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 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.
A comprehensive account of a large scale experimental PRA conducted for SCF in Vietnam. The approach taken and its justification (not agreed by all doners) is detailed. The methodology section is extensive, discussing the theory behind PRA, training, tools and fieldwork, as well as problems such as the external and timeconsuming production of the report. The final report gives details of the education system and educations problems encountered, in general terms and by specific commune. In some communes this is felt to be one of the most significant constraints, and potential solutions are discussed in detail.
This pamphlet summarises the results of a study conducted by the National Development Service on Nepal and Unicef. Teams of data-collectors went to nine different parts of Nepal showing illiterate villagers a wide variety of pictures in various colours and shadings. The results showed that most of the visual aids used by the health service were not recognised or misinterpreted by local people. Suggestions are made as to how visuals might be improved in response to feedback from villagers.
Describes the main process, and explores the problems encountered, during the ACTIONAID-Nepal utilization survey in the Rural Development Area of Sindhupalchowk, in September 1991. Objectives of the survey were: to assess how far the ideas and assets which the community has developed with Action Aid Nepal are being utilised, and the community's perception of the impact of these; to involve the community and thus increase their understanding; to increase AAN's understanding of the conditions of the poorest. The week of survey work was carried out by teams which comprised of the Community Development Committee (CDC) members, other local people and staff facilitators - staff, but not community members, were trained in PRA. Selective tools and techniques of PRA methods were used to gather all the information; the village map (of which examples are given in the appendix) was the most extensively used, semi-structured interviews were employed to collect information on household's participation in activities, and time trend and preference ranking methods were also drawn upon. Problems encountered in the survey were that indicators had not been agreed through a participatory process, the three-day training in PRA techniques was found to be insufficient, and structured questions left gaps and revealed bias. The bulk of the report is devoted to the survey findings
The report deals with the social implications of the cost-recovery measures adopted in the Zambian health and education sectors since 1989. The focus of the study is on the impact of the charges on access to basic health care and primary education among the poorest sections of the urban and rural population. The report is also concerned with the way poor communities, and the most vulnerable households within them, cope with demands to contribute more. It concludes by reviewing alternative ways of ensuring that the poorest are able to maintain access to basic services. A mix of approaches were used, including a range of standard RRA methods, focus-group work and anthropological insights from more traditional sources. The study also drew on a baseline survey and intensive household studies which had been carried out over several years.
PRA is set in the context of other participatory approaches to development, such as PAR. A table is used to present the varying ways of using "participation" showing to what extent local people are involved. This paper looks at PRA 'in terms of the potential it offers for colearning within a process oriented toward a goal of collective action'. Drawing on personal experiences, the process of using visualisations within PRA is analyzed in detail. Compared with conventional research methods such as interviewing, 'constructing a visual representation is in itself an analytic act'. The 'focus of activity shifts from the researcher to the representation' and the visualised product acts as a focus for discussions, a shared reference point. Difference can be explored by using visuals to extend focus group work, such as to discuss gender differences in separate groups of men and women. Visualisations can thus provide a way of discussing sensitive issues or points of conflict by moving the conversation to an object rather than to the individuals concerned. Drama, as a more dynamic visual form, offers creative potential to explore issues rather than the usual didactic theatre used in health education. PRA leads to a wider understanding of 'health' as being the result of issues such as inequality and poverty. Health workers can use the visual methods to 'bridge the gap between medical messages and local knowledge' and to change their role so they are learning from people's experiences.
This report is of an RRA training workshop which was carried out in one of the pilot sites of the Bhutan-German Integrated Forest Management Project in Wangdi District, Bhutan, in 1995. The first part of the report outlines the purpose and approach of the different methods, and how they were used in the field. They included mapping, transects, semi-structured interviewing and focus group interviews, seasonal calendars, tree ranking, institutional diagramming, wealth/well-being ranking, 'vision-drawing' by children, and problem ranking. The results were then presented at a feedback meeting with municipality representatives. The second part of the report presents the findings of the RRA.
This paper explores the use of rapid appraisal in defining the health and social needs of a community. The aim is to formulate joint action plans between residents and service providers. Data was collected by an extended primary care team from three sources to build a profile of the community: existing documents about the neighbourhood, interviews with a range of informants, and direct observations. Perceived problems of the community and suggestions for change were used as the main outcome measures of the study. Interviews and focus groups identified six priorities for change, many of which were not health related. These changes have been or are being implemented. The paper concludes that an expanded primary care team can use rapid appraisal as a first step in identifying and meeting local health needs. It facilitates a multi-disciplinary approach and complements quantitative methods of assessing need.
This report provides an assessment of the extent of and changes in poverty in Kenya during the '80s and early '90s. It uses data from different sources and of different kinds, including was a Participatory Poverty Assessment (PPA) and a Welfare Monitoring Survey (WMS). Interestingly, in three out of five districts the results yielded by the two approaches were almost identical. The PPA provided critical insights on a number of issues - people's perceptions of the extent and causes of poverty, the status of women, the extent of and reasons for low school enrolment, the reasons for not using public health facilities and the ways in which poor people cope with food insecurity and drought. Methods used included social mapping and wealth ranking, interviews and focus groups discussions. The different chapters present the findings of the study, focusing on economic development and poverty; revitalising the rural economy; structural transformation in agriculture; social sector spending (education and health); food security and nutrition; and targeted programmes and institutional factors. A strategy of programmes and policies for poverty reduction is suggested.
This is a longer version of the paper by Lily in Koning (ed.) Proceedings of the International Symposium on Participatory Research in Health Promotion (1994). The paper outlines the background to the evolving Women's Development Project (WDP) in Bangladesh. It focuses on a health education component of the project, and gives an example of community mapping in a Bangladeshi village, conducted with village-based volunteer health educators (VHEs). The process of the exercise is reported, as are the reactions of the VHEs. The mapping exercise led to a discussion of the achievements and challenges faced, illustrating the potential role of mapping in enabling women to look at their own work in a new way. Other potential uses of PRA in the WDP are listed.
The paper is a descriptive and explorative study on the experience of the International Institute of Rural Reconstruction in the conduct of Participatory Action Research (PAR) and its contributions in the development of a community managed health programme in Barangay Pinagsanhan in Cavite, Philippines. The experience showed that the initial conduct of PAR helped in the codification of the people's concept of health. It also familiarised them with a more systematic learning process for the planning and implementation of a more culturally-sensitive community health programme. Recommendations to maximise contributions of the PAR exercise in enhancing community cooperation and the villagers' critical thinking capability are suggested. The institutionalisation of PAR as a management tool for the planning and implementation of community programmes is also discussed.
This case book was prepared by an independent task force on 'community action for social development' as a prelude to the Copenhagen Social Summit. The 12 case studies on successful community-based social development are from a wide range of countries, such as Zimbabwe, Colombia, Tanzania, Sweden, India, Kenya, Poland, Pakistan, Tibet, Thailand and China. This casebook presents diversity of the worldwide movement towards community- based social development and defines a common process used by the successful programs. A common theme that runs through these case studies is that sustainable social development is difficult but possible; outside agencies involved in sustainable human development should respect people, their values and cultures, build trust and share power and responsibility with the people. The book also stresses the need to provide space for community action and maintain close co-operation between the state, community and NGO.
This report is a review of the different participatory methodologies used in development throughout Africa. It includes overviews of the literature on participatory development, and participation in agriculture and natural resource management, forestry, health, credit, literacy, water, and urban programming. Numerous methodologies are outlined (e.g. animation rurale, auto-evaluation, GRAAP, Theatre for Development, RRA etc.). ACORD's experience with participatory methodologies in Burkina Faso, Mali, Uganda and Sudan are discussed in detail. There are annotated bibliographies on ACORD and key general publications relating to participatory methodologies, and lists of key institutions.
This report presents the results of a PRA focusing on natural resources management in Kenya. It contains descriptions of historical background on the locality, natural resources, water and soil conservation, agricultural practices, discussions of key social issues and infrastructure (health and education) and analysis of institutions and local leadership. Problems and opportunities are identified, and a village resource management plan was devised. Action by the community and other actors as a result of the PRA is discussed, and some problems in implementation are noted. The report ends with reflections on PRA and the participatory planning process. Positive reflections include enabling the community to undertake their own analysis, promoting an integrated view of development, and development of the village plan. Problems included insufficient participation by marginal groups and by women, and the feeling that PRA is inappropriate to statistical analysis.
