This paper describes the methodology used for Cresswell's "PRA Investigation into the Health and Social Needs of People Living in Danesmoor". The project took 34 days to complete, consisting of 54 individual interviews, two group interviews and eight groups of school children. The PRA approach is described, outlining its relevance to the work with this community in the UK. PRA methods used are listed with their application in "community assessment of health and social needs as undertaken in Danesmoor". Implications for professionals working in the area are considered and the future potential use of PRA explored. Further research is suggested around why there is poor uptake of certain key services.
Unemployment and health: the development of the use of PRA in identified communities in Staveley, North Derbyshire
This study in Staveley, an area with high unemployment, aimed to: i) identify & enable people to address the personal risk factors for cardio-vascular diseases ii) enable unemployed workers to discuss health difficulties specific to unemployment iii) promote a greater understanding of the specific health needs of unemployed people Unemployed people and 200 children were interviewed, then key people in the professions of education, health, social services, police, clergy and housing. Video, photos and mapping were used and people "had an opportunity to test their own health by filling in a health profile questionnaire". The various groups' different perceptions of the problems and suggested solutions are analysed. There is a need for "an informed, integrated, inter-agency approach with the involvement of unemployed people in order to respond effectively to the problems of unemployment".
Planning for Real is a set of community-building tools which has been developed over the last 20 years, first in the UK, then in various parts of Europe and the US, and currently on trial in parts of Africa, India, South-East Asia and Latin America. The article focuses on the use of the method in urban areas where all sense of community has been lost, and where there is profound mutual distrust between the residents and the local officials. Planning for Real allows people to explore possibilities, sort out options, rank priorities, share out responsibilities and set out a plan of action. It is also a strategy designed to establish common ground between 'Us' and 'Them' as a basis for a combined operation to create a working neighbourhood.
This eight day workshop on PRA integrated practical community placements in Guelph to provide use for the techniques acquired during the theoretical sessions. The report highlights constraints around timing and venue when organizing a workshop in a 'Northern' country, and gives ideas for fieldwork.
Exploring the potential for primary environmental care: rapid appraisal in squatter communities in Salvador da Bahia, Brazil
This paper discusses the methods of collecting information in a field study carried out in Salvador da Bahia (Brazil) a suburb of Salvador. The study was part of a training exercise for students of the "International Course for Primary Health Care Managers at District Level in Developing Countries" based in Italy. The study also aimed to explore the potential for Primary Environmental Care and identify ways by which the local health district could support squatter communities. A rapid appraisal was carried out in three squatter communities. Secondary data was analysed, life history interviews were conducted, a "risk map" was drawn in which local participants geographically located problems, focus groups and ranking, key informant interviews, ten institutions with an interest in environmental issues were interviewed, and a feed-back meeting was held for all community members. It is concluded that RRA is well suited to study fast-changing environments, a potential danger of the exercise is taken to be undue expectation-raising of the local community. Finally "microplans" are introduced as a possible means of making RRA action oriented. Five pages are devoted to illustrations arising from the exercises.
This brief article describes some of the problems the authors encountered conducting pile sorting and free listing with women in a slum area. It emerged that these women did not view their health problems in "lists" but rather as part of the socio-cultural context of their lives. The authors discover a more effective way of involving participants is to organise group meetings on specific topics.
This is a newsletter which describes the formation of the Midnet PRA group and includes a number of very short articles and thoughts on practitioners experiences with PRA in Southern Africa. Experiences shared include working with young people, in education, with periurban communities, for catchment management and for land reform. The methods used are discussed with details of venn diagrammes for community organisation, historical time lines. There are reports from trainings in Namaqualand and Namibia. The thoughts that emerged from evaluation/ reflection and planning meetings included the ideas of rapid learning and sharing and the need for more training. The final article summarises the PRA and gender workshop held at IIED in December 1993.
A three day training workshop and three weeks of fieldwork were conducted by a team of nine women in two parts (one typically urban and the other typically rural) of the Gaza Strip. The purpose was to understand the social and economic roles of women better, to obtain more information on women's projects and teach PRA methods to other women. A wide range of PRA tools were used. The PRA covered all aspects of women's socio-economic wellbeing including health. In the urban areas, health problems include the psychological and physical stress consistent with exposure to military activities. Possible development alternatives are discussed and ranked: a health clinic is the first of four alternatives in the rural area and the third of seven in the urban area
Participative rural appraisal: potential applications in family planning, health and nutrition programmes
The paper is divided into three sections: I) origins of PRA - its advantages and disadvantages; II) the potential applications of PRA in family planning, health and nutrition. This is discussed with specific reference to India and three stages of PRA development are envisaged i) techniques which are simple enough to be applied on a routine basis with local health workers acting as facilitators (verbal feedback on healthcare performance, recording of seasonal trends, village mapping and verbal autopsies). ii) techniques in category i) which work well might then be applied on a continuous basis to monitor and manage service performance iii) PRA is then used in a more formal way to facilitate research and development. III) suggestions are made on how PRA might be institutionalised, again using the Indian example. NGOs are considered to be vital to institutionalize the PRA process. The speed at which governments are able to absorb PRA techniques will be determined by the rate at which suitable NGO support for the process can be made available.
This draft section of a paper, which includes the use of formal survey methods including questionnaires, discusses the use of participatory methods in urban research. The introductory section highlights the need for urban based research, with a focus on urban poverty. The aims are: to measure the nature and causes of urban poverty, understand household survival and coping mechanisms, and design policy and programmes. The increase in use of participatory techniques, with their emphasis on communication, a holistic analysis, visual techniques and triangulation could apply equally to urban situations as to rural ones. The process of participatory research, the nature of the information collected and the involvement of communites are outlined. It is argued that conducting "PRA" in urban area may have logistical advantages, and is applicable beyond the scope of poverty analysis. The dangers in application are mentioned, and the paper concludes with a list of tools, such as SSIs, ranking, maps, transects, calanders, timelines and livelihood analysis which are discussed in detail.
Article focuses on the lowest-income groups of Khartoum and their struggle to find shelter in the city. After giving an overview of housing conditions and the ways in which poorer groups find accommodation, the author describes the legal and illegal housing submarkets. He argues that understanding these is essential in order to change housing and living conditions. Discussion then turns to government attitudes toward housing problems, and the description of the development of two low-income housing areas in Khartoum. Very little emphasis is placed on participation and nowhere is PRA or RRA methodology mentioned. In the conclusions, the author states that community participation is a realistic alternative to current policies, and that low-income groups have used it successfully for a long time. The author argues that limited public resources could be best put toward supporting community-based organisations who work to improve infrastructure and basic services.
An action learning approach using Rapid Analysis Methods - a modified form of RRA - has been developed by the Development Adminstration Group (DAG) at the University of Birmingham. The approach has been used in urban management training courses run by DAG and the Town and Country Planning Organisation (TCPO) in the Ministry of Urban Development, New Delhi, India. The aim of the methodology is to enhance problem-solving ability. This weakness in problem analysis has recently been identified as a central concern in the need to strengthen indigenous policy-making capacity. The article discusses the extent to which ideas about RRA can be transferred to the urban context and used in training programmes for government officials.
Rapid assessment procedures in urban communities: the experience of the Health and Habitat Project in Barrio San Jorge, Argentina
The Habitat and Health Project was implemented in 1992 by IIED-Latin America in Barrio San Jorge, a poor squatter settlement in Buenos Aires. The article describes how three preliminary focus groups were piloted to test participatory methodologies on a small scale. The aim of the focus groups was to get to know local people's perspectives on the main health and habitat problems of the barrio, and to identify local facilitators with whom the project could work. Joint progress could then be made in the design and implementation of initiatives. The results of the pilot suggested that problems of low levels of community organisation and participation were not fully overcome. An evaluation of the experience has been used to revise the strategy for the second phase of the project.
This study suggests a comprehensive strategy for dealing with the problems of environmental sanitation in urban Indonesia. The objectives were: to propose strategies for environmental sanitation which involve and capitalize on local participation; to initiate a process of consultation with local communities aimed at envisaging suitable work approaches acceptable for both beneficiaries and local government institutions. The strategies suggested by the study will be based on: 1) investigation of the behavior and perceptions of urban populations 2) improved understanding of the factors influencing individual and collective choice of water and sanitation options 3) better comprehension of how urban dwellers view the usefulness of the municipal institutions in providing water, sanitation and solid waste services as compared to services provided by the informal sector or by the households themselves 4) an understanding of how the degree of envrionmental awareness varies among groups with different socio-economic characteristics. The study is divided into two parts; first is the Rapid Urban Appraisal (RUA) in the fifteen selected kampungs, second is a detailed interview survey of 800 respondents in the 15 kampungs. This report presents the preliminary findings of the RUA only, including details of group discussions and card games used to rank people's perceptions of environmental problems confronting them.
The death of the clinic? Linkages betwen the changing and multiple production roles of urban women and their health status in the Dominican Republic
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.