chapter on community competence and public health
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Wed Mar 26 09:23:03 CDT 2008
[ed: Bill sent this message to me and allowed me to forward it to the list.]
From: "Bill Ninacs" <bill at lacle.coop>
Ninacs, W. A., and Leroux, R. (2007). “Intersectoral Action and
Empowerment: Keys to Ensuring Community Competence and Improving Public
Health” in C. Dumont and G. Kielhofner (Directors), Positive Approaches
to Health, Hauppauge (New York), Nova Science Publishers, Inc., pp. 169-185.
Here’s an abstract of the chapter:
A community is competent when it provides access for its members to the
resources required to ensure their health and well-being and when its
members use the accessible resources to their advantage. Intersectoral
action is a key to succeeding on the first level while empowerment is a
prerequisite to achieving the second.
Successful intersectoral action depends on an understanding of the role
that each sector plays with regards to a community’s diverse functions.
The public and private sectors are generally instrumental while the
nonprofit sector includes an existential component. Concerted action
between the sectors can thus result in a broader perspective of health
promotion and more comprehensive, partnership-based service delivery.
Enabling factors include a win-win approach and realizing that the
process takes time and resources. Obstacles include lack of flexibility,
especially in government institutions, hidden agendas and unrealistic
There are at least two simultaneous empowerment processes required for a
community to be competent and there exists a dialectical relationship
between the two. The individual empowerment process is comprised of four
components (participation, technical ability, self-esteem, critical
consciousness), each of which evolves along a continuum of its own.
Empowerment stems from the interweaving of the four, with each component
simultaneously building on and strengthening the others, and thus
intervention is needed on all four levels at the same time. The
community empowerment process also has four interwoven components:
participation, knowledge and ability, communication, and community
capital. Intersectoral participation is influenced by the essential
interaction of each process' components, since the two processes build
upon and strengthen each other.
An organisation can be an empowering environment since it is a
functional community. The role of organisations in intersectoral
participation is thus central. Since the majority of community-based
organisations operate in the health arena, either by offering social
support to specific — and often at risk — population groups or by
providing crisis or specialized interventions on problems such as
homelessness, poverty, suicide prevention, prostitution, mental health,
food security and nutrition, substance abuse, HIV/aids and domestic
violence, ensuring that these organisations support individual and
community empowerment can be considered to be a vital public health issue.
Finally, an organisation is an entity unto itself and, within the larger
community that it is part of, it evolves through an empowerment process
similar to that of an individual, but with recognition replacing
self-esteem. Intersectoral strategies must take this process into
consideration in order to be successful.
Trust you’re well.
William A. Ninacs
Coopérative de consultation en développement La Clé
Place communautaire Rita-Saint-Pierre
59, rue Monfette, local 208
Victoriaville (Québec) G6P 1J8
téléphone : (819) 758-7797, poste 226
télécopieur : (819) 758-2906
courriel : bill at lacle.coop
site internet : http://www.lacle.coop
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