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.
This community handbook is designed to help health workers address three questions: i) How do you measure community malnutrition? ii) What are the food problems in your community? iii) Which problems should you attack? A series of appendices describe various practical ways of measuring child development. Health workers are encouraged to analyse and act upon the various socio-economic causes of ill health. An extensive list of further information sources is provided, with little emphasis on methodology.
It is argued that rural appraisal (talking with local people) needs to be undertaken by sanitary engineers to free them from five types of inhibition: 1) assumptions based on academic subdivisions; 2) the assumption that rural communities have no significant technology of their own; 3) a tendency to overlook opportunities for detailed improvements and go for technological solutions; 4) a failure to recognise the 'invisible' components of local technology - its software and organisational form; 5) assumptions based on professional or western cultural values.
Conventional studies of child feeding practices are difficult and time-consuming, since family food use is a sensitive topic since it hinges on economic status and power relationships. The author argues that since "this information can only be obtained by workers trusted by the community, after both sides have understood and become concerned with the object of the investigation". The roles of an RRA facilitator in providing, collecting, interpreting and discussing information are outlined. Section 2 discusses 8 questions relating to feeding practices, covering problems with conventional food consumption surveys, trust between researchers and researched, the importance of relating reported to actual practices, evaluating 'satisfactory' feeding practices, understanding mothers' perceptions of practices, problems and obstacles to change, and the importance of sharing information for mutual learning between the interviewer and the community.
This article argues that it is not always necessary to undertake costly surveys. A rapid reconnaissance 'sounding' of the local situation should generate sufficient information to enable a project to be started which will generate more information as it proceeds. The reasons for a cultural preference among planning officials for surveys - which often generate more information than is needed - are discussed, as are the dangers of using a limited set of conventional information gathering methods - which can miss key facets of rural lives. Ways of gaining a better understanding through 'soundings' are discussed, including officials chatting in a more informal style, using the sondeo method, involving local people as researchers and group discussions. The validity of soundings data is explored. The data requirements for practical action differ from the requirements of routine reporting systems. Attitudes and behaviour must also change to enable officials to use imagination and lateral thinking about information requirements and collection methods. Examples are drawn from health and hygiene.
Community-Based Workshops for Evaluating and Planning Sanitation Programs: A Case Study of Primary Schools Sanitation in Lesotho
The Lesotho Primary Schools Sanitation Project, undertaken in 1976-9, had limited success. When a follow-up project was proposed, it was decided to hold workshops to find out the communities' views on how the follow-up should be designed. Workshop participants included school and community representatives, ministerial and donor agency representatives. This paper describes the results of those workshops held in March 1981. Most of the report discusses technical implications of the workshop discussions. A final section discusses the role of community based workshops in development planning.
This is the second of a series of articles by World Vision International. It begins with the description of how a community deepen their understanding of their situation by using participatory mapping technique. The first part of the report is on Participatory process, community evaluation and planning , and the recognition of basic participatory principles that must be acknowledged in people and key characteristics of a good facilitator. It further describes a world vision exercise on participatory planning where match boxes were used to represent households in Brazil. In this exercise different kinds and lengths on match sticks were used to identify the various categories of people in the community. This enabled the community to identify the number of children of school going age in the community and then followed on to develop educational and nutritional programmes . It has a Christian theme, and draws on parallels between the work of Christ and Participatory processes. The report includes photocopied photos of the maps and the key of match sticks for the census of the community.
Underutilisation of Public Sector Health Facilities in IMO State Nigeria, A Study with Focus Groups: Final Report
Ten focus group sessions were held in Imo State Nigeria to explain the under-utilization of public sector health services. Groups consisted of village women, village men, elementary school teachers, traditional medical practitioners, male civil servants, female civil servants and nursing staff. Rural and urban sites were selected in major sub-cultural zones. Focus groups revealed under-utilization had several causes: limited accessibility of services; high user costs; lack of supplies; uncaring attitudes of staff; nepotism and financial misappropriation. Implications for government action are suggested: strategies for reducing costs; making health care more accessible; improving the quality of services and educating the consumer. The role of the state in health care may need clarification to ensure it complements non-state health care provision. Suggestions are made for further research in which focus group studies can be used throughout.
This manual is divided into six chapters and appendixes: 1) describes the evolution of RAP - the modification of traditional anthropological techniques to fit a time constraint of 4 - 8 weeks. 2) outlines the anthropological methods of formal interviews, informal interviews, conversation, observation, participant observation and focus groups. Types of information records are outlined. 3) details how to conduct a focus group and record information. 4) gives guidance on the selection training and supervision of field workers. 5) gives some examples of data analysis and presentation (cognitive maps, graphs of perceptions of the effort in childbirth, diarrohea taxonomies). 6) a final page is devoted to the outline of a final report. Extensive appendices cover the types of questions to be used in gathering health information.
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.
Rapid Assessment Procedures (RAP) is a data collection tool which takes standard anthropological techniques and adapts them for use with health programmes. It provides a systematic methodology for conducting rapid qualitative assessments of local conditions and needs, knowledge, attitudes and practices. The methods used include formal and informal interviews, conversations, observation, participant observation and focus groups (01). RAP can be used with other techniques to make quick assessments for planning or evaluation (02). The video documents a RAP survey carried out by Foster Parents Plan International in Guatemala. RAP was used to assemble data for programme planning with the aim of understanding people's attitudes towards vaccination. By comparing their views with the programme's objectives the two could be merged to optimise access to primary health care (03). The various techniques used during the survey included formal and informal interviews (05), conversation (06), observation (06.30), participant observation (07) and focus group discussions (07.30). The survey also investigated existing health services such as the pharmacy and local healers to provide a total analysis of the health needs of the community (08). The different methods and sources used in the survey provided triangulation and increased the accuracy of the information (09). RAP can be used at different stages of the project cycle, for project planning as well as process and concluding evaluations (011). It is a flexible tool which can be adapted to fit different areas, situations and populations (14).