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

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<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: ●● 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: ●● ●● ●● ●● ●● ●● 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
A community assessment facilitator should keep the following in mind: ●● ●● ●● ●● ●● Put participants (especially women) into the driver’s seat – enabling them to take over the process of analysis, map their own world, identify their own priorities and constraints, do their own problem solving and make their own decisions. Use a participatory approach to promote peer learning and two-way communication, rather than passive listening. Use the different groups and methods to cross-check and compare in<strong>for</strong>mation and analysis. Be prepared to self-evaluate – facilitators should continuously assess their own behavior and learn from the workshops. Create a sense of ownership among all players of the analysis, strategies and plans to improve women’s health. Chapter A: Introduction 13
Page 1: Guide for<
Page 4 and 5: Contents Preface ..................
Page 6 and 7: 6 Guide fo
Page 8 and 9: Abbreviations ART ARV CA CD4 CBO CL
Page 10 and 11: Why was this Guide
Page 14 and 15: Community Assessme
Page 16 and 17: ●● ●● ●● ●● ●●
Page 18 and 19: Step 2: Set Objectives Develop clea
Page 20 and 21: Step 5: Select the Field Sites It i
Page 22 and 23: There are other factors to consider
Page 24 and 25: The following tasks will be shared
Page 26 and 27: Checklist of Materials FLIPCHART PA
Page 28 and 29: Additional Activities ● ● COMMU
Page 30 and 31: Session 1: Introductions and Breaki
Page 32 and 33: Examples of Meeting Rules ●●
Page 34 and 35: ➋ SUMMARIZE: Explain what was lea
Page 36 and 37: Preparation: ●● ●● Tape six
Page 38 and 39: Explain that we cannot make diagnos
Page 40 and 41: Steps: The first two steps are opti
Page 42 and 43: Service Providers and Type of Servi
Page 44 and 45: Session 5: Women’s Experience Usi
Page 46 and 47: Put up the four topic cards along t
Page 48 and 49: Session 7: Evaluation, Follow up an
Page 50 and 51: Additional Activity: Site Visit to
Page 52 and 53: General Informatio
Page 54 and 55: General Informatio
Page 56 and 57: ➌ WARM-UP AND INTRODUCTIONS (10 m
Page 58 and 59: Session 3: Problem Analysis and Pro
Page 60 and 61: Session 4: Questions and Answers Fa
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Pulling It All Together - The Round
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●● ●● If you have to leave
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Active Listening - When participant
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Keep Objectives in Mind As the faci
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●● Be clear with the translator
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5. USE SMALL GROUPS TO BUILD PARTIC
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●● ●● ●● ●● Keep a
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A n n e x A : Fact Sheets A1. HIV a
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HIV is not transmitted by: ●●
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A3. Condoms Male Condoms Rubber, Jo
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A4. Sexually Transmitted Infections
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Herpes cannot be cured, but there a
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Medicine for Treat
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Boils and abscesses. These are pain
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In places where live yogurt is avai
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A8. Human Rights and HIV Promoting
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A9. Pregnancy, Childbirth and Feedi
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A single drug (“monotherapy” -
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What Are the Causes of Gender-based
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What Can a Community</stron
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A11. Cervical Cancer and Pap Smear
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A n n e x B : Energizers You can us
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Affirmation Claps Unity Clap: Rub y
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Silhouette 1 108 Annex C: Silhouett
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