Community organising: activating people power to create health

The shift from a predominant focus on treatment to prevention is a challenge faced by health systems around the world. With increasing demands on health systems, aging populations and diminishing resources, moving upstream to create health is vital. Yet, how can health systems make this seemingly impossible shift?

Community organising offers one approach. Community organising is an approach to social change that enables people with the greatest interest in change to turn the resources they have into the power they need to enact and protect change.

Key factors that determine the applicability of the community organising approach are the nature of the challenge being faced, who the people are, and where power is vested. Community organising can be applied in situations where the people who want change lack the resources, ability or power to bring about the change they want. These situations require a shift in power, which is achieved by bringing people together to share their resources in different ways.

Community organising is based on building power by standing together with others. It combines and redirects resources to achieve a shared purpose.

It begins with developing leaders, builds community around those leaders based on a shared purpose, and builds power out of that community.

There are five leadership practices in community organising. The first three build power and the last two use it:

1. Shared story – public narrative connects with people’s values and creates a call to action.
2. Shared commitment – intentional relationship building through shared stories and understanding others’ interests.
3. Shared structure – building interdependent teams, roles, running meetings and setting norms.
4. Shared strategy – strategising to use available resources to achieve goals.
5. Shared action – taking effective collective action that develops individual leadership, builds the organisation and achieves real outcomes.

Public narrative, or story-telling, is a key leadership tool. Story-telling speaks to the heart. It allows leaders to connect with people’s values and create a sense of empathy, urgency, hope, solidarity, anger, and the conviction that we can make a difference. These are the emotions that motivate people to take action.

A good story must connect with the audience and include a clear call to action. It should contain:

• a challenge or a problem that must be faced
• characters that the audience can relate to
• a choice made about how to deal with the challenge or problem
• an outcome that teaches the ‘moral’ of the story.

Some common pitfalls to avoid are:

• reciting your resume rather than sharing an experience
• trying to tell your whole life story rather than focusing on one or two key points that explain your motivation for change
• making your story impersonal by focussing too much on an issue rather than on personal experience
• being too abstract
• forgetting a message of hope.

Community organising uses an interdependent model of leadership. The interdependent leadership structure is another key element in building power. An effective interdependent leadership team is diverse, has clear boundaries defining membership of the team, sets norms to guide behaviour, has a shared purpose, and establishes clear roles within the team.

Handle the Jandal is an example of a successful community organising campaign[i]. The campaign aims to improve mental health and wellbeing among Polynesian youth in Counties Manukau by helping them to deal with pressure. Through Handle the Jandal, Ko Awatea has learnt a number of important lessons about launching a health campaign:

• Do things with people, not to them – give them decision-making power and meaningful responsibility.
• Allow people to identify the problems that matter to them, not the ones that matter to healthcare organisations.
• Community organising demands that healthcare organisations trust the community.
• Connect with people’s hearts and values.
• Build relationships and trust that the relationships will drive the work, even if there is no clear strategy at the outset.

From an organisational perspective, factors that made Handle the Jandal a success are:

• support from senior leadership
• recruitment of a full-time lead organiser
• expert community organising support and coaching
• a conscious decision to ‘let go’ of control of the campaign and let the community take control
• having somewhere to focus resources in the face of overwhelming problems
• continuing to tell the story to build momentum and keep people engaged.

This article is adapted from Alexandra Nicholas and Margaret Aimer’s sessions at Ko Awatea’s APAC Forum 2015.

The APAC Forum 2016 will be held in Sydney, Australia, 12-14 September. Click here to see the programme and register. 

[1] Han H, Nicholas A, Aimer M, Gray J. An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand. Australasian Psychiatry. 2015 Dec;23(6):670-4. doi: 10.1177/1039856215597539.