title: Utility of participatory rural appraisal for health needs assessment and planning.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  The objective of PRA was to initiate community involvement and to understand the needs of health care from a community perspective.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Community Health Sciences, Aga Khan University, Karachi.
authors.forename: M A
authors.initials: MA
authors.lastname: Mahmood
authors.forename: K S
authors.initials: KS
authors.lastname: Khan
authors.forename: M M
authors.initials: MM
authors.lastname: Kadir
authors.forename: N
authors.initials: N
authors.lastname: Barney
authors.forename: S
authors.initials: S
authors.lastname: Ali
authors.forename: R
authors.initials: R
authors.lastname: Tunio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D018672:Community Health Planning / Q000458:organization & administration*; D003256:Community Participation; D003906:Developing Countries; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010154:Pakistan; D011203:Poverty; D011247:Pregnancy; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care; D034121:Reproductive Health Services / Q000458:organization & administration*; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*