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This paper examines the problem of finding measurements for the two major principles of primary health care (PHC): equity and participation. However, attention is focused on the assessment of participation. A methodology is presented to define indicators for assessing participation in health care programmes. It sets out to provide a process-oriented framework for those involved in PHC programmes to describe participation in their programme and, upon that basis, to plan their future actions. It is based on premise that broader participation is achieved by developing a wider range of activities. The paper is divided into five parts. The first section reviews past efforts in measuring PHC by frameworks besides those which only examine the improvement in health status and in measuring participation. The second section discusses the conceptual framework for assessing participation, while the next section elaborates on the analytical framework. Part four presents the methodology. The development of process indicators is critical to the understanding of health improvements and community participation. These indicators will help demonstrate whether participation ôhas become narrower, broader, or remained unchangedö, along a continuum that will establish a baseline for comparison. Five factors or indicators said to influence participation are 1) leadership, 2) organisation, 3) resource mobilisation, 4) management, and 5) needs assessment. Part five describes a case study of rural health programmes in Nepal using the analysis. The paper includes an appendix of questions suggesting how indicators might be identified.

This long and detailed study describes how the mandal (administrative area) of Devikere in Jagalar, Karnataka State was selected as the appropriate site for an Action Aid anti-poverty project. A socio-economic survey was conducted by a multi-disciplinary team using mainly RRA techniques. The methodology employed appears to have much in common with farming systems research. A section of the report is devoted to health issues. This includes: nutrition and food availability; mother and child wellbeing, health practices and beliefs; the environment; housing; occupation and health services. The anthropological/ethnographic technique of using case studies of individuals adds a strong human dimension to the study. Separate sections are devoted to women, infrastructure and sanitation, and socio-economic conditions.

Section seven of this workshop report focuses specifically on M&E and Project Benefit M&E (PBME). The introduction to this section lists some of the shortcomings, or 'weaknesses', of a "conventional" M&E program and then highlights some of the main 'potential contributions' from RRA methodologies for M&E activities. These include; increasing the cost effectiveness of data collection in areas such as cropping calendars, labour profiles, and crop and input prices; helping in determining cropping parameters and; improving the effectiveness monitoring through the use of diagnostic surveys. In the second section, Mick Howes explores the uses of RRA methodologies to evaluate NGO projects. Using the example of the preliminary study of an irrigation tank renovation project in Sri Lanka, the author provides a useful account of an evaluation approach which employs some RRA methods in determining 'the context', 'the impact, 'project the system' of the NGO's intervention. Methods included mapping techniques, group interviews and household case studies. In the concluding discussion, the author suggests points in which RRA methods may be further employed to improve both the case study evaluation and other participatory forms of evaluation of NGO projects.