chapter on community competence and public health

[Discussion list for COMM-ORG]

[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 
expectations.



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.



Best wishes,



Bill





William A. Ninacs



Coopérative de consultation en développement La Clé

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