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This thesis reconsiders women's health status from the perspective of changing and multiple productive roles. A reading of Foucault's 'The Birth of the Clinic' is used to problematise both the current focus of health care and the system of measurement through which it sees and represents the world. Shifting social and economic boundaries have radically altered the terrain of health policy and thus, health indicators are no longer focusing attention on the most central health issues. It is suggested that the apparatus of health indicators and their system of measurement is now inappropriate (from the author's abstract). The methodology combines quantitative and qualitative approaches. Chapter six focuses on the qualitative aspects of the research and would have the most relevance to urban PRA. A week of participatory urban appraisal was conducted in a slum in Santo Domingo. The purpose of the reserch was to gain an understanding of how women perceive the changes in their productive roles and the impact these changes have had on their health status. Methods used included semi-structured interviews, card sorting, constructing activity and time lines, ranking and scoring, and constructing a community map and history.

This paper examines participatory evaluation in projects of the NGO PLAN International in Senegal. Through brief case studies it compares the viability of PRA evaluations in urban and rural contexts, and reflects upon the extent to which the methods can be used to reach the least advantaged groups in the communities. A number of criteria are used in assessing PRA as an evaluation tool: limited dependence ono external facilitators; replicability; community 'buy-in' to the process; adaptability to local time constraints; broad participation; reliability of data; turn-around time from data collection to use. The author concludes that PRA is problematic in urban settings if a 'community' is assumed in the same way as in rural areas. Some aspects for improvement (e.g. need to be more focused, and to prevent it from being appropriated by certain groups to the exclusion of others) are discussed.