Participatory health assessment in Haiti: practical tools for community empowerment.
BACKGROUND
Recent changes in development practices have recognized the importance of community involvement in assessing needs and resources. Community based participatory research, including Participatory Rural Appraisal (PRA), provides a process that empowers communities to identify their own needs and build on their strengths.


OBJECTIVE
This paper describes a participatory health assessment in Haiti using a methodology that can be replicated in other settings. In contrast with traditional, needs-based assessment, this assessment was designed to train participants to discover their own needs and assets, in preparation for a potential community health program.


METHODS
A training team was invited by a faith community to facilitate an appraisal in three villages in northwestern Haiti. Facilitators trained local participants to implement PRA tools such as mapping, scoring, focus groups, and root cause analysis to discover perceptions of socioeconomic and health contexts of the community. The local team members conducted the activities with other community participants, analyzed the results together, and presented the findings to each community.


RESULTS
Key findings across the activities included loss of productive land, minimal irrigation or sanitation resources, priorities of maternal health, malnutrition, diarrhea, and a general distrust of organizations, but the existence of some effective local groups.


CONCLUSIONS
The PRA process empowered participants to define and prioritize their problems, identify potential resources, and offered insights into the practical implementation of research tools. The authors describe the methodology and implications of choosing a participatory health assessment, including the advantages, challenges, and potential for replication in other settings.
Sethi
Stephen
S
Loma Linda University School of Public Health, USA.
Belliard
Juan Carlos
JC
D003153:Community Health Services / Q000458:organization & administration*; D055812:Community-Based Participatory Research; D017144:Focus Groups; D006205:Haiti; D006301:Health Services Needs and Demand; D006801:Humans; D011209:Power, Psychological; D019035:Rural Health Services / Q000458:organization & administration*