Resources

The BOSTID REA research programme is concerned with how to integrate epidemiological methods into the field of planning and delivery of health services. The aim of the BOSTID programme is to change REA from being an art into a legitimate discipline. Several methods are discussed which are intended to be faster and cheaper than conventional data collection: cluster sample surveys; case control methods; quality assurance sampling and risk assessment and surveillance.

This report outlines a four day workshop conducted by the Indian NGO SPEECH in Manavarayanenthal, Tamil Nadu. The primary purpose of the exercise was to introduce 23 NGO participants to PRA principles and to evolve new stategies in planning specific health projects. Training took place through a mixture of lectures and activities, which included social mapping (by mixed groups and women only), health mapping, time lines, historical transects, seasonality diagrams, venn diagrams, disease ranking, focus groups with women on the reproductive cycle and a problem linkage exercise. The report includes feedback on the lessons participants learned and some of the illustrations generated by the village participants.

This manual is primarily aimed at helping aid staff supervise in a way which deepens insight into local situations, is supportive of health workers, and is focused on improving the quality of service to the poor. The checklists of questions are intended to be adapted rather than definitively applied. This manual gives practical advice on avoiding the pomp and ceremony of visits which often distracts from appreciating the health situation at community level. RRA techniques are recommended in order to gain a real understanding of health needs. Suggestions are made as to how to talk with health/nutrition workers to get an idea of their integration into the community, their understanding of health in a wider context, recent training, ability to question the health messages that they deliver and the extent of supervisory support. The author then recommends that an attempt is made to decide which problems relate to an individual and which are systemic problems that need to be addressed at the centre or state level. An Annex is included of a sample field visit report.

This article highlights disease control problems and problems hampering multidisciplinary reasearch. Traditional social science and epidemiological methods are often too time-consuming to address the immediate and urgent needs of disease control programmes therefore rapid assessment methods to provide information on health status, health impact, health services and health behaviour are essential. A distinction is made between the efficacy of disease control tools and community effectiveness, emphasising the potential for rapid assessment to improve community effectiveness. The article describes the development and validation of rapid assessments and techniques.

This paper explains how various PRA exercises have been used to help health - and other - workers think through and challenge the assumptions that they make in their work. Thus the process of conducting the exercise is often in some ways more important than the outcome. Examples are given of PRA which has led to reversals in learning in Asia and Africa. It is concluded that PRA does not solve problems but rather reveals the complexity of the problems encountered - PRA is not a fad or fashion but a fundamental challenge to conventional approaches to development.

This report discusses appropriate mechanisms for community involvement in different social, economic, and political contexts and identifies the corresponding requirements for training health personnel and strengthening communities. Participatory methods are suggested for training health workers. It is suggested that monitoring and evaluation involves a mixture of quantitative and qualitative techniques.

The article focuses on the collection and use of ethnoveterinary data in the context of community-based animal health care training programmes in Kenya. The programmes ranged from pastoral areas such as Samburu and Pokot to settled farming in Meru and Machakos and were carried out by the Kenya Livestock Programme (KLP) of the Intermediate Technology Development Group (ITDG) in collaboration with various community-based NGOs. The lessons learned in the programme and directions for the future are also discussed.