Bangladesh Reality Check 2008: listening to poor people's realities about primary healthcare and primary education
This report is a result of the first ever Uganda Participatory Poverty Assessment Process (UPPAP) in which local people were consulted in 36 rural and urban sites in nine districts in Uganda. In this assessment "voices" and perspectives of the poor are brought to the fore to influence district and national planning, implementation and monitoring. The report covers perceptions of poverty and wellbeing and strategies for coping with being poor, as well as the degree to which the poor have access to, and benefit from, services and infrastructure. It goes on to look at issues of government and poverty, along with the role that security plays in development. Finally there are rcommendations and messages for policy makers. The report points to the fact that poverty is more than just income and expenditure or the lack of basic needs, it is also a feeling of powerlessness. Poverty in the eyes of the poor is location specific, multi-dimensional, cyclic and seasonal and requires a holistic approach to it's alleviation.
This describes a Participatory Poverty Assessment (PPA) undertaken by the Government of Kenya and the World Bank during Febuary-April 1994. It had three primary objectives; to understand poverty from the perspective of the poor, to start a process of dialogue between policy makers, district level providers and the poor and to address the issue of the 'value added' of the PPA approach to understanding poverty. Methods used included mapping, wealth ranking, seasonal analysis, trend and price analysis, focus group discussions, key informant interviews; visual card methods, gender analysis, understanding health seeking behaviour; and incomplete sentences. Statistically the findings of the PPA and the Welfare Monitoring Survey based on an established poverty line were strikingly similar. The study also found a gap in the perception of poverty between the poor themselves and district officials. Separate chapters look at poverty in urban Nairobi and Mandera district.
Health researchers often wish to study the impact of wealth on health outcomes. To do this they must collect data on social and economic factors. However, the collection of detailed data on income and expenditure is rare in health studies in developing countries. Instead, researchers generally adopt more rapid procedures based on survey methodology. Increasingly this has included the use of Principal Components Analysis (PCA) to generate a number of separate indicators of welfare. An alternative approach is to utilise participatory wealth ranking to generate a measure of household wealth. The aim of this paper was to compare the results of Participatory Wealth Ranking (PWR) and an indicator-based survey methodology conducted within a health research programme (the IMAGE study) in rural South Africa. The data point to widespread and severe poverty among the study population, including indications of high unemployment, reliance on wage remittance and state grants, poor access to clothing, and fragile food and educational security. Household wealth indices were created from both techniques, using PCA to combine the survey data. Data from both techniques was available from 1467 households. There was a high level of internal of consistency in the participatory wealth ranking data However there was only moderate agreement between the ranking of householdsÆ relative wealth from the two techniques, although both techniques identified similar factors as of importance in determining wealth. The reasons for the discrepancy are unclear, but are likely to include methodological and conceptual factors inherent in both techniques. PWR may be a useful tool for the assessment of relative wealth in health studies in developing countries.