A PRA workshop held in a Canadian university led to reflections on holding PRA training in an academic institution. Points included: underlying tensions between participants who are part of the academic hierarchy, different mix of "starting orientations and personal goals", difficulty of setting up field work. The issues all relate to establishing who the training participants are and the implicit assumptions around the training venue.
This document reports on the proceedings of an international symposium on participatory research (PR) in health promotion, which was held in Liverpool, UK in September 1993. It contains the full text of three keynote addresses: an historical perspective to participatory research; the challenges and concerns presented by feminism; and a case study of participatory action research in a women's health programme in India. Short (2-3 page) summaries of the introductions to the workshops are also presented, covering a range of PR and health-related issues. These include: training in PR; examples of frameworks to implement PR; evaluation of participation; relationships between research institutions and communities; integration of PR in government services; participation of health workers in formative research and evaluation; PR in healthy city projects in the UK; community-based needs assessment and health information systems; reflections on and examples of PR in women's health; use of PR in HIV/AIDS prevention; the use of draw and write methods with schoolchildren; PR and the promotion of health in the work setting; and the use of PR in water and sanitation projects.
Minutes of the International Seminar on Collaborative Health Systems Research, Ayutthaya, Thailand, 26-28 November 1990
The Collaborative Health Systems Research Group is a network of health policy makers and academics, supported by the European Commission. The Group takes the view that 'lack of knowledge is now not the main limiting factor in the improvement of health'. The group aims to improve the interface between methodologies from the bio-medical sciences and the social sciences. Health systems research employs both quantitative and qualitative methods. Classical epidemiological methods are used as well as systems analysis and operational research in order to activate research.
Using questionnaires through an existing administrative system: a new approach to health interview surveys
A review of recent developments in health interview procedures within decentralised health planning emphasising the importance of beneficiaries' perceptions of their health problems in the success or failure of primary health care. The methodology used is that of 'indirect' health interviews channelled through existing administrative systems and self-administered by recipients. The article describes ongoing research designed to test this approach in seven African countries and discusses methodological problems and limitations.
Anthropological methods have been introduced into rapid assessment procedures (RAP) for a number of diseases and related health issues. This article discusses the suitability of the approach for health research in countries where tropical diseases are endemic. Adjustments to conventional methods are necessary, given the limited time in the field and the need to ensure the validity and reliability of data. Although rapid assessment has certain shortcomings and does not obviate the need for long-term studies, a mix of research methods, use of multi-disciplinary teams and attention to contradictions within the study population will produce valid data in a relatively short period.
Verbal autopsies are widely used to describe the causes of death in individuals who die outside of hospital or clinic settings, but are seldom validated. The technique assumes that disease which cause death can be easily distinguished from one another by distinct syndromes and that these are reported accurately by lay respondents. The article describes the potential problems of syndrome definition and the likely biases from poor recognition and recall by bereaved relatives; how these might be tested and what can be done when verbal autopsy cannot identify the cause of death.
The Communities' Toolbox: The idea, methods and tools for participatory assessment, monitoring and evaluation in community forestry
This manual follows on from a concept paper also prepared by D'Arcy Davis-Case and is the result of an Agroforestry Monitoring and Evaluation Project workshop which was held in 1988. The field manual is divided into three sections. Section One introduces the idea of participatory Assessment, Monitoring and Evaluation [PAME] and provides some two-way communication exercises for field staff. Section Two provides the methods determining information needs, and ways that information can be analyzed and presented. While Section Three described the information collecting tools, and offers some suggestions for the selection of tools. There are 23 tools listed in this latter selection, including; Semi-structured interviews (tool 9), Ranking, Rating and Sorting (tool 10), Maps and mapping (tool 14) and community directed visual images (tool 21). Although the RRA/PRA methodology is not specifically mentioned, this manual does represent a very useful and well ordered contribution to the literature of PM&E, while some of the tools described under PAME are directly applicable to a PRA orientated approach.
The article describes the experience of participatory research in a squatter settlement in the Dominican Republic. The research was undertaken as part of a larger study which aimed to explore the links between urban women's changing and multiple productive roles and their health. The article summarises the qualitative participatory research, concentrating on the implications of PUA, in terms of method (what worked, and what did not), and where appropriate, substance (the urban debates uncovered in the process).
A Discussion of the Reliability of Measures of Hygiene Behaviours: The Case of the Health Behaviour Intervention Project, Lima, Peru
This paper discusses the use of qualitative and quantitative methods to eliminate systematic sources of error in quantitative measurement of hygiene behaviours in the Health Behaviour Intervention project in Lima, Peru. The authors argue that the combination of methodologies can give public health better data for the design and implementation of interventions to prevent disease. In relation to qualitative methods, the paper discusses the reliability of structured observation data for health intervention studies. It presents background on structured observation in Lima, reliability of measure across observers and over time, and preliminary significant associations between behaviours and diarrhoeal disease.
New agricultural technologies are often inappropriate to the needs of small farmers because scientists lack information about their needs and objectives. The IPRA method is a set of procedures which has been developed to put technology designers in regular contact with small farmers so they can better exchange information which will orient research to real needs. Farmers and scientists learn from each other and work together to identify problems, plan experiments and evaluate solutions. The aim is to mobilise the expertise and resourcefulness of small farmers so they can be active partners in agricultural research. The DVD demonstrates the various stages of the IPRA method as carried out in a village in rural Colombia. During first contacts with the villagers a rapport was established as the researchers attempted to carry out routine village tasks (09). Diagnostic meetings were then held for farmers to discuss common problems and the scope for improvement (10). When the farmers priorities had been established the researchers suggested new plant varieties, fertilisers and other components. The various options were considered for testing by the farmers (13). The farmers and researchers agreed on the components of the field trials and the same trial was conducted on several farms to obtain comparative results (14). The standing crop and the harvest were assessed by the farmers (17), and their families participated in evaluating samples of the products for flavour, quality and texture (18).
Fish from Malawi's lakes provide approximately 70% of the country's animal protein, although as the population has increased per capita consumption has declined. Smallholder aquaculture is expanding rapidly in the southern part of the country and has the potential to alleviate some of these shortfalls in fish supply by providing a cheap protein source (01). The film looks at a collaborative research programme developed by the Fisheries Department, the International Centre for Living Aquatic Resources Management (ICLARM) funded by GTZ, and the University of Malawi. The programme aims to develop aquaculture technology which is appropriate to the needs of rural farmers (02). Constant evaluation and feedback from farmers to researchers means that the research can be refined according to farmer's needs (03). While there had been a rapid expansion in fish farming in Malawi, catches were variable and often poor. The problems were due to a lack of suitable fish species and feeds and poor water fertility (06), as well as farmers' inability to invest and the lack of integration of fish farming into the traditional farming system (07). An on-farm survey of resources and farming systems allowed researchers to prioritise research needs and develop aquaculture models relevant to the local agricultural situation (07). Methods of increasing overall productivity were investigated, including assessing the use of grass as an input (08), compost technologies for improving water fertility (10), and integrating agriculture and aquaculture systems (12). Methods of harvesting fish using locally available materials were also investigated (14). Open days at the aquaculture centre provide opportunities for farmers and researchers to interact. Farmers also participate in on-farm discussion and testing of technologies (19). The constant evaluation and feedback from farmers to researchers means that research agendas can be refined to meet farmers needs (21).
This film demonstrates a participatory approach to crop research which has been developed by the International Crop Research Institute for the Semi-Arid Tropics (ICRISAT) in India. It aims to bring researchers closer to farmers through on-farm evaluation of pest-resistant varieties. The approach was developed to overcome the limitations of the transfer of technology approach, which is often innappropriate to the complex, risk-prone agriculture of the semi-arid tropics (07). It recognises that farmers and scientists perform complementary activities, and advocates a decentralised and participatory approach in which scientists perform a facilitating and support role (08). The research was carried out in collaboration with women farmers, who play an important role in maintaining biological diversity. First, the pest problem was diagnosed and the different varieties grown by farmers were analysed (09). In the second stage the characteristics of the farmer's varieties were matched with those of the scientist's pre-release lines. On-farm trials were then conducted in different villages (11). After harvesting the farmers carried out their own evaluation of the genetic material (14). The different varieties were ranked to elicit the farmer's preferences, according to their own criteria (16). The scientists learned that a mosaic of varieties better suit the diverse situations faced by farmers in these complex dryland environments than the uniform introduction of a standard seed (23).
The Centre for Tropical Disease Research Medical School at the University of Guerrero, Mexico has been developing the Sentinel Survey process since 1985. Community-based Sentinel Surveys are a tool for developing dialogue among families, local leaders, district health services and regional and national level health planners about health risks (00). They are based on the premise that through careful, inexpensive measurement, dialogue and using the perspective of the family health possibilities can be changed (02). The video focuses on a village survey (one of 43 sentinel sites in Guerrero) which investigated family practices that might increase the risk of parasites and diarrhoea (10). All households in the village were surveyed by local health workers. Blood, faeces and saliva tests were processed quickly and the data fed back to the community (14). A preliminary risk analysis of common practices such as using contaminated water to wash vegetables or keeping pigs in the yard was also carried out by health staff in the field using laptop computers (15). The results were distributed to the community the next day and demonstrated to the community that by changing certain practices their families' health could be improved (15.30). The information gathered can be shared with other district health authorities, as well as with regional and national level bodies. It can also be used as the basis for dialogue with relevant sectors such as the water or education authorities (23).