?