1 ‘Unpacking’ community

empowerment for
strategic planning

This chapter discusses the key domains of empowerment that enable com-
munities to better organize themselves, both socially and structurally, to-
wards the goal of social and political change. Empowerment is achieved
through strategic planning to improve each ‘domain’, where a need has been
identified by the members of a community. This is termed the ‘domains
approach’ and has been used to build empowered communities within
health promotion programming in Asia, Africa and the Pacific. In practice
the ap- proach involves setting a baseline for community empowerment and
then developing a series of strategies to strengthen each domain. The chapter
discusses the application of the ‘domains approach’ and how it can be
adapted by practitioners to suit their different circumstances in health pro-
motion programming.

The domains of community empowerment

Several authors have attempted to identify the areas of influence on com-

munity empowerment (Gibbon 1999; Laverack 2001) and in Table 5.1 I
summarize the work of three authors to identify the ‘domains’ of three
similar concepts: community participation, community capacity and
community development.
The domains of empowerment represent how communities can better
organize and mobilize themselves towards collective action including the
aspects of social interaction and networking in a community. For example,
the existence of functional leadership, supported by established organiza-
tional structures, with the participation of its members who have demon-
strated the ability to mobilize resources, would indicate a community which
already has strong social support elements. There are at least nine ‘domains’
for community empowerment (Laverack 2001), as follows:

1 Improves participation.
2 Develops local leadership.
3 Builds empowering organizational structures.
 ‘UNPACKING’ COMMUNITY EMPOWERMENT 61

Table 5.1 The domains of three community-based concepts

Community participation Community capacity Community development

factors (Rifkin et al. dimensions (Goodman et components (Labonte
1988) al. 1998) 1998)

Participation Participation
Leadership Leadership
Organization Sense of community, its
Community organization
history and values
Resource mobilization Resources Resource mobilization
Needs assessment Priorities set using some
form of analysis and
targeted
Critical reflection Sharing of knowledge
Social and interorganizational
Community as identity and
networks
locality
Mediation skills
Management programme Role of an outside agent
Skills Equitable relationships
between community and agents
Community power Power dynamics

4 Increases problem assessment capacities.

5 Enhances the ability of the community to ‘ask why’ (critical
awareness).
6 Improves resource mobilization.
7 Strengthens links to other organizations and people.
8 Creates an equitable relationship with outside agents.
9 Increases control over programme management.

Next is an interpretation of each domain. Case study examples of how to

use the domains approach for building community empowerment are pro-
vided in Chapters 7 and 8.
Improves participation

Participation is basic to community empowerment. It describes the involve-

ment of individuals in groups and in ‘communities of interest’ that share and
have the capacity to begin to address their needs. In the context of health
programming, community participation can be defined as:

the process by which members of the community, either

individually or collectively and with varying degrees of
commitment: develop the capability to assume greater responsibility
for assessing their health needs and problems; plan and then act to
implement their solutions; create and maintain organizations in
support of these efforts; and evaluate the effects and bring about
necessary adjustments in goals and programmes on an on-going
basis.
(Zakus and Lysack 1998: 2)

This definition also encompasses many of the characteristics of an empow-

ered community, essentially allowing people to become involved in activities
which influence their lives and health. However, while individuals are able
to influence the direction and implementation of a programme through their
participation, this alone does not constitute community empowerment. For
participation to be empowering it must not only involve the development of
skills and abilities but must also raise critical awareness to enable people to
make more informed decisions and to take action.
In a westernized context, the difference between participation and em-
powerment therefore lies in whether people simply ‘participate’ or actually
take part in social and political action. To illustrate this, Box 5.1 provides an
example of the interpretation of participation in a health promotion pro-
gramme in a Fijian context.

Box 5.1 Participation and health promotion in a traditional Fijian context

Participation was not interpreted by the respondents of one project in Fiji as having a role in the
decisions concerning design, implementation and evaluation. Their interpretation was more
closely associated with Sherry Arnstein’s (1969) degrees of tokenism (informing, consultation
and placation). This may have been because their experience of programmes was limited to
top-down approaches in which their input in decision-making were not required. However, it
was also closely related to their own social structure in which every person has a
predetermined role or re- sponsibility. Katz (1993) points out that Fijian life is organized
hierarchically, a system that permeates all aspects of life and can exclude many individuals from
taking part in the decision-making process. Lewaravu (1986) further points out that
the level of participation of each community member is differentiated by their traditional
roles and tasks and it is the senior members of the community who take part in decision-
making while the majority of people would only be involved in ceremonies or in activities
such as food preparation.

Develops local leadership

Participation and leadership are closely connected because, just as leaders

require a strong participant base, participation requires the direction and
structure of strong leadership. Participation without a formal leader who
takes responsibility for getting things done, deals with conflict and provides
a direction for the group can often lead to disorganization (Goodman et al.
1998).
The structure of community leadership, which may be historically or
culturally determined, can exclude marginalized groups and represent only
the elite. Marginalization is a process by which an individual or a group of
individuals are denied access to, or positions of, power – for example, eco-
nomic and political influence – within a society (Marshall 1998). Certain
groups within a community may not support the aim of a programme or
local leaders may be in conflict with one another. Their inclusion can create
dys- function in the planning and implementation of the programme and
make it more difficult to achieve the objectives. To exclude certain
individuals and groups is undemocratic and does not fit within the ethos of
empowerment that encourages community participation.
Karina Constantino-David (1995), a writer in community development,
discusses the experiences of community organizing in the Philippines and
the success of utilizing local leaders or ‘organic organizers’. Competent
leaders were developed by civil society organizations among poor people
who offered a more insightful understanding of the community problems
and culture. However, it was found that a lack of skills training and previous
management experience among these people created limitations in their role
as leaders. Leadership style and skills can therefore influence the way in
which groups and communities develop and in turn this can influence
empowerment.
Examples of leadership skills that can be enhanced through
interventions in a health promotion programme context include:

* an empowerment style of leadership which encourages and

supports the ideas and planning efforts of the community, using
democratic decision-making processes and the sharing of
information;
* collecting and analysing data; evaluating community initiatives; fa-
cilitation; and problem-solving;
* conflict resolution;
 * the ability to connect to other leaders and organizations to gain re-
sources and establish partnerships (Kumpfer 1993).

Builds empowering organizational structures

Organizational structures in a community include committees, faith groups,

social and sports clubs and women’s associations. These are the organiza-
tional elements which represent the ways in which people come together in
order to address their concerns. They are also the way in which people come
together to socialize – for example, to organize sporting and cultural events
and to observe traditional customs and rituals. In this way the organizational
structures help community members to interact and to connect. In a pro-
gramme context it is also the way in which people come together to identify
their problems, to find solutions to their problems and to plan for action to
resolve their problems. The existence of, and the level at which, these orga-
nizations function is crucial to community empowerment. When existing
organizational structures are not present, outside agencies have themselves
established groups to address the programme concerns. However, the estab-
lishment of a new organizational structure such as a village health committee
is insufficient to guarantee that it will be functional or that the community
will organize itself. There must be a sense of community cohesion among its
members. This is often characterized by a concern for community issues, a
sense of connection to the people (family, friendships) and feelings of be-
longing manifested through customs, place, rituals and traditions.
The characteristics of a functional community organization have been
found to include a membership of elected representatives that meet and
participate on a regular basis. The members have an agreed membership
structure (chairperson, secretary, core members etc.) that keeps records such
as previous meetings and financial accounts. A functional community orga-
nization is also able to identify and resolve conflict quickly and its members
are able to identify the ‘problems’ of, and the resources available to, their
‘interest group’ (Jones and Laverack 2003).

Increases problem assessment capacities

Problem assessment is most empowering when the identification of

problems, solutions to the problems and actions to resolve the problems are
carried out by the community. However, this fundamental principle
continues to be a major shortcoming of many health promotion programmes.
Practitioners must accept that the success of a programme depends to a great
extent on the commitment and involvement of the intended beneficiaries.
People are much more likely to be committed if they have a sense of
ownership in regard to the problems and solutions being addressed by the
programme. This is the case
even if the problems being addressed are not those identified by the outside
agent.
Outside agents obviously do often have new and useful information to
offer, for example the latest information on how to prevent cancer. The point
is that this information should not be imposed over the expressed needs and
concerns that reside among community members. The best approach is to
use a ‘facilitated dialogue’ between the community and the outside agents to
allow the knowledge and priorities of both to decide an appropriate
direction for the programme. Problem assessment undertaken by community
members can also strengthen their role in the design of the programme.
Programmes that do not address community concerns and that do not
involve the com- munity in the process of problem assessment usually do not
achieve their purpose (Laverack 2004).

Enhances the ability of the community to ‘ask why’

Generally small groups focus inwards on the needs of their members but as
they develop into community organizations they must be able to broaden
outwards to the environment that creates those needs in the first place.
Asking ‘why’ is the ability of the community to be able to critically assess the
underlying causes of their powerlessness. It is also the ability of the com-
munity to be able to develop strategies to bring about personal, social and
political change based on an understanding of their own circumstances.
Asking ‘why’ can be described as ‘the ability to reflect on the assumptions
underlying our and others’ ideas and actions and to contemplate alternative
ways of living’ (Goodman et al. 1998: 272).
Fundamentally, ‘asking why’ is a process of discussion, reflection and
collective action that is also called ‘critical reflection’, ‘critical thinking’ and
‘critical consciousness’. The key term here is ‘critical’, where community
members take a long, hard and analytical look at their situation and de-
termine the social, political and economic reasons for their powerlessness. It
has been described as a process of emancipation through learning or educa-
tion, originally developed by the educationalist Paulo Freire in literacy pro-
grammes for slum dwellers in Brazil. People become the subjects of their
own learning, involving critical reflection and an analysis of personal circum-
stances. This is achieved through group dialogue to share ideas and experi-
ences and to promote critical thinking by posing problems to allow people to
uncover the root causes of the unequal distribution of power. Once they are
critically aware the group can start to plan actions to change the underlying
political, economic and other circumstances that influence their lives.
Improves resource mobilization

The ability of a community to mobilize resources from within and to ne-

gotiate resources from beyond itself is an indication of a high degree of skill
and organization. Goodman et al. (1998) discuss resources in terms of ‘tra-
ditional capital’, such as property and money, and ‘social capital’, which
includes a sense of trust and the ability to cooperate with one another and
with other communities. That communities possess both traditional and so-
cial capital is sometimes ignored by outside agents who bring with them the
perceived necessary resources for the programme.
The outside agents may be expected to provide assistance to mobilize
resources at the beginning of a programme but control over these must be
increasingly carried out by the community, otherwise a paternalistic re-
lationship can develop. Resources that health promoters might expect to
mobilize from a community are traditionally based on voluntary labour
(participation), materials, local knowledge and implementation insights, as
well as some small financial contribution. There are paradoxically empow-
ering reasons for expecting some financial, as well as human, resource con-
tributions from the community. A community health promotion granting
programme in Canada, for example, required some evidence of financial
support from community proponents, which was to be matched by the
funding agency at a 3:1 or greater basis. The reasoning was that if the com-
munity failed to mobilize any financial resources, the issues being proposed
may not have strong community support and may reflect the interests only
of the few persons making the programme proposal (Labonte 1996).

Strengthens links to other organizations and people

Links with other people and organizations include partnerships, coalitions

and health alliances. Partnerships demonstrate the ability of the community
to develop relationships with different groups or organizations based on re-
cognition of overlapping or mutual interests, and interpersonal and inter-
organizational respect. They also demonstrate the ability to network,
collaborate, cooperate and to develop relationships that promote a heigh-
tened interdependency among community members. Partnerships may in-
volve an exchange of services, pursuit of a joint venture based on a shared
goal or an advocacy initiative to change public or private policies.
A community-based coalition can be defined as ‘a group of individuals
representing diverse organisations, factions, or constituencies within the
community who agree to work together to achieve a common goal’ (Butter-
foss et al. 1996: 66). Unlike partnerships, coalitions represent a diversity of
views on a common issue and member groups have to learn to set aside
differences and deal with internal conflicts. The outputs of links with other
organizations and individuals may include proposals, recruitment of new
members and the generation of resources resulting in improvements for the
majority of the people in the community.
Health alliances can be described as cooperation and collaboration to
create a partnership between organizations and individuals to enable people
to increase control over, and to improve, their health. A health alliance is a
collaboration that goes beyond health care and through the collective efforts
of its members attempts to bring about social, political and environmental
change to positively affect health (Jones et al. 2002).
Partnerships, coalitions and health alliances have become a popular
theme within health promotion and are seen to be a two-way process in-
corporating both top-down and bottom-up principles of programming. It is
implicit that the process is fully participatory and that government organi-
zations do not merely consult or engage with people and the ‘community’.
People are involved in the decision-making processes of the programme,
which has the aim of being an empowering experience.

Creates an equitable relationship with outside agents

Outside agents are practitioners, government employees, funding agencies,

the representatives of agencies or organizations that do not form part of the
community but are working with them to effect change. In a programme
context the main role of the outside agent should be to link the community to
resources or to assist the community to mobilize and organize itself to gain
power. This can be especially important at the beginning of a programme
when the process of community empowerment may be slow to start and the
capacity of the community has to be built with the help of an outside agent.
The role of the outside agent is essentially one of the transformation of
power over the control of decisions and resources, to allow clients to gain
more control by discovering their own power from within.
The qualities of an empowering relationship in a programme context
include:

* fostering the support of community and political leaders, including

the involvement of marginalized groups;
* helping to negotiate new partnerships with other organizations;
* facilitating capacity-building through activities such as skills
training and conflict management;
* developing specific skill areas such as self-evaluation.

The role of the outside agent as an evaluator is particularly important

because they help to ‘construct a shared vision of the past and future,
provide judgements of project accomplishments, mediate stakeholder issues,
build
commitment to project objectives, and facilitate a consensus’ (Thompson
1990: 379).
However, the role of the outside agent as an evaluator is somewhat
contested in the literature. Cracknell (1996: 32) points out that there has been
a shift in the role of the evaluator from ‘that of disinterested observer to that
of moderator . . . negotiator . . . [and] agents of change’. Other roles are as
facilitator, enabler, coach and guide. It is difficult for many outside agents to
be a neutral and detached observer of a programme when they often have so
much invested in its success. While the outside agent is expected to make
objective judgements about the quality and outcome of the programme, it
should also be an empowering experience for the community. To facilitate
this, the outside agent should ensure that community members are actively
involved in the design and implementation of the evaluation, for example by
using participatory techniques or self-assessment based on the knowledge
and experience of community members.

Increases control over programme management

The role of the outside agent and programme management are closely linked
and sometimes communities decide to combine these two domains for the
purpose of assessment. At the heart of management is who controls the way
in which the programme is designed, implemented, managed and evaluated.
Karina Constantino-David (1995) argues that the priorities of outside agents
have shifted towards the expectation for better programme manage- ment,
including financial systems. As programme management becomes more
sophisticated the outside agents are less willing to transfer responsibility and
skills to the community, which is perceived as having poor skills. Pro-
gramme management that empowers the community includes control by the
community members over all the decisions in regard to the programme. To
do this the community must first have a sense of ownership of the pro-
gramme, which in turn must address their needs and concerns. The role of the
outside agent is to increasingly transform power relationships by transferring
responsibility to the community through a systematic process of capacity-
building.

Strategic planning for community empowerment

As discussed in Chapter 4, top-down programming is predominately used in

health promotion and it is therefore the outside agent who identifies the
issue to be addressed and who controls the implementation and evaluation.
Plainly put, the programme is externally imposed and paternalistic.
However, by using the domains approach it becomes easier for practitioners
to engage with
and help to empower communities. It is the beneficiaries who also identify concerns, who have
increasing control of the programme and are able to develop strategies to address their concerns. The
domains approach gives the practitioner a more precise way of developing strategies to build
community empowerment. The key question practitioners need to ask themselves is: how has the
programme, from its planning through its implementation, through its evaluation, intentionally sought
to enhance community empowerment in each domain? (Laverack 2004).
The domains approach does not therefore start with a blank slate onto which people are expected to
project their immediate concerns. The approach is participatory and has clear roles and responsibilities
for all participants. In practical terms this allows the different participants of a programme to ex- press
their views, share their experiences and challenge existing values and beliefs. Different participants may
have different opinions and the approach allows individuals to participate in an equal relationship that
facilitates the involvement of each member through discussion and interaction with one another.
The domains approach is implemented in four steps (Laverack 2003):

1 Preparation, including the development of a culturally appropriate definition for

empowerment.
2 Setting a baseline for each domain.
3 Strategic planning and the assessment of resources.
4 Evaluation and visual representation.

Step 1: preparation

It is important to use interpretations of power and empowerment that are relevant and important to the
participants, set within their cultural context. Westernized concepts of power and empowerment can
have different inter- pretations to those in social settings in non-westernized countries. The idea is to use
terms that have been identified and defined by the clients themselves to provide a mutual
understanding of the programme in which they are in- volved and toward which they are expected to
contribute. A working defi- nition of power and empowerment is developed through the use of simple
qualitative methods. I provide an example of how this definition was devel- oped in a Fijian context in
Box 5.2.
The nine empowerment domains, although comprehensive, may exclude areas of influence that are
relevant to community members. It is important to carry out a period of discussion prior to Step 2 to
adapt the meaning of each domain in order to meet the requirements of the cultural context. The
domains approach is flexible in that it allows the selected domains to be changed, if necessary, during
the programme.