Mobile Home Appraisal guides
Needs Assessment in Farrokhshahr City, Iran, Using Rapid Appraisal Method in 2004
Introduction:
The most important goals of community based participatory research are organizing and exploiting of relevant data in order to solve local problems. In this way Farokhshahr population lab, in Farokhshahr city, Chahar Mahal and Bakhtiary province of Iran, founded in 2004, to empower local community to recognize and solve their problems in a development based manner, and the final goal was health promotion.
In this center, running participatory research is an important fact that consists of community mobilization, needs assessment, priority setting, intervention and evaluation (1).
Following community mobilization, we should run needs assessment and then priority setting (2).
Needs is the gap between current status and ideal situation, and this is recognized via needs assessment project (2).
In Farokhshahr population lab, the main goal is development and health promotion for all local people (1).
In various international researches, rapid appraisal needs assessment was applied to identify different needs in social and health fields (3-10).
In this survey, needs assessment project was conducted in Farokhshsahr city, in order to perform applied research based on real community needs and not merely based on researcher ideas.
Methods:
This project is a community based participatory research that conducted using rapid appraisal needs assessment method.
Study population consisted of all 45000 residents of Farokhshahr city. Sample size was 40 groups and each group included 6-12 members. The sample size (400 persons) was then selected from study population using random sampling. These 400 persons were selected by systemic random method, with two variables:
Gender (male and female) -
Age-
(0-10 years: children, 16-19 years: teenager, 19-25 Years: young, 25-65 years: middle age, >65years: aging group)
These persons were invited to center and interviews made by team members, then FGDs performed to determine local needs. The question due to 0-10 years child, were asked from their mothers.
Rapid appraisal needs assessment method is a qualitative one that local knowledge; skills and researches are used. This method is based on 3 processes:
Observation-
Interview with different groups of local people-
Information gathering-
The advantages of this method are:
Informing local community,-
Identification of each person role and responsibilities-
Optimum utilization of information (data) and resources-
In all research phases, stake holder had a key and leading role, they gathered correct information that after analyzing should lead to set priorities, perform interventions and then evaluate the whole processes.
All of research phases were performed with, active participation of Farokhshahr research and development population lab members (located in Chahar mahal & Bakhtiari province) under Shahrekord University of medical sciences supervision.
In the population lab community mobilization formed in an organization named “Farokhshahr development team”.
Research and development population center established in Farokhshahr in 2004 and consisted of authorities and all of stakehaloles.
In this team local people representatives, organized in 10 active work committees. These committees were including:
- Aging group committee
Youth committee-
Woman committee-
Cultural, artistic and religious committee-
Social security committee-
Health and food committee-
Sport & entertainment committee-
Construction committee-
The head of these committees was the members of research and development team.
Initially, the local information (community profile), including Farokhshahr population, age distribution, mortality causes, health care system, literacy indices, security occupation , culture, communication and housing, were collected by team members under supervision of academic researchers.
Information gathered from 3 sources:
Current local information (community profile)
Observation and record information
Interview with current local population groups in Farokhshahr (two variables: gender and age).
Finally, gathered information from mentioned sources organized and categorized in 9 groups, this process performed with active participation of team members and academic researchers’ supervision.
Results
In this investigation, 40 problems were estimated and categorized in 9 groups ( problems of aging group, youth group, women group, construction group, sport and exercising group, health and food group, social security group , artistic cultural group and occupation group )(Table 1).
Discussion:
In this survey, using rapid appraisal needs assessment method, with active participation of Farokhshahr people, a wide range of social problems were recognized, the identified problem were not merely health based, but also included social and cultural issues.
Rapid appraisal needs assessment method was used in many researches and in all studies this method was the most proper and most cost – benefit one to obtain a wide range of problems with local people participation (3-10).
A common point in all these studies, is obtaining a wide rage of social to health needs.
In a research that conducted in northern Ireland , a wide range of social and health problems such as loss of sale locations , loss of aging group support to increase in psychiatric drugs , were obtained(3).
In the other study that performed in Buenos Aires with focus group discussions (FGDs), a wide range of problems such as air pollution, addiction to alcohol and opium recognized (4).
In a research conducted in Soweto’s South Africans researchers concluded that in according to restriction of resources and necessity of efficient utilization of these limited resources, policy makers should apply methods that encompass health issues comprehensively, and this obtain via participatory research by all relevant community stake holders. Finally they concluded that, they can use this method in all regions of South Africa efficiently (5).
In a study conducted in socially deprived, multiethnic district in south east London with a population of over 700,000 to undertake a district wide review of primary health care services and identify the views of users and providers about current arrangements and options for development, Widespread dissatisfaction with current arrangement was identified, with specific problems relating to access, variability, demand for services, and interagency communication. Many of these problems are now being planned or piloted (4).
In a study conducted between 670 homes in Edinburgh, six priorities were identified, many of which were not health related. They conducted that an expanded primary care team can use rapid appraisal as a first step in identifying and meeting local health needs. It facilitates a multidisciplinary approach and complements quantitative methods of assessing needs (7).
Results of our study had a full coordination with mentioned researches and the common point of all is active participation of local people in all process stages, and determination of community oriented rather only health–oriented needs.
We recommended that since resource constraints are likely to remain in the foreseeable future, and therefore efficiency remains an important concern, methods should encompass health problems comprehensively, and this is possible through all local stake holder participation.
In this field rapid appraisal needs assessment is the most proper one. It is applicable in all country regions and has rapid and cost benefit impacts with involvement of all stake holders and policy makers.
TABLE 1: Farokhshahr local population problems derived by qualitative rapid appraisal needs assessment method in 2004
Occupation problems Social security problems Youth problems Health problems Women problems
Loss of job opportunity Addiction , easy access to narcotics Psychiatric disorders Mental health Lack of women knowledge about health and nutrition
Incorrect leading of capital investment Increasing troublesome cyclist Unemployment Lack of health knowledge & training Lack of place for doing art works
Loss of job security Inadequate police personnel Addiction Bad environmental health & sanitation Loss of sport saloons
Lack of experienced experts in creating jobs Inadequate light in passages Puberty health Inadequate knowledge about nutrition Women cultural limits and barriers
Cultural barriers on employment Improper police station location —- —- Loss of part-time job for women
Sport problems Construction problems Cultural and
artistic problems Aging group problems
Lack of sport saloons High cost of housing & lack of mass construction Lack of suitable saloon for ceremonies , restaurant & hotel Loss of aging group associated organization
Pour availability to sport saloon for many people Not revival of old building of city Lack of university centers Lack of adequate knowledge of aging group needs
No completion of swimming pool project Heavy trucks traffic in city Expanded unnecessary grief ceremonies Lack of financial resources and aging group insurance
Cultural limitation for women sport Weak taxi services —– Not paying attention to emotional needs of aging group
Acknowledgment:
This project was financially supported by ministry of health, Iran, and Shahrekord University of medical sciences, Shahrekord, Iran.
References:
1-Jamshidi E. population Research Center, an Approach to community Health and Empowerment. Tehran University of Medical Sciences and Health Services.2003.p:4-35
2- Jamshidi E. Participatory Research Methodology workshop. Tehran University of Medical Sciences and Health Services, 2004, p: 13-27
3- Lazenbatt A. Lynch UO, Neill E. Revealing the hidden troubles in Northern Ireland: the role of participatory rapid appraisal. Health Educ Res. 12001 Oct; 16(5): 567-78
4- Lotersztain M, Zorat M, Lecouna M. Motta M. Use of the rapid appraisal method for the identification of perceived needs in a low class barrio in the city of Buenos Aires. Aten Primaria 2000 Dec; 26(10): 690-2
5- Rispel L, Doherty J, Makiwane F, Webb N. Developing a plan for primary health care facilities in Soweto, South Africa, Part I: Guiding principles and methods. Health policy plan. 1996 Dec; 11(4): 385-93
6- Dale J, Shipman C, Lacock L, Davies M. Creating a shared vision of out of hours care: using rapid appraisal methods to create an interagency, community oriented. Approach to service development BMKJ. 1996 May; 312(7040): 1206-10
7- Murray SA, Taurnbull L, McCallum J, and Little A. Listening to local voices: adapting rapid appraisal to assess health and social needs in general practice. BMJ 1994 Apr; 308 (6934): 979
8- Murray SA, Graham LJ. Practice based health needs assessment: use of four methods in a small neighbourhood. BMJ 1995 Jun, 310 (6992): 1443-8
9- Sogoric S. Application of the modified method of rapid appraisal toassess community health needs for making Rapid City health profiles and city action plans for health. CMJ. 1998 Sep: 39(3): 267-75
10- Rifkin SB. Paradigms lost: toward a new understanding of community participation in health programs. Acta Trop. 1996 Apr; 6192): 79-92
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