Mahmood M A, Khan K S, Kadir M M, Barney N, Ali S, Tunio R
Department of Community Health Sciences, Aga Khan University, Karachi.
J Pak Med Assoc. 2002 Jul;52(7):296-300.
While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research methods. PRA is considered as a better framework to assess, analyse and develop programs with communities.
The objective of PRA was to initiate community involvement and to understand the needs of health care from a community perspective.
PRA was conducted with groups of men and women from three rural areas in a district of Sindh, Pakistan using a life cycle framework. The community members identified various stages of their life with the associated health issues.
This research was empowering to community members as it facilitated community involvement. The respondents took charge of the process of identification of health needs at PRA sessions. PRA helped identify health problems considered prevalent and important by the community. More importantly, it helped potential service providers and the community to initiate community involvement in planning.
PRA is not only an effective tool for assessment and analysis of health issues but also a vehicle to promote community involvement. Additionally, participatory methods contribute to understand the context of quantitative data generated for planning purposes.
虽然贫困和缺乏生活机会是疾病负担以及婴儿和孕产妇死亡率高的根本原因,但医疗保健不足也起了很大作用。往往得不到医疗照顾的正是那些最需要的人。现有的卫生服务在管理时未考虑接受度和需求视角。这进一步降低了医疗保健的有效性和公平性。为指导一个全国性非政府组织进行生殖健康服务规划,在信德省的一个地区结合参与式农村评估(PRA)以及定性和定量研究方法对卫生需求进行了评估。PRA被认为是与社区一起评估、分析和制定项目的更好框架。
PRA的目的是促使社区参与并从社区视角了解医疗保健需求。
在巴基斯坦信德省一个地区的三个农村地区,采用生命周期框架对男性和女性群体进行了PRA。社区成员确定了他们生活的各个阶段以及相关的健康问题。
这项研究增强了社区成员的权能,因为它促进了社区参与。受访者在PRA会议上负责确定卫生需求的过程。PRA有助于确定社区认为普遍且重要的健康问题。更重要的是,它帮助潜在的服务提供者和社区在规划中启动社区参与。
PRA不仅是评估和分析健康问题的有效工具,也是促进社区参与的手段。此外,参与式方法有助于理解为规划目的而生成的定量数据的背景。