Health in Your Hands - Findings from an Indian Study on Using Participatory Tools by Indigenous Communities towards Attaining Improvements in Health Outcomes

A study was undertaken in two districts of India, Adilabad (Andhra Pradesh) which has 35% indigenous castes along with primitive tribes and Ganjam (Orissa) which has 66.3% population below the poverty line (DLHS III) to understand the health needs and formulate strategies to achieve it. Both districts are characterized by a poverty-stricken rural and tribal population, poor health infrastructure and support systems and abysmal health indicators.

From within the selected districts, approximately quarter million population was covered over 473 villages (Census of India 2001). One of the study tool selected was Participatory Rural Appraisal (PRA). PRA was used to analyse the current situation and potential within village community, analyse problems and their causes, and support households to identify activities that respond to difficulties and opportunities. Major tools used included a) Dream map - to understand dreams, aspirations and changes that people would like, b) Venn diagram - to identify, prioritise and categorize the diseases prevalent in the area, and c) Mobility maps – to understand movements of men and women separately for accessing health care. The PRA was undertaken with the help of local NGOs who were trained on PRA skills and enjoyed community’s trust.

The team successfully undertook PRA in 96% of the villages and were unable to conduct in remaining 4% primarily because they were uninhabited. Findings suggested that local indigenous communities are equipped to undertake exercises of such a nature and chalk out their village health plans. Active participation from within the tribal and marginalized village communities, resulted in prioritizing health and crafting future course of action towards improving health outcomes.

The study recommends a) bottom-up approach of using PRA tools towards attaining health goals for village community, and b) listing and prioritizing of their health needs for the development of actionable plan for future course.