Community development

Community development is based on a collective action model of health promotion. There are various useful definitions of CD, including one developed by Smithies and Adams whilst working at the HEA. This definition specifies a number of principles inherent in this way of working:

• Groups rather than individuals.
• Work with disadvantaged and marginalised groups is given priority.
• A positive holistic view of health is encouraged.
• CD aims to increase self-confidence.
• CD aims to improve relationships between professionals and voluntary and statutory groups, although it may also challenge statutory organisations in order to meet needs.
• The community defines its own needs rather than receiving a professionally presented list of needs.
• The process of the work is seen as important in its own right.
• CD values people whatever their background, starts from where they are, and challenges discriminatory or oppressive behaviour from individuals or bureaucracies.
• CD promotes access to information and resources.

CD can operate on a variety of levels. Often people view it as grass roots work - working with local communities. However, CD can have much wider implications than this, and if it is to develop into collective action that brings about change in the wider community or within statutory organisations then a CD strategy is necessary.

If CD concentrates only on grass roots activity, projects will inevitably confront organisational blocks and barriers at the interface between communities and organisations.

A CD strategy aims to open up barriers and remove blocks by working an a number of levels. A successful CD strategy needs to compromise four elements:

• Grass roots work.
• Organisational development.
• Community infrastructure.
• Participation.

Resourcing grass roots work and local action is clearly the central element of any CD strategy. It is often the work that begins first and forms the major part of the CD strategy. It should aim to build upon the shared experiences of gay men's lives in order to promote new solutions to the group's own defined concerns and issues. This element of the strategy can utilise many methods. For example:

• Outreach work - going out to work with MSM in pubs, clubs, cottages and cruising areas.
• Group work - talking with existing groups.
• Training - offering courses and sessions.
• Funding - offering small grants to pump-prime projects.
• Helping to set up groups - using advertising or word of mouth to start groups, and encouraging them to meet for social, self-help and social action reasons.
• Campaigning - enabling Men who have sex with Men (MSM) to express their concerns, perhaps by demonstrating or using the media.
• Producing material - MSM can produce their own educational and informational materials, which meet their needs and are relevant to the local context.

Work at grass roots level may be inadequate on its own to bring about far-reaching change. Organisations too need to develop and change to respond to the articulated needs of MSM and in order for MSM to participate in decision making and gain a fair share of resources. Policies may need to be changed as well.

Working in a CD way can draw on a range of methods, including:

• Participaring in committees - enabling the involvement of MSM in statutory sector and voluntary organisation structures.
• Lobbying - working from outside organisations to change their practices.
• Training for organisations' workers - this could include training about particular issues and/or processes.
• Structural and management change - suggesting to organisations that they should change their structures, processes and / or management methods, and enabling them to do so.
• Consultation and participation strategies (see below) - suggesting that the organisation consults more widely and sets up mechanisms for community participation, and enabling it to do so.

Essentially this means bringing together groups and networks to encourage them to share (collectivise) their experiences and concerns and to act together for change. Again it can involve a range of activities, many of which have been mentioned above, such as training events, conferences, financial support, producing publications, offering advice and support to groups, and forming forums and organisations.

Any Yorkshire MESMAC project will also need to consider the fourth element: how to involve MSM in the structures and processes of the project itself. This can be achieved by MSM taking part in steering groups, undertaking research, forming advice groups, and so on.

Within Yorkshire MESMAC we feel that CD is a particularly important and effective way to work with MSM because:

• MSM are a disadvantaged group, and CD works specifically to address the needs of disadvantaged groups and to reduce inequalities in health.
• CD supports different communities in working together.
• CD approaches involve valuing people's background and experience, and building on it.
• HIV prevention is not just about behaviour change; it is about creating a climate where men feel able to make choices. CD enables this to happen.
• CD approaches recognise that there are constraints on choice, such as environment, oppression, class, poverty, the need for relationships.
• CD methods boost the self-confidence and self-esteem of participants.
• CD empowers people to organise themselves.
• CD approaches are accessible.
• It promotes a sense of community.
• It allows educators to identify community needs that are not being met.
• Men can become involved, and this facilitates an exchange of ideas.
• Through CD methods it is possible to gain access to men who would not normally receive information and support, who in turn can then pass this on to others.
• CD methods allow ownership of the work by the men concerned.
• It is a holistic way of working; all men's needs are taken into account, not compartmentalised to diseases, parts of the body or circumstances.
• Trust is promoted between workers and participants.
• It brings a great deal of energy and diversity into the work.
• It incorporates an equal opportunities approach.