Transcript Document

PARTICIPATORY LEARNING AND ACTION (PLA)
FOR COMMUNITY HEALTH DEVELOPMENT
DR. (MRS.) RAJNI BAGGA
ASSOCIATE PROFESSOR
NATIONAL INSTITUTE OF HEALTH & FAMILY WELFARE,
MUNIRKA, NEW DELHI - 110067.
E-mail:[email protected] & [email protected]
Phones: 26165959,26107773, Fax:91-11-26101623
PARTICIPATORY LEARNING AND
ACTION
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INTRODUCTION
CONCEPT &DEFINITION
ORIGIN& EVOLUTION OF PLA
PRINCIPLES OF PLA
TOOLS AND TECHNIQUES
APPLICATION OF PLA IN HEALTH
RATIONAL
POTENTIAL USE
IMPACT & BENEFITS
CONCERNS & CHALLENGES
CONCLUSION
INTRODUCTION
Participatory approaches like PLA
developed in
response to concerns
regarding a top down approach to
developing strategies for addressing local
concerns
These strategies have a much greater
chance of success if local community is
involved in the process from start to finish
 PLA can empower women,
poor and disadvantaged, giving
them more control over their lives
 An explicit concern with the
quality of interaction, including a
stress on personal values,
attitudes and behaviour as a
prerequisite for effective work.
 The use of open-ended, adaptable visual
methods within a flexible, interactive
learning process, rather than the use of set
sequences of specific methods for preidentified ends;
Generate important often surprising
insights, which can contribute to policies, to
serving the needs of the poor and
marginalized section of the population
 It can challenge the perceptions of those
in authority and begin to change attitudes
and agendas
PLA methods are based on principles aimed at
offsetting the deficiencies in the earlier
investigative approaches in the health
development and has over the years developed
out of a dissatisfaction with common modes of
investigation, formal questionnaires and
surveys and rural development tourism
CONCEPT/DEFINITION
Robert Chambers 2002 :
“A growing family of approaches,
methods, attitudes and behaviour to
enable and empower people to share,
analyse and enhance their knowledge of
life and conditions and to plan, act,
monitor, evaluate and reflect”.
CONCEPT/ DEFINITION
Richard Heaver
described PRA –
(1991)
has
also
“PRA embraces a series of techniques,
many of them recently developed in
India, for using local people’s
knowledge and skills to learn about
local conditions, identifying local
development problems and plan
responses to them
ORIGIN AND EVOLUTION
PLA approaches have developed out of Rapid Rural
Appraisal (RRA) techniques, which were first
systemized in the late 1970s.
RRA techniques in turn developed out of:
dissatisfaction with large scale
surveys which gave delayed results
questionnaire
dissatisfaction with the unreliability of impressions
gained during the field visits made by urban based
professionals which came to be known as ‘RURAL
DEVELOPMENT TOURISM’
For quickly gaining qualitative insights into a
situation
CONTD.
ORIGIN AND EVOLUTION
FROM RRA TO PRA / PLA
From 1970 onwards Participatory tools- for
promoting and participation of the poor &
marginalized in improving their wellbeing.
These tools arose from two beliefs:
 The knowledge & experience of poor and
marginalized have value and not to be
dismissed as irrelevant or wrong,
 Poor and marginalized have the right to
resources traditionally defined by them.
FROM RRA TO PRA /PLA
Agha Khan Rural Support Programme (India)
conducted participatory RRA in two villages of Gujrat,
in 1988
Few of the Govt. organizations which got their staff
trained and promoted PRA are:
Dry lands development board. Karnataka
Several forestry departments
National Academy of Administration, Mussouri
In India PLA more popular in the NGO
sector and particularly three NGO’s:
Action Aid in Bangalore,
MYRADA
AghaKhan Rural Support Project in
Gujarat
FOR
 Nature of Process RRA
Mode
EMPOWERMENT
PRA
PLA
Extractive Elicitative Participative Sharing Empowering
 Outsider’s Role
Investigator
 Information
owned, analyzed
& used by
Outsiders
Facilitator
Local
People
PLA has evolved from Rapid Rural Appraisal (RRA) and refers to a process that
empowers local people to act upon, change their conditions and situations
PLA AND JOHARI WINDOW
Information known
to every one
What we know
and what they
know
What we know
and they do not
know
Teach
Knowledge
belongs only to
community
and we do not
know
Learn
Knowledge
belongs only to
professionals
What they know
Knowledge acquired
by learning together
What we do not
know and they do
not know
PRINCIPLES OF PLA
PLA ENTAILS SHIFT FROM
Empowering
Dominating
Closed
Open
Individual
Group
Measuring
Comparing
Reserve
Frustration
Rapport
Fun
Verbal
Visual
PRINCIPLES OF PLA
 Triangulation
 Optimal Ignorance and Optimal imprecision
 Direct contact, face to face, in the field
 Critical self awareness
 Changing behaviour and attitudes
 A culture of sharing
 Commitment
 Empowering
 Flexibility, Innovation, Improvisation
 Learning directly from, local people
PRINCIPLES, BEHAVIOUR & ATTITUDES
DESIRABLE
ATTITUDES
RIGHT
BEHAVIOUR
- OPENNESS
 - CURIOSITY
- HUMILITY
 - ACCEPTANCE
- EMPATHY

- SENSITIVITY
- SHARING
 - EMBRACING ERRORS
- FRIENDLY
 - LISTENING AND NOT
LECTURING
- RESPECTFUL
OPTIMAL
IGNORANCE
 AVOID COLLECTING UNNECESSARY
DATA
PRINCIPLES, BEHAVIOUR & ATTITUDES
COMMITTMENT
- To equity
-Empowering those who are
marginalized,
specially
women, children and elderly
CRITICAL
SELF
AWARENESS
- About attitudes & behaviour
- Embracing & Learning from
error
- Taking personal responsibilities
REVERSALS
Learning from , with and by local
people directly and face to face
seeking to understand their
perceptions, priorities & needs
VISUAL TOOLS
Participatory Mapping
DISCUSSION
TOOLS
Institutional
Programming (Venn
Diagram)
Seasonal Diagram
Focus Group
Discussion
Daily activity Chart
Semi- Structured
Interviews
Body Mapping
Trend Analysis
Pair wise Ranking
Force Field Analysis
Causal Impact Diagram
Impact Evaluation
OBSERVATIONAL
TOOLS
Participant
Observation – DIY,
taking part in local
activities
Transect Walks
TOOLS AND TECHNIQUES
APPLICATION OF THE TOOLS DO NOT
FOLLOW ANY FIXED SCHEME. IT IS
VERY FLEXIBLE AND DEPENDS UPON
THE EVOLUTION OF THE PROCESS,
NEED OF THE SITUATION AND USER’S
OWN BEST JUDGEMENT
TOOLS AND TECHNIQUES
BUT MERE APPLICATION OF THESE ARE NOT
SUFFICIENT UNLESS THE FACILITATOR / USER
HAS THE DESIRABLE ATTITUDE AND
BEHAVIOUR AND THE USER MOVES FROM
TALKING TO DOING & FROM DOING TO BEING
TOOLS AND TECHNIQUES
TOOLS CAN ALSO BE CATEGORIZED AS PER
THEIR USE AND SEQUENCE IN WHICH THEY ARE
USED
TOOLS FOR EXPLORATION AND IDENTIFICATION OF PROBLEMS
TOOLS FOR PRIORITIZATION OF PROBLEMS
TOOLS FOR ANALYSIS
TOOLS FOR SOLUTION / IMPLEMENTATION
In 1978 at Alma-Ata, Primary Health was
defined by WHO & UNICEF as :
“Essential Health care universally accessible to
individuals and their families in the community
by means acceptable to them, through their full
participation and at a cost that the community
and the country can afford”
RATIONALE FOR CONDUCTING
PLA IN HEALTH
Both Primary Health Care and Community
Development recognizes that the process of achieving the
goal - through the development of Local Initiatives,
Participation, Self-confidence, Self-reliance and
Cooperation - is more important than the achievement of
the goals and objectives
 HEALTH IS NOT THE RESPONSIBILITY OF THE
HEALTH SECTOR ALONE, BUT IS AFFECTED BY
THE DEVELOPMENT ACTIVITIES IN OTHER
SECTORS SUCH AS EDUCATION, HOUSING AND
SOCIAL SERVICES. HENCE A NEED EXISTS TO
INTEGRATE ALL SUCH DEVELOPMENT
ACTIVITIES THROUGH PLA.
RATIONALE FOR CONDUCTING PLA

DEVELOPMENT OF SELF-RELIANCE AND SOCIAL AWARENESS
THROUGH CONTINUING COMMUNITY PARTICIPATION IS A
KEY FACTOR IN IMPROVING HEALTH.

IF HEALTH CARE IS TO IMPROVE IT IS ESSENTIAL THAT
COMMUNITY SHOULD DEFINE IT’S NEEDS AND SUGGESTS
WAYS OF MEETING THEM.

DECENTRALIZATION IS NECESSARY IF COMMUNITY NEEDS
ARE TO BE MET AND PROBLEMS SOLVED.

LOCAL COMMUNITY RESOURCES, FINANCIAL AND HUMAN,
CAN MAKE AN IMPORTANT CONTRIBUTION TO HEALTH AND
DEVELOPMENT ACTIVITIES.
PLA FOR COMMUNITY HEALTH
PROJECT
Problem
Identification
Evaluation
Problem
Prioritization
Monitoring
HEALTH PROJECT
CYCLE
Possible
Solution
Identification
Implementation
Action
Planning
PLA FOR COMMUNITY HEALTH
DEVELOPMENT
1.
It has been recognized that for health services to
be truly effective, potential recipients must be
involved in every stage of the process
2.
This project cycle is conceived as an
empowering approach to enable the local
community especially the marginalized and the
women to review and articulate their own
perceptions of need and identify them
3.
Enables the local people e.g, women to
reconsider their own belief systems,
surrounding health and illness, exchange
knowledge/ideas.
PLA FOR COMMUNITY HEALTH
DEVELOPMENT
4.
PLA broadens the lens of ‘health’ of local people
to focus on the wider dimensions of well-being
5.
It offers health professionals (outsiders) and
local people an approach in determining
priorities and developing strategies for action
and improving well-being
POTENTIAL OF PLA
Its Positive impact and benefits for Community Health
Development :
1. Use and Application of PLA is wide spread
2. Generates rapport and forces outsiders to learn, listen
and understand
3. It provide highly accurate information: Local people’s
knowledge of local conditions is often greater than had
been supposed
4. Plans drawn up in a prescriptive manner by local people
are more likely to work than plans drawn up by
outsiders
5. The participative nature of the process is a “ Development
Benefit” in itself, in terms of empowering people
6. Highly cost-effective
PLA FOR EMPOWERMENT

PARADIGM SHIFT TO RECOGNIZE THE
ABILITY AND CAPACITY OF LOCAL
PEOPLE– INNOVATION

PEOPLE TAKE RESPONSIBILITY AND
ACTION FOR IMPROVEMENTS

EXPERTS NEED TO GIVE UP POWER AND
CONTROL OVER PROJECT OUTCOMES –
ROLES REVERSAL

‘BOTTOM UP’ APPROACH
CONCERNS & CHALLENGES OF
PLA IN HEALTH SECTOR
1. A family of approaches for reversing centralization,
standardization and top-down development.
2. Biggest challenge includes achieving changes in our
personal attitudes and behaviour towards
community & the disadvantaged.
2. Behaviour and Attitude: more important than
methods
CONCERNS & CHALLENGES OF
PLA IN HEALTH SECTOR
3. The need to recognize and work at personal
responsibility, professional ethics, such
as developing self- critical attitude.
4. To initiate and sustain process of change;
empowering disadvantaged people & communities,
transferring health services and reorienting
individuals.
CONCLUSIONS
1.
PLA, IS NOT A BANDAGE TO STICK
TOGETHER OLD FAILING CONCEPTS AND
APPROACHES.
2.
RURAL DEVELOPMENT TOURISM HAS TO
GO, INSTEAD LOCAL COMMUNITIES ARE
TO BE INVOLVED FOR IDENTIFYING,
PRIORITIZING, ANALYSING AND
SUGGESTING SOLUTIONS TO THEIR
PROBLEMS
CONCLUSIONS
3.
UNDER RCH PROGRAMME, PLA CAN
BECOME THE BASIS OF PLANNING AT THE
MOST PERIPHERAL LEVEL WHEREBY THE
HEALTH WORKER IS SUPPOSED TO
FINALIZE THE PLAN AFTER DETAILED
CONSULTATION WITH COMMUNITY AND
COMMUNITY LEADERS, INFACT,
CORRECTLY CARRIED OUT COMMUNITY
NEED ASSESSMENT (CNA) IS AN EXAMPLE
OF PLA APPLICATION
4.
FOR EMPOWERING THE MARGINALIZED
SECTION OF THE POPULATION WHICH
INCLUDES WOMEN, CHILDREN, ELDERLY,
PLA HAS LOT TO OFFER
CONCLUSIONS
5.
WE HAVE REACHED A CRITICAL POINT
IN THE HISTORY OF MANKIND. WITH
GOVERNMENTS’ EFFORTS STAGNATING
WORLD OVER, LOCAL COMMUNITIES
ARE WHERE MANY OF THE CHANGES
WILL HAVE TO START. THE
PARTICIPATORY APPROACHES LIKE PLA
CAN HELP TO ENABLE LOCAL ANALYSIS
AND PLANNING, WITHIN AND BY
COMMUNITIES.