Community Engagement Community Manual Engagement Manual
Overview DESCRIPTION The FamilyDOC Community Engagement Manual is a comprehensive manual that seeks to ensure the replicability of community engagement best practices for FamilyDOC Clinics.
BACKGROUND The FamilyDOC Clinic is envisioned to be a chain of community-based primary care clinics. The clinic is a 3-in-1 healthcare facility composed of an outpatient clinic, a laboratory and diagnostic facility, and a pharmacy. It aims to provide quality healthcare for the growing Filipino middleclass, while at the same time maintaining affordability and accessibility. The pilot site is in Poblacion, Muntinlupa.
GOALS OF COMMUNITY ENGAGEMENT To establish long-term partnerships with key stakeholders in the community To work closely in partnership with key stakeholders in promoting health and wellness in the community through the services offered at FamilyDOC Clinics
HOW TO USE THE MANUAL This manual will serve as a guide whenever a new site for a FamilyDOC clinic has been identified and steps for engaging the community around it need to be initiated.
The steps outlined in this manual are meant to be undertaken from the time a clinic site is identified up to the clinic opening. Ideally, this will span two months following the Timeline included. This manual includes a case study of the community engagement done in Barangay Poblacion, Muntinlupa City. Specific examples from the experiences of setting up the pilot site are referenced within blue boxes.
// Contents 04
Initiating the Community Engagement 04 / Environmental Scan 05 / Stakeholder Analysis 06 / Contact Key Stakeholders 07 / Healthcare Mapping 08 / Focus Group Discussion Formal Introduction with Stakeholders MOA 09 / Brand Activation
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Sustaining the Community Engagement 10 / Quarterly Updates Form groups or member clubs
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Timeline
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Appendix
I
Initiating the Community Engagement A. ENVIRONMENTAL SCAN Source: Strategic Management Concepts and Cases, 13th Edition by Daft (2011)
An environmental scan is necessary in order
Technological factors
to know of and respond to the external factors that may affect the context in which the clinic and the community are existing in. By doing so, certain measures can be undertaken to make the clinic more resilient to factors which it can’t control.
Survey trends in product innovations, applications of knowledge, focus of private and government-supported R&D expenditures, new communication technologies, attitudes toward technology, and Internet access.
Legal factors Political factors
Survey existing policies (especially health policies), laws, enforcement, and regulation.
Survey community leaders, political parties, and special interest groups. Survey political conditions, conflicts, programs, philosophies, and attitudes toward government. Survey current and priority health programs of DOH (at local level) and LGUs.
Environmental factors Survey recycling, waste management, endangered species, energy conservation, pollution control, traffic congestion, and inner city environments.
Economic factors Survey per capita income, socioeconomic status, sources of income, employment & unemployment rates, supply and demand of goods (especially health services), consumption patterns, and price fluctuations.
Social factors Survey population, geographical area, childbearing rates, marriages, divorces, births, deaths, life expectancy rates, lifestyles, ethical concerns, sex roles, equality, education, attitudes toward leisure time, social programs, religion, number of churches, population changes by race, age, sex, and level of affluence, tastes, and preferences.
Figure 1. External forces affecting the organization. Adapted from Strategic Management Concepts and Cases, 13th Edition by Daft (2011)
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Table 1. Environmental Scan Table External Factor Political Economic Social Technological Legal Environmental
Key Observations in Community
B. STAKEHOLDER ANALYSIS
BLUE BOX #1
It is important to know about the stakeholders
Women’s Groups Special consideration needs to be made for women’s groups present in the community. Studies (Hemard, et al., 1998) show that women are known to be the gatekeepers of health in the household. Their decision making influences all members of the family. Therefore, tapping women’s groups would provide access to health of the families in the community.
as they are the movers and shakers of any venture. When stakeholders are carefully analyzed and engaged, resources will be easily mobilized. Who are the stakeholders? What are the priorities of each stakeholder? What are the available resources of each stakeholder? What are the motivations of each stakeholder?
Special Interest Groups In the stakeholder analysis, include informal groups like midwives association, homeowners association, cooperatives, and transportation groups (TODA) since these groups already have close ties with the community.
Table 2. Stakeholder Analysis Name / Role
Stake
Stand on the Issue
Intensity of Stand
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Degree of Influence
Insight / Action
C.C.ESTABLISH CONTACT WITH KEY STAKEHOLDERS Establish Contact with Key Stakeholders
City
. . . . . . . Barangay
.
Set a courtesy call to the barangay captain Acquire contact information of barangay officials and members of any community groups
. . . . . . Municipal Health Office (or City Health Office)
. . . . . Community groups
Inform groups of available amenities in the clinic they can access.
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D. HEALTHCARE MAPPING
The goal of healthcare mapping is to generate
Geographical mapping
data to understand the existing market within the target community. This is done through collection of geographic data and market analysis of existing health services within the vicinity of the FamilyDOC site.
Map the targeted community of the clinic based on its geographical location.
BLUE BOX #2 Poblacion FamilyDOC Clinic Map The pilot clinic in Muntinlupa City was constructed in Brgy. Poblacion but nearby barangays such as Putatan and Tunasan were also geographically close to the clinic, so these communities were engaged as well.
Overview of health in the area Information on existing health programs and status can be obtained from the city health office. Health Status Checklist Top Causes of Morbidity and Mortality Current Community Health Status and Health Issues Schedule of Health Programs and Activities Healthcare Facilities and Personnel Barangay Health Worker Program and Personnel Existing Health-related Informal Groups or NGOs
Survey of services and signal prices of health providers
Figure 2. A photo showing Muntinlupa City and its component barangays. Poblacion is in orange.
Do an ocular inspection of all the health service providers in the area including hospitals, diagnostic laboratories, clinics, pharmacies, and health centers. Survey the prices of signal health services in existing healthcare providers in order to compare the competitiveness of the prices of the health services of FamilyDOC clinic. Signal health services are the most commonly availed health services from providers that the public use to gauge financial accessibility (ex: CBC, urinalysis, fecalysis, chest xray, ultrasound, 2D echo).
Referral network BLUE BOX #3 It is essential to establish relationships with nearby tertiary hospitals. An agreement with the medical director of Ospital ng Muntinlupa (OsMun) was made to be able to refer admitting patients. It is also important to establish relationships with other referring health centers, clinics, or doctors in the community who may want to refer to FamilyDOC for consult, laboratory workup, imaging, or pharmacy.
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E. FOCUS GROUP DISCUSSION
F. FORMAL INTRODUCTION WITH KEY STAKHOLDERS
Focus
group discussions or FGDs provide insights into a specific patient’s experience of health. FGDs also have the additional benefit of increasing awareness about FamilyDOC through word-of-mouth advertising and is consistent with the desire to provide personalized care for the family. Participants usually appreciate that the clinic makes efforts to listen to their comments and suggestions.
By this point, you may already have established relationships with the key stakeholders. In this step, formally introduce the clinic management to the key stakeholders. Propose partnerships and ask about avenues where FamilyDOC may be of help to the community.
Steps
G. MEMORANDUM OF AGREEMENT
Recruit participants Recruit facilitators Carry out methodology of FGD (research questions, activities, and flow of discussion) Data analysis and presentation
Proposed partnership with Municipal Health Office
Initial FGDs should be focused on branding and logo studies. However, future FGDs can focus on the experience of healthcare in the community. This will allow FamilyDOC to understand the usual experience of health in the market and address any concerns elicited during the discussion.
BHW program (1 training per site for approximately 30 BHWs)
Proposed Barangay
partnership
with
LGU/
Healthy Family Series Pop-up clinics (before opening) Seminars, talks (at least 1 per quarter throughout the year)
BLUE BOX #4 FGD in Poblacion An FGD in Poblacion, Muntinlupa was conducted as part of studies on the “FamilyDOC” brand. Eleven participants, mothers from the community, were recruited with the help of the barangay hall. The FGD was done in a Jollibee branch, and participants were given tokens for
Proposed partnership Municipality/Mayor
with
the
Partnering province or citywide may be necessary later on when clinics are scaling up.
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H. BRAND ACTIVATION
Door-to-Door Visits by Physicians to Key Groups FamilyDOC Physicians make their presence known to the community by visiting homes of the leaders of key groups.
Soft Opening The establishment begins operating but with little promotion to precede the grand opening.
Pop-up Clinic/Fair An event wherein clinics will be setup to accommodate the health needs of the community.
Grand Opening A publicized event to announce the official opening of FamilyDOC. It is important to invite key stakeholders in the LGU at least two weeks before opening.
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II
Sustaining the Community Engagement A. QUARTERLY UPDATES
To
maintain an open line of communication with the LGU and other institutional partners, quarterly updates containing data on the health status of the community should be provided.
B. FORM GROUPS OR MEMBER CLUBS
Having member clubs is one way to actively engage both formal and informal community groups.
Clubs Mothers: Kumare Club Senior Citizens Club Children: Kids Crew Men: Bastketball Team, Liga
Steps Recruit club members from the FamilyDOC members pool. Hold activities where club members can bond. Tap these core groups in engaging the community.
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Initiating the Engagement
Sustaining the Engagement
BHW Referral Program
Form Groups / Member Clubs
Quarterly Updates
Brand Activation
Memorandum of Agreement
contact details of key group leaders
data to be presented
invitations for LGU
draft of MOA
FamilyDOC staff
facilitators, participants, FGD questionnaires
Focus Group Discussion
Formal Introduction with Key Stakeholders
researchers, mapping app (Google Maps)
letters to key stakeholders
stakeholder analysis table, researchers
data sources, researchers
Resources Needed
Healthcare Mapping
Establish Contact with Key Stakeholders
Stakeholder Analysis
Environmental Scan
Activity
Week Week Week Week Week Week Week Week After 1 2 3 4 5 6 7 8 Opening
III Timeline
Appendix SAMPLE LETTER OF INTENT 8 April 2015
Mayor Atty. Jaime R. Fresnedi Mayor Muntinlupa City Dear Honorable Fresnedi, Greetings! FamilyDOC Clinic will be opening its pilot branch in Poblacion, Muntinlupa by June 2015. In line with our thrust of providing affordable quality healthcare, we realize the importance of understanding the community and their health needs. We would like to request for your permission to speak with your Municipal Health Officer, Dr. Magdalena C. Meana, and obtain baseline health data. We are interested in understanding the current health services and programs of Muntinlupa City. We would also like to speak to Barangay Captain Allen F. Ampaya of Poblacion and Barangay Captain Walter F. Arcilla of Tunasan. These are the barangays around our clinic and we would like to understand more about the political, social and economic situation of the community. Our goal is to identify the important stakeholders and to understand current healthcare patterns. It is our hope that by engaging the community, we can improve the quality of our health services and complement any existing health programs in Muntinlupa. Thank you for your kind attention. You may contact me at 09188151218 or rizzyalejandro@gmail.com for any additional questions or comments. I will also be in touch with your office to follow-up this request. We would be grateful for any assistance you can provide us with. Sincerely, Maria Carissa A. Alejandro Community Engagement Officer FamilyDOC Clinic