Definitions of COPAR:

 A social development approach that aims to transform the

apathetic, individualistic and voiceless poor into dynamic,
participatory and politically responsive community.

 A collective, participatory, transformative, liberative, sustained and

systematic process of building people’s organizations by mobilizing
and enhancing the capabilities and resources of the people for the
resolution of their issues and concerns towards effecting change in
their existing oppressive and exploitative conditions (1994 National
Rural Conference)

 A process by which a community identifies its needs and objectives,

develops confidence to take action in respect to them and in doing
so, extends and develops cooperative and collaborative attitudes
and practices in the community (Ross 1967)

 A continuous and sustained process of educating the people to

understand and develop their critical awareness of their existing
condition, working with the people collectively and efficiently on
their immediate and long-term problems, and mobilizing the people
to develop their capability and readiness to respond and take action
on their immediate needs towards solving their long-term problems
(CO: A manual of experience, PCPD)

Importance of COPAR:
1. COPAR is an important tool for community development and people
empowerment as this helps the community workers to generate
community participation in development activities.

2. COPAR prepares people/clients to eventually take over the

management of a development programs in the future.

3. COPAR maximizes community participation and involvement;

community resources are mobilized for community services.
Principles of COPAR:
1. People, especially the most oppressed, exploited and deprived
sectors are open to change, have the capacity to change and are
able to bring about change.

2. COPAR should be based on the interest of the poorest sectors of

society

3. COPAR should lead to a self-reliant community and society.

COPAR Process:
 A progressive cycle of action-reflection action which begins with
small, local and concrete issues identified by the people and the
evaluation and the reflection of and on the action taken by them.

 Consciousness through experimental learning central to the COPAR

process because it places emphasis on learning that emerges from
concrete action and which enriches succeeding action.

 COPAR is participatory and mass-based because it is primarily

directed towards and biased in favor of the poor, the powerless and
oppressed.

 COPAR is group-centered and not leader-oriented. Leaders are

identified, emerge and are tested through action rather than
appointed or selected by some external force or entity.

Objectives of COPAR:
• To make people aware of the social realities towards the
development of the social initiative, optimal use of the human.
Technical and material resources.
 • To form structures that would hold peoples basic interest as
oppressed and deprived sectors f the community and as people
bound by the interest to served people.

• To initiate the responsible actions intended to address holistically

the various community health social problems.

Emphasis of COPAR in Primary Health Care:

• The community works to solve their own problem.

• The direction is internal rather than external direction.

• The development of the capacity to establish a project is really

important for there is a conscious raising to perceive health and
medical care within the total structure of the community.

Phases of COPAR
I. Pre-entry Phase
A. Is the initial phase of the organizing process where the
community/organizer looks for communities to serve/help.

B. It is considered the simplest phase in terms of actual outputs,

activities and strategies and time spent for it.

Activities include:
1. Designing a plan for community development including all its
activities and strategies for care
development.
2. Designing criteria for the selection of site
3. Actually selecting the site for community care
II. Entry Phase
A. Sometimes called the social preparation phase as to the activities done
here includes the sensitization of the people on the critical events in
their life, innovating them to share their dreams and ideas on how to
 manage their concerns and eventually mobilizing them to take
collective action on these.

B. This phase signals the actual entry of the community worker/organizer

into the community. She must be guided by the following guidelines
however.

1. Recognizes the role of local authorities by paying them visits to

inform them of their presence and activities.

2. The appearance, speech, behavior and lifestyle should be in keeping

with those of the community residents without disregard of their
being role models.

3. Avoid raising the consciousness of the community residents; adopt a

low-key profile.
C. The organizer tries to immerse himself or herself in the community to
get to know the culture,
history, economy, leaders and lifestyle of the people. This is done by
participating in social and
economic, formal and informal activities of the people.

Some suggested activities to facilitate integration are:

a. Participate in direct production activities of the people.

b. Conduct house to house visits.
c. Seek out and converse with the people where they usually
congregate.
d. Lend and hand in household chores.
e. Avoid gambling and too much drinking.

III. Organization Building Phase

A. Entails the formation of more formal structures and the inclusion of
more formal procedures of planning, implementation, and evaluating
 community-wide activities. It is at this phase where the
organized leaders or groups are being given trainings (formal, informal,
OJT) to develop their skills and in managing their own
concerns/programs.

IV. Sustenance and Strengthening Phase

A. Occurs when the community organization has already been established
and the community members are already actively participating in
community-wide undertakings. At this point, the different communities
setup in the organization building phase are already expected to be
functioning by way of planning, implementing and evaluating their own
programs with the overall guidance from the community-wide
organization.

1. Strategies used may include:

a. Education and training
b. Networking and linkaging
c. Conduct of mobilization on health and development concerns
d. Implementing of livelihood projects
e. Developing Secondary Leaders

Anatomy and Physiology of the Gastrointestinal Tract

Audio transcript; narrated by Annette Buyserie, Oregon State University
The anatomy and physiology of domestic species’ GI tracts share many similar characteristics.
However, each species has specific variations in the anatomy and physiology of their digestive
tract that influence the feedstuff consumed and utilization efficiency. The anatomical and
physiological variations between the species are the rationale for differential feeding between
species.
The initial component in the GI tract of all domestic species is the mouth and its associated
structures such as the tongue and teeth. The primary functions of the mouth are prehension and
mastication. As stated, species' variations exist that influence the feedstuff consumed and
utilization efficiency. For example, prehension and therefore selectivity differ between species
such as cattle, sheep, and horses. During the mastication process, saliva is added to the feed. The
functions of saliva are to moisten the feed, aid in bolus formation, and coat the bolus. A bolus is
a mass of moistened and chewed feed. In some species, the saliva contains enzymes and
therefore initiates enzymatic digestion of the feed. Finally, the saliva contains sodium
bicarbonate that acts as a buffer. In ruminants, the buffering capacity of saliva is essential to
maintain rumen pH.
From the mouth, the consumed feed travels to the esophagus. The esophagus is essentially a tube
from the mouth to the stomach or, in ruminants, to the reticulorumen. As the first two
compartments of the rumen system, the reticulum and rumen, are not completely separate, the
initial portion of the system may be referred to as the reticulorumen. The primary function of the
esophagus is to transport the bolus from the mouth to the stomach or reticulorumen via muscular
contractions. In nonruminants, the esophagus only moves the bolus downward. In contrast, in
ruminants, the esophagus has the ability to move the bolus both downward and upward. The
upward movement of a bolus from the reticulorumen to the mouth is part of the process of
rumination. Rumination is the process of regurgitation and remastication to reduce the particle
size of feed and aid in digestion of fibrous components.
The glandular stomach is the next component of the GI tract for nonruminants and nonpoultry.
The variations in the GI tract of ruminants and poultry will be discussed later in the lecture. The
functions of the glandular stomach include temporary storage and mixing of the feed. In addition,
the stomach also functions as the initial site of protein digestion. Finally, the high concentration
of hydrochloric acid (HCl) in the stomach is bactericidal. The cumulative activities of the
stomach produce chyme. Chyme is the partially digested, acidic mixture of feed that travels to
the small intestine.
The component subsequent to the glandular stomach is the small intestine. The small intestine is
the primary site in the GI tract for enzymatic digestion. The small intestine is divided into three
regions. The first region of the small intestine is the duodenum. Bile salts are released into the
duodenum. Bile salts are produced by the liver and stored in the gall bladder until their release
into the duodenum. Bile salts function to neutralize the chyme entering the small intestine and to
emulsify fats preparing them for further digestion. Relatively large number and quantities of
pancreatic enzymes are also secreted into the duodenum. The enzymes are produced in the
pancreas and secreted into the duodenum via a duct. The pancreatic enzymes aid in the digestion
of proteins, carbohydrates (CHO), and lipids. Additional duodenal enzymes aid in the digestion
of proteins and CHO. The second and third portions are the jejunum and the ileum, respectively.
Enzymatic digestions continue in the jejunum and ileum.
The small intestine is a primary site for nutrient absorption. The interior of the small intestine is
lined with both villi and microvilli. Villi and microvilli are present in each section of the small
intestine. The primary function of the villi and microvilli are to increase the surface area and
therefore absorption efficiency of the small intestine. Figure 1.5 illustrates the structure and
orientation of the villi and microvilli in the small intestine.

The villi are finger-like projections that extend into the lumen of the small intestine. As
illustrated, the villi are a composite of many cells and contain extensive circulatory and lymph
system components to transport the nutrients following absorption. Also illustrated in Figure 1.5
are the microvilli. Microvilli are the microscopic projections from each cell that comprise the
villi.
The final component of the GI tract is the large intestine. The large intestine is divided into three
sections. The three sections are the cecum, colon, and rectum. The functions of the cecum and
colon are absorption of some organic compounds, absorption and resorption of water, and some
microbial digestion. The primary type of digestion that occurs in the cecum and colon is
microbial digestion. However, as the cecum and colon are located subsequent to the primary
absorptive site, the absorption efficiency of microbial fermentation is lower than pre-absorption
efficiency. The function of the rectum is excretion of fecal material.
The GI tract is also the site for a few additional functions. The GI tract functions as a route for
excretion of processed toxicants and excess minerals. Finally, the GI tract is the site of synthesis
of nutrients by microorganisms. Examples of the nutrients synthesized by microorganisms are
water-soluble vitamins, amino acids, proteins, CHO, and lipids. The location and extent of
microbial fermentation vary between species. Further, the location in the GI tract relative to the
digestion and absorptive sites determine utilization efficiency.

Digestion and Absorption

Digestion is the breakdown of food into smaller particles or individual nutrients. It is
accomplished through six basic processes, with the help of several body fluids-particularly
digestive juices that are made up of compounds such as saliva, mucus, enzymes, hydrochloric
acid, bicarbonate, and bile.
The six processes of digestion involve: (1) the movement of food and liquids; (2) the lubrication
of food with bodily secretions; (3) the mechanical breakdown of carbohydrates, fats, and
proteins; (4) the reabsorption of nutrients-especially water; (5) the production of nutrients such
as vitamin K and biotin by friendly bacteria; and (6) the excretion of waste products.
Comprehension of the tasks or processes needed to break down food are essential to an
understanding of how and when food really begins to function within the body. For example, not
understanding that carbohydrates break down into glucose could lead one to believe that the best
source of glucose is in liquid form such as a soft drink. This could cause one to miss out on the
nutrients (and great taste) in fruits, vegetables, and grains. Likewise, not understanding the
digestion process could lead a person to believe in the myth of "food combining," or perhaps to
think it is normal to be hungry all the time. But, in fact, the digestive processes normal to human
physiology can simultaneously handle carbohydrates, fats, and proteins-and allow people to go
several hours between meals, especially if meals are balanced in fiber and the individual
nutrients needed.

GI Tract Physiology
Digestion begins in the mouth with the action of salivary amylase. The food material then
progresses past the esophagus and into the stomach. A bolus (soft mass) of chewed food moves
by muscular wave actions, called peristalsis, from the mouth to the pharynx, and then past the
epiglottis that covers the larynx. The epiglottis closes off the air passage so that one doesn't
choke. The cardiac sphincter prevents reflux of stomach contents into the esophagus.

From the Stomach to the Small Intestine

Food mixtures leaving the stomach are called chyme, and this empties into the small intestine
after about two to four hours in the stomach. The small intestine is where most digestion takes
place. A pyloric sphincter controls the rate of flow of chyme from the stomach into the small
intestine.
Most digestion occurs in the upper portion of the small intestine, called the duodenum. Below the
duodenum is the jejunum, and then there is the last segment, called the ileum. About 5 percent of
undigested food products are broken down in the ileum. This is why some people can have a
small part of their intestine removed and still seem to digest most foods with little problem.
Digestion of food that enters the small intestine is usually complete after three to ten hours. Once
digestion is essentially finished, waste products leave the ileum with the help of fiber, and these
solids then enter the large intestine (the colon). In the colon, water is reabsorbed; some nutrients
are produced by friendly bacteria (vitamin K, biotin, vitamin B12); fibers are digested to various
acids and gases; and minerals, such as potassium and sodium, are reabsorbed (when needed).
Any fiber that is not broken down-and small amounts of other undigested products-are excreted
in the feces.

Protective Factors
During digestion in the stomach, large proteins break down into smaller protein forms, and
harmful bacteria can become inactive. Hydrochloric acid is especially important for this because
it lowers the pH of the stomach contents below 2. Along with the uncoiling of protein in the
stomach, a little carbohydrate and lipid are broken down with the help of enzymes (called
amylase and lipase, respectively).
In the stomach, carbohydrates in foods turn to starch, but it is not until the chyme reaches the
small intestine and becomes more neutralized that starch turns to simple sugars that are then
absorbed into the portal vein, which transports them to the liver. Also in the small intestine,
lipids (mostly in the form of triglycerides) are emulsified and form monoglycerides and free
fatty acids that can then go through the lymph system to the heart and bloodstream.
As previously mentioned, the mouth, stomach, small intestine, and colon are the major organs of
digestion. However, the liver, gallbladder, and pancreas are also important to the process. The
liver detoxifies foreign compounds, such as natural toxicants in foods and drugs. The liver also
makes bile, an emulsifier, which enters the small intestine and prepares fats and oils for
digestion. This bile is stored in the gallbladder prior to delivery to the small intestine. A
hormone called cholecystokinin helps control the release of bile.
The pancreas makes pancreatic juice consisting of enzymes (amylases, lipases, and proteases)
and bicarbonate, which helps neutralize acidic secretions produced during digestion. The
pancreas delivers the pancreatic juice to the small intestine, in response to a signal of food in the
intestine and the release of the hormone secretin. The pancreas also has another function, the
secretion of the hormones insulin and glucagon, which helps maintain a steady state of blood
sugar in the body (insulin decreases blood glucose concentration, while glucagon increases it).
Food moves from the mouth to the epiglottis, bypassing the trachea, into the esophagus, past the
cardiac sphincter into the stomach, past the pyloric valve into the small intestine (duodenum,
jejunum, ileum), and then
The tract running from the esophagus to the large intestine is called the alimentary canal, and it is
where most digestion occurs. As food is pushed through the system, it encounters numerous
specialized processes that act on it in different ways, extracting nutrients and rejecting waste.
[Illustration by Argosy. The Gale Group.] past the ileocecal valve into the colon. Waste then
leaves the colon through the rectum and anus. When chyme reaches the small intestine, the
pancreas and liver contribute to the digestion by providing products such as bicarbonate,
enzymes, and bile.
Absorption
Absorption is the movement of molecules across the gastrointestinal (GI) tract into the
circulatory system. Most of the end-products of digestion, along with vitamins, minerals, and
water, are absorbed in the small intestinal lumen by four mechanisms for absorption: (1) active
transport, (2) passive diffusion, (3) endocytosis, and (4) facilitative diffusion. Active transport
requires energy.
Nutrient absorption is efficient because the GI tract is folded with several surfaces for absorption
and these surfaces are lined with villi (hairlike projections) and microvilli cells. As one nutrition
textbook puts it, each person has a surface area "equivalent to the surface of a tennis court"
packed into his or her gut (Insel et al., p. 81). Efficient absorption can be compromised due to
lactose intolerance. Lactose intolerance is not uncommon in the world, affecting about 25
percent of the U.S. population and 75 percent of the worldwide population. It is usually due to
the lack or absence of the enzyme lactase, which breaks down milk sugar.
Lactose intolerance is not a food allergy. Food allergies are serious, even life threatening, but
most people with lactose intolerance can digest small amounts of milk, especially in yogurt and
cheese.
Protein, carbohydrate, lipid, and most vitamin absorption occur in the small intestine. Once
proteins are broken down by proteases they are absorbed as dipeptides, tripeptides, and
individual amino acids. Carbohydrates, including both sugar and starch molecules, are broken
down by enzymes in the intestine to disaccharides called sucrose, lactose, and maltose, and then
finally into the end-products known as glucose, fructose, and galactose, which are absorbed
mostly by active transport. Lipase, an enzyme in the pancreas and the small intestine, and bile
from the liver, break down lipids into fatty acids and monglycerides; these end-products then are
absorbed through villi cells as triglycerides.
Alcohol is not a nutrient, but 80 percent of consumed alcohol is absorbed in the small intestine.
The other 20 percent is absorbed into the stomach. Alcohol is absorbed by simple diffusion,
which explains why gastric ulcers are not uncommon in people who drink excessively.

Coordination and Transport of Nutrients into the Blood or

to the Heart
Hormones and the nervous system coordinate digestion and absorption. The presence of food, or
the thought or smell of food, can cause a positive response from these systems. Factors that can
inhibit digestion include stress, cold foods, and bacteria.
After foods are digested and nutrients are absorbed, they are transported to specific places
throughout the body. Water-soluble nutrients leave the GI tract in the blood and travel via the
portal vein, first to the liver and then to the heart. Unlike the vascular system for water-soluble
nutrients, the lymphatic system has no pump for fat-soluble nutrients; instead, these nutrients
eventually enter the vascular system, though they bypass the activity of the liver at first.