CDI Module 4: Mapping Community Structure, Networks and Organization

©Jhpiego Corporation

The Johns Hopkins University

A Training Program on Community- Directed Intervention (CDI) to Improve Access to Essential Health Services

Module 4 Objectives

By the end of this module, learners will: State the definition of community used in “to roll out

community-directed interventions (CDIs)” Describe the purpose of community mapping in

building support and solving problems Explain the value of involving community members

in mapping their own community List the steps and activities needed to map the

organizations and resources in a community

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Community in CDI

In CDI, we create a strong community-clinic linkage

We start our definition of community by identifying all the settlements, villages, etc. that are served by a primary health care facility (catchment area)

To make CDI effective, we work with each of the smallest functional units of a community (such as a kindred, clan, neighborhood, hamlet)

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Mapping

Mapping is: A very important component of almost all

practical situation assessments A joint activity with the community that can help

everyone involved learn moreAll programs need to have a sense of where: People live The problem areas are The community resources are located Others are doing their activities

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Resource and Social Mapping

Locating Physical Structures Health facilities and providers Schools, religious institutions Boundaries

Understanding Social Relationships Existing organizations, associations, societies and

levels of activity Wards (sub-districts), kinship groups Utilization patterns and barriers

Communities are built from their social networks

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Why Social Mapping?

In mapping, we are interested in our target population—for example pregnant women—and the people or groups with whom they relate: Pregnant women People pregnant women turn to for advice and

assistance Key members of social networks to which pregnant

women belong

Mapping helps link people in need with the services and resources they need

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Social Mapping Helps Make Sense

Mapping provides useful tools for making sense of social networks and behaviors related to using services during pregnancy

In this case, we are interested in: The size of the population group we are targeting Their utilization behaviors The places and persons to whom they go for help What attracts them to these people and places

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Mapping Is Not Just about Locations

When community members are involved in mapping, they learn more about the problems and resources in their community

They can visualize service quality issues like access and equity

What can you tell about the community from this map?

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Components of Mapping

During the community meeting: Ask the group to list key persons and

organizations in the community that can help promote the program

Identify any potential road blocks or people who might oppose the program

Learn about the community’s past development efforts and why these did or did not succeed Past efforts provide lessons on how to undertake

future efforts more successfully

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Map Health and Development Resources

Ask people: To name and describe the location of key health and

development resources that the community values, such as: Healers Opinion leaders Medicine shops Local associations, etc.

About major sub-divisions (e.g., wards, communities, kindreds/clans and settlements)

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Map Resources for Women

Specifically ask about resources—people and organizations—to whom pregnant women go for advice and help, for example: Where do they get advice? Are there women who regularly deliver babies? Where do they get medicines? From whom do they get financial, emotional and other

support?

Take notes during the meeting

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Identify Women’s Associations and Support Groups

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Use the Social Mapping Information

At the community meeting, encourage people to use the information generated to help plan program development, for example: Develop criteria for the best types of people to serve

as community-directed distributors (CDDs)—for example, for malaria in pregnancy (MIP) programming

Determine sub-communities (e.g., kindreds/clans, settlements, neighborhoods) that could form the basis of selecting CDDs)

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If There Is Time, Actual Maps Can Be Drawn and Kept with the Community

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Mapping Varies by Type of Community

Many factors influence a community’s structure, organization and networks, such as: The status and

concentration of the services in the area

Whether it is urban or rural

The way people utilize the services that are available

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Rural and Urban Communities

Some Rural Issues Greater community cohesion and identity Smaller and more dispersed units Seasonal habitations (e.g., farm hamlets) Generally poorer

Can you think of other examples?

Some Urban Issues Weaker identity and cohesion More compact, but people travel far for work and

social needs Financial gain often supersedes other social needs Greater divide between poverty and wealth

Chart the Mapping Results forMalaria in Pregnancy

Community Resource Specific Examples

Names of women leaders

Names of community sub-sections (e.g., kindreds/clans, settlements)

Names and locations of health resources—public, private, indigenous

Names of key women’s social groups

Other special resources for pregnant women

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Discussion—A Look at Other Issues

Let’s think of another health issue, for example: Community management

of child illness Food security Home-based care for

people with HIV

What are the community resources we would need to find and map for these issues?

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Chart the Results forAnother Health Issue

Community Resource Specific Examples

Names of leaders

Names of community sub-sections (e.g., kindreds/clans, settlements)

Names and locations of health resources—public, private, indigenous

Names of key social groups

Other special resources

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Summary and Conclusions

Community members’ involvement in social mapping can help them learn more about problems and resources in their community

Service issues like access and equity are more easily visualized by community members

Community participation in mapping makes community landmarks and identity more visible

Mapping helps link people in need with the services and resources they need

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