Guide for Community Assessments on Women's Health Care - ICRW

<strong>Community</strong> <strong>Assessments</strong> Facilitate Greater Learning
The community assessment methodology drew on the methods of participatory learning
and action (PLA), an approach that builds on local knowledge and experience. <strong>Community</strong>
participants talk about their lives, concerns and priorities, and then identify, discuss and
ultimately devise solutions <strong>for</strong> their own problems. The process helps both the community and
the team facilitating the community assessment gain a deeper understanding of the issues.
Getting the women to talk openly about their health concerns and experiences meant breaking
through the taboos around HIV, sexually transmitted infections (STIs), abortion, female genital
mutilation, rape and sexual abuse. These are sensitive issues that women rarely talk about
privately, much less publicly. The participatory learning tools were carefully chosen to help get
these issues into the open. Body Mapping, <strong>for</strong> example, was used because of its capacity to
encourage women to name the parts of their bodies, including sexual body parts. Once women
started talking about the vagina, clitoris and other sexual body parts in explicit language, the
ice was broken and they began to talk about health issues which affect the body, including STIs
and violence. Getting the women to talk about these issues personally took careful facilitation
and the creation of a com<strong>for</strong>table and safe environment in which they could feel free to express
themselves.
Another key feature of the community assessment approach was collecting data from different
stakeholders – HIV-positive women, non-positive women, service providers and community
leaders. After meeting separately to talk openly and clarify their own ideas, all peer groups came
together <strong>for</strong> a joint meeting to share what they had discussed and work together to analyze and
discuss how to solve the problems.
In summary, the community assessment approach used by the Parliamentarians <strong>for</strong> Women’s
Health project involved:
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Separate workshops with different stakeholder groups, including HIV-positive women,
HIV-negative and untested women, service providers and community leaders.
● ● A joint workshop with all stakeholder groups.
● ● Use of different participatory methods and the expertise of skilled facilitators to get
participants talking openly, raising issues and analyzing their own experiences.
● ● Involvement of HIV-positive women as key planners and facilitators of the process, and
the parliamentarians as co-facilitators and active listeners.
The process helped the community to:
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Identify and prioritize the main health problems women face.
Map the services available in the community to address these problems.
Define the crucial gaps in services.
Analyze women’s experience in using health services.
Identify barriers to health services.
Identify crucial problems that undermine women’s health as well as possible solutions.
12 Chapter A: Introduction