4. Project implementation and structure II
Project coordination
Project coordination became a complex process given the commitment that each partner had made to working in
partnership.
Project team
The Project Team was the coordinating body for the project and included representatives from each of the four partners, as well as the project coordinator. It provided leadership and direction for the design, implementation and evaluation of the project, using a participatory decision making model. Each partner had only one voice at the decision making table. Three of the four partners (Centretown Community Health Centre; LAZO; Gentium) were represented on the team by Hispanic women professionals who are also LAZO madrinas. Representatives from the group of Lay Health Promoters/Participatory Researchers also participated in Project Team meetings, as did other staff from the partner organizations. The Project Team therefore could draw on a wide range of expertise in community development, health, education, training, social work, administration, academic scholarship, teaching, counselling, organizing, feminist action, anti-racism, and social research.
Meetings were bilingual (Spanish and English). The Project Team met at least once a month to make decisions about training, programming, research, budget, dissemination, administration, and participation in events. The Project Team also designed and revised workplans, approved budgets, dealt with communication issues, and reviewed the overall project implementation. All partners and the project coordinator participated actively in the Project Team.
Health promotion coordination and support
Centretown Community Health Centre (CCHC) provided important support to health promotion co-ordination (see in-kind contributions). A CCHC Health Promoter participated in some of the training sessions, to share the CCHC approach to health promotion and discuss where and how lay health promotion activities might fit in. After the training, a different CCHC Health Promoter worked closely with the LHP/PRs to organize health education activities, such as workshops, displays, presentations to ESL classes, and participation in events, such as the Health Festival. The Health Promoter collaborated with the LAZO Co-investigator and the Project Co-ordinator to provide on-the-job training to the LHP/PRs. She also was an active member of the Project Team, and supported other project activities as needed (for example, Mujer Sana's presentation at a CCHC multicultural fair).
Research co-ordination and support
Gentium Consulting provided essential support to research co-ordination. This included leadership in the development and revision of conceptual frameworks, evaluation strategies, and research design; document review; development of data collection strategies and tools; review and creation of data bases; data management; and ongoing revision and reflection on the nature and direction of Mujer Sana as a participatory action research project. The LAZO co-investigator was an active partner in training and supervising of data entry clerical staff, and, with Gentium, in providing individual support and on-the-job training to Participatory Researchers. The LAZO co-investigator also took the lead in the translation of many tools and documents, essential to the co-ordination of a bilingual research project, and in linking the research activities to community capacity and community needs. Gentium and LAZO managed and supervised the work of LHP/PRS in the collection of data from the community (surveys, in-depth interviews), and in the participatory analysis of qualitative data.
Project administration
Each of the partners had their own structure, administrative mechanisms and policies, and assumed responsibility for different elements of the project. Understanding each others' administrative requirements and expectations, and setting up workable systems among all partners, proved to be an interesting challenge (see Key Findings).
As an example of administrative complexity: the Project Co-ordinator, the Administrative Assistant, and the Lay Health Promoters/Participatory Researchers, were hired as staff of Centretown Community Health Centre (CCHC). This was done with the intention of offering them maximum protection and economic benefit (they were legally employees, protected by provincial labour standards, subject to CCHC's personnel policies, and entitled to pro-rated benefits such as dental insurance which are available to CCHC employees). The LAZO Co-investigator also formally became an employee of CCHC, was entitled to benefits, and participated in some CCHC internal activities; in practice, however, she functioned more as an independent co-investigator accountable to the LAZO group. Gentium co-ordinated overall research activities for the project, including collection, processing, management and analysis of data, and, with the LAZO co-investigator, supervised the LHP/PRs in all their research activities. Research interns were managed and supervised by the CHRU co-investigator.
Within CCHC, Mujer Sana/Comunidad Sana activities became a component of the Community Health Promotion Team, and the Manager of that team provided supervision for the Project Coordinator. The Project Coordinator in turn provided supervision for the health promotion activities of Lay Health Promoters/ Participatory Researchers, jointly with the LAZO Co-investigator. The Manager of Community Health Promotion also was the liaison person to the CCHC board of directors, other CCHC committees and other CCHC staff and management, including the Executive Director. CCHC systems and structures (such as human resource policies, financial accounting systems, information systems and equipment, and the primary care facility) were essential to implement a demonstration project of this type. Participation of the Manager of Community Health Promotion on the Project Team, and the fact that CCHC was the case study site for the intervention, also guaranteed that the CCHC was a full partner in the project, with involvement that extended well beyond administrative functions.
The relationship of the Community Health Research Unit (CHRU) and of Gentium Consulting to the Mujer Sana project was through separate, fixed-cost, purchase-of-services agreements, rather than employer-employee. Some research assistants were hired as employees of the CHRU through the university mechanism; others, as contractors to Gentium, on purchase-of-service agreements. At different times in the project, different research assistants worked out of CCHC, CHRU, or Gentium offices, and their work was managed and supervised by different project partners. Because of the participatory and horizontal nature of the project, the involvement of these two partners also extended well beyond what is customary in a consultancy or purchase-of-service relation.
