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

Put up the four topic cards along the wall – HEALTH SERVICES, COMMUNITY, HOUSEHOLD,
WORKPLACE – and ask participants to identify barriers under each heading. Use small or buzz
groups <strong>for</strong> this discussion. If you are short on time, discuss this issue in plenary.
Health Services <strong>Community</strong> Household Workplace
●● Long distances to
health facilities and
long waiting times.
●● Insufficient levels of
health care staff.
●● Nurses too busy and
lack skills to counsel
HIV-positive women
re: family planning.
●● Stigma by health
staff toward people
living with HIV.
●● Inconsistent
in<strong>for</strong>mation on
breast-feeding <strong>for</strong>
HIV-positive women.
●● Pap smears – no
in<strong>for</strong>mation, not
easily available.
●● Lack of treatment
services <strong>for</strong> cancer.
●● Lack of openness re:
talking about sexual
and reproductive
health issues.
●● Traditional healers
don’t have protective
gloves and poorly
briefed on HIV and
AIDS.
●● Erosion of extended
family & community
spirit results in less
voluntarism and
mutual support
●● Police overcharge
rape victims <strong>for</strong>
<strong>for</strong>ms used as
evidence in court.
●● Poverty – people
cannot af<strong>for</strong>d clinic
fees & drugs.
●● Women’s inequality:
women depend
on partners
economically and
have little say over
sex/use of condoms
or control of
resources.
●● Women’s heavy
workload stops them
from going to the
clinic.
●● Violence stops
women from
reporting cases of
abuse to the police.
●● High cost of
mosquito nets.
●● Culture – women
need permission
from mother-in-law
to get treatment.
●● Stigma and
discrimination.
●● Lack of
confidentiality.
●● Taking time off work
is unpaid (especially
<strong>for</strong> women in the
casual sector) or
may result in loss of
employment.
●● Difficult to talk about
health issues with
employers without
being victimized.
Session 6: Problem Analysis and Problem Solving
Target Groups: ALL
Facilitator’s Note: This is the final major step in the analysis process. During this step the group
identifies the most important health problems (from those identified in Sessions 4 and 5) and works
on solutions.
Some groups may not have time <strong>for</strong> this step. If so, don’t worry – it also is included in the workshop
on Day Five.
Things to Guard Against:
It is important to get everyone to see this exercise as something real, and not just a wish list to be
sent to government. The idea is to get participants to think of what they could do themselves as a
community without a lot of outside support, and what things they would like to tell their MP. One
way to organize solutions is into “no cost” and “low cost” categories.
As part of introducing this step you should re-explain the objectives of the workshop and help people
understand that we are not there to deliver a list of demands to the MP or anyone else. Talk about
why it’s good that the priority issues will be taken up by MPs and what they will be likely to do with
them – the next stage of the process, assuming that there will be a round table meeting or something
to follow up with.
46 Chapter C: Facilitating <strong>Community</strong> Assessment Workshops