The Nhlangwini Integrated Rural Development Project aims to empower local people, in order that they may improve their quality of life, by helping them develop strategies for addressing basic needs. The Nhlangwini Ward is situated in southern KwaZulu, South Africa. Three workshops were held over a period of three months during 1989. The first examined development problems in the area; the second specifically probed those problems associated with family planning; the third was a development planning workshop, employing visual techniques described in some detail by the paper. Participants were asked to draw local resources by imagining they could view the area from a helicopter. The process of adopting visual techniques has resulted in a change in emphasis - as a result of findings, the integrated development programme has switched approaches with regard to issues facing women, and in terms of its goal setting mechanisms.
In order to obtain detailed information about project participants's daily tasks, particularly in a gender context, 139 calenders were constructed for one specific day. The timeline focused on all the activities undertaken during that day, including agricultural work. Men did more agricultural work than women, although women worked harder overall. Of the 103 agricultural workers surveyed, the men spent more time with livestock, both were involved in nursery work, and men carried out slightly more work in the fields. The other projects studied were water and santitation, women's income generating projects and education. The gender difference in perception of agricultural tasks is noted, which relates closely to time spent talking, resting and in 'reproductive' chores.
This paper describes the methodology used for Cresswell's "PRA Investigation into the Health and Social Needs of People Living in Danesmoor". The project took 34 days to complete, consisting of 54 individual interviews, two group interviews and eight groups of school children. The PRA approach is described, outlining its relevance to the work with this community in the UK. PRA methods used are listed with their application in "community assessment of health and social needs as undertaken in Danesmoor". Implications for professionals working in the area are considered and the future potential use of PRA explored. Further research is suggested around why there is poor uptake of certain key services.
The aim of this study was to identify the health and social problems in relation to Danesmoor, an area in North Derbyshire with high unemployment. PRA techniques were used to collect qualitative information from three main sources : key community people, community members, professionals working in the area. Questions were asked regarding people's perceptions of the area, the health and social problems, existing care service provision and "magic wand" - "within reason what would benefit individuals, families and the community as a whole". This report presents the findings under the groups of people interviewed (eg single mothers, children, health visitors, doctors, playgroup leader), giving direct quotations and their suggested magic wand solution to the problems. Lack of communication and coordination between various service providers is identified as a key issue. Finally an "overall magic wand" (solution to common problems) and a plan of action were made.
This study in Staveley, an area with high unemployment, aimed to: i) identify & enable people to address the personal risk factors for cardio-vascular diseases ii) enable unemployed workers to discuss health difficulties specific to unemployment iii) promote a greater understanding of the specific health needs of unemployed people Unemployed people and 200 children were interviewed, then key people in the professions of education, health, social services, police, clergy and housing. Video, photos and mapping were used and people "had an opportunity to test their own health by filling in a health profile questionnaire". The various groups' different perceptions of the problems and suggested solutions are analysed. There is a need for "an informed, integrated, inter-agency approach with the involvement of unemployed people in order to respond effectively to the problems of unemployment".
This paper discusses the methods of collecting information in a field study carried out in Salvador da Bahia (Brazil) a suburb of Salvador. The study was part of a training exercise for students of the "International Course for Primary Health Care Managers at District Level in Developing Countries" based in Italy. The study also aimed to explore the potential for Primary Environmental Care and identify ways by which the local health district could support squatter communities. A rapid appraisal was carried out in three squatter communities. Secondary data was analysed, life history interviews were conducted, a "risk map" was drawn in which local participants geographically located problems, focus groups and ranking, key informant interviews, ten institutions with an interest in environmental issues were interviewed, and a feed-back meeting was held for all community members. It is concluded that RRA is well suited to study fast-changing environments, a potential danger of the exercise is taken to be undue expectation-raising of the local community. Finally "microplans" are introduced as a possible means of making RRA action oriented. Five pages are devoted to illustrations arising from the exercises.
This study represents some of the lessons learned over three years by the Indian NGO, The Activists for Social Alternatives (ASA). The origins and principles of PRA are outlined. Six case studies of PRA are given of which two are health-related. Herbal PRA: herbal practitioners identified 144 herbs and their uses, a historical time line of diseases and treatments was constructed (this is given in an appendix). Twenty most important herbs were identified which the herbalists promised to help raise in village herb gardens. Health PRA: this was conducted as a training exercise with 20 NGOs in Tamil Nadu. PRA exercises helped replace curative notions of health care with a focus on the socio-economic causes of ill health. The results of a wealth ranking and a health matrix are presented in the appendixes.
In the West African nation of Togo mid-level health workers are being routinely trained to conduct focus-group interviews with mothers of children under five. The intent is to establish qualitative data bases that complement conventional survey data. The authors document the findings of a five-day training programme during which health workers collected data from 81 focus groups (324 mothers). Two unanticipated effects emerged: firstly that the focus group method democratized data gathering by forcing health workers out of their perceived roles as experts and teachers; secondly that by stimulating this shift in roles community competence was enhanced, thereby promoting collaborative programme planning by health workers and target villages. Evidence is given that focus-group discussions paved the way for highly successful education campaigns which dramatically increased child vaccination rates.
Effective health planning requires good quality data, but many health facilities lack the ability to provide this. Health questions often have to be answered within specific research studies. Microcomputers are now generally recommended and used by researchers for data analysis at the end of projects. The article reviews the use of microcomputer based management of data collection during a study. A selection of pojects are described, all of which have used microcomputers in a decentralised fachio, closer to the point of data collection. The main advantages of this approach are a significant reduction in error rates, and the ability to produce data quickly.
This article outlines one of a series of workshops conducted for NGOs and local Government officials in Tamil Nadu by the Society for Peoples' Education and Economic Change (SPEECH). The 23 participants spent four days learning PRA theory and conducting fieldwork in a village near Tiruchuli. The workshop also analysed group dynamics and recorded the very favourable impressions of participants. Examples are given of village maps, models, matrices and linkage diagrams.
This brief article describes some of the problems the authors encountered conducting pile sorting and free listing with women in a slum area. It emerged that these women did not view their health problems in "lists" but rather as part of the socio-cultural context of their lives. The authors discover a more effective way of involving participants is to organise group meetings on specific topics.
This article consists of observations arising from the author's visits to several NGOs on the Indian sub-continent. Four main suggestions are made: conduct limited direct observations; use pile sorting techniques with key informants; experiment by modifying the pile sort technique; conduct key informant interviews on issues relating to the context of women's health.
This paper presents the results of an international workshop convened to examine verbal autopsy methods with the goal of achieving a consensus on methodological approaches. A verbal autopsy is an interview designed to identify specific medical syndromes, using information about the terminal illness elicited from relatives of the deceased person. Particular attention is paid to the difficulties of cause-specific mortality of children in developing countries.
Newsletter informing about World Neighbors project in Mali involving report of the methods used and insights on methodology and behaviour and attitudes.
This study aims to provide some insight into the work of traditional healers in Cambodia, focussing on HIV/AIDS/STIs and related conditions in the context of their wider role. The study was conducted over two months in Phnom Penh and Battambang. It provides an overview of who traditional healers are, the services they provide, how traditional healers and others perceive their role in HIV/AIDS prevention and care, and existing links and associations between traditional healers and others. The main findings of the study are as follows:
" Traditional healers are a very diverse group without a single identity.
" They were reported to treat almost all illnesses, with some healers specialising in treating people with HIV.
" AIDS, STIs and TB are treated with traditional medicine, with magic and ritual sometimes a component of this.
" Clients of the healers are perceived to be poor or of medium needs.
" Many people with HIV who are using traditional medicine reported substantial improvements in their health, though the side-effects and unknown toxicities are of serious concern of health workers.
" Many biomedical practitioners and health workers stated that they do not believe that traditional medicine is effective.