Community assessment and planning for maternal and child health programs : a participatory approach in Ethiopia

The methodology for the assessment included both participatory and qualitative methods, a process requiring 8-9 days in each community. Activities were conducted in four phases. (1) Health staff and community team members collaborated to identify and build partnerships. Health staff were introduced to the community at a public meeting where it was emphasized that the teams would work together with the community to determine the community"s health care priorities. (2) A household survey was conducted to collect information on key child health care behaviors in a sample of households. Survey topics included prevalence and treatment of specific illnesses, and practices pertaining to reproductive health, infant and child feeding, hygiene, and care-seeking. Health care behaviors that were deemed detrimental by health teams were ranked by groups of men and women in the community according to the importance of the behavior and the feasibility of changing it. Based on the community ranking, 3-5 emphasis behaviors were selected. (3) Reasons behind those behaviors were explored through semi-structured interviews, seasonal calendars, and matrix ranking. For example, a reason cited for parents in Konteb not bringing their children for measles vaccination was fear of side effects. (4) Health teams worked with community members to develop health care interventions addressing the reasons behind the selected behaviors. During a public meeting, a plan for implementing the strategies was developed, which included the identification of resource needs and allocation of responsibilities. For example, in Alba, men promised to help women with some chores such as fetching water, allowing them more time to exclusively breast-feed their babies for the first 6 months.