Participatory Learning and Action 37:
PLA Notes 37: Sexual and Reproductive HealthIIED, February 2000. 128 pp.
Price: US$25.00
Guest Editors: Andrea Cornwall and Alice Welbourn
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Summary
The theme section of this issue of PLA Notes focuses on the use of participatory approaches in Sexual and Reproductive Health, building on previous RRA/PLA Notes issues on Health (RRA Notes 16, 1992) and HIV/AIDS (PLA Notes 23, 1995). The issue brings together accounts of exciting initiatives from around the world that hold the potential to transform this arena of work, which has traditionally tended to provide information and services rather than seek to engage people more actively in processes of change. Ranging from innovative uses of participatory methods to enhance communication and understanding to strategies to amplify the voices of people who would otherwise remain unheard in policy and institutional processes, the articles in this issue offer food for thought and lessons from experience.
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1. Searching for participatory approaches: findings of the Yunnan PRA Network
Lu Xing
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Abstract
Participatory approaches were introduced to Yunnan Province, the People's Republic of China in 1993. Since then, a group of practitioners in Yunnan has started to search for ways of implementing participatory approaches within the Chinese context. This paper summarises the major findings of the practitioners' experiences in research, action and extension projects, and presents the current state of the practitioners' theoretical thoughts on participation.
2. 'Trading places, trading ideas': review of the second 'Dare-to-Share Fair' on participatory development
Mark P. Lammerink, Bram Posthumus and Willem van Weperen
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Abstract
This paper reports the results of the 'Dare-to-Share Fair' held in The Hague, The Netherlands on the 13th and 14th October 1999. The subject of the event was sharing experiences around participatory approaches to development and learning from the field how to assist people in their development in such a way that they actually own the process.
SPECIAL ISSUE:
The use of participatory approaches with sexual and reproductive health
3. From reproduction to rights: Participatory approaches to sexual and reproductive health
Andrea Cornwall and Alice Welbourn
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Abstract
This article explores the challenges that the use of participatory approaches poses for sexual and reproductive health (SRH) work.
4. Ain't misbehavin': beyond individual behaviour change
Jerker Edström with Arturo Cristobal, Chulani de Soyza and Tilly Sellers
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5. Seminar on HIV and girls and young women, November 1999, London
Working Group on Children and HIV; UK NGO AIDS Consortium
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Abstract
The Consortium represents 50-55 UK-based development organisations working with HIV/AIDS issues in all parts of the world. This seminar was organised in response to growing concern around the world about the impact of HIV/AIDS on young people and, in particular, the differential effect it appears to be having on girls and young women. The seminar was therefore designed to address issues related to the vulnerability of girls to HIV/AIDS and was concerned in particular with sexual abuse, exploitation and violence.
6. Helping NGO staff (and then community groups) analyse reproductive health & gender issues
World Neighbors programme partners in Nepal
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Abstract
World Neighbors, teamed up with national and local Nepalese NGOs, conducts a comprehensive, in-depth assessment to determine women's health concerns and develop some strategies to address these needs.
7. Collaborative planning to improve women's health
Carla Rull Boussen
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Abstract
This article briefly describes the collaborative planning process using examples from local NGOs' work in Beni Suef, a governorate in Upper Egypt.
8. Participatory and learning action as a tool to explore adolescent sexual and reproductive health
Mary Simasiku, Gladys Nkama and Michelle Munro
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Abstract
This article discusses CARE's experience in involving young people in action research in order to design appropriate adolescent reproductive health programmes in CARE-supported Ministry of Health clinics and their catchment areas.
9. Lessons from 'Auntie Stella': using PRA to promote reproductive health education in Zimbabwe's secondary schools
Barbara Kaim and Ratidzai Ndlovu
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Abstract
This article tries to find out what information, perceptions and concerns adolescents have about their reproductive health and their sources of information and support in the Zimbabwean context. It also describes the development of a reproductive health education pack called 'Auntie Stella', based on the stories, experiences and expressed needs of the adolescents themselves and using the question and answer format of helpline letters.
10. More talk, less sex: AIDS prevention through schools
Noerine Kaleeba, Joyce Kadowe, Daniel Kalinaki and Glen Williams
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Abstract
This article describes the School Health and AIDS Prevention Project started in 1993 by the African Medical and Research Foundation (AMREF), together with the Soroti District Administration, in 95 primary schools in two rural counties and Soroti town. The project aimed to encourage safer sexual behaviour, particularly abstinence, amongst primary school pupils. The article provides some feedback from a selection of the project's participants, both students and teachers.
11. Experiences of using a participatory approach in Cambodia: Exposing the needs of sex and good women
Julie Forder
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Abstract
This article describes a project in which participatory tools are used for sexual health assessment with young garment workers in three factories of Phnom Penh, the Cambodian capital.
12. Participatory learning and action requires good facilitators - who aren't always around
Andrew Hobbs and Mary Simasiku
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Abstract
This article discusses how important facilitation is for good participatory research in the context of 50 participatory learning activities on sexual health for young people, produced by a Zambian NGO, the Family Health Trust.
13. Moving beyond the 'KAP GAP'. A community-based reproductive health programme in Eastern Province, Zambia
Gill Gordon and Florence Phiri
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Abstract
This article describes a holistic sexual and reproductive health (SRH) project in the Eastern Province of Zambia. It focuses on participatory approaches used, gender issues, male involvement and the integration of SRH issues at community and clinic levels. The article aims to demonstrate the opportunities and challenges faced by a government programme that uses participatory approaches in its everyday work to achieve the vision committed to at the International Conference on Population and Development held in Cairo in 1994.
14. Gambian experiences with Stepping Stones: 1996-99
Matthew Shaw and Michelle Jawo
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Abstract
The 'Stepping Stones Gambia' project is a collaboration between five organisations. The partnership began in 1997 to adapt, implement and evaluate the original Stepping Stones workshop programme. This is a manual describing a series of participatory exercises designed to facilitate HIV prevention by encouraging a gender analysis of sex and its context. The workshops then move into assertiveness training, encouraging participants to be assertive about their feelings and dialogue with their partners, focusing on communication and relationship skills. It operates around a workshop structure, with separate peer age and gender groups.
15. A new approach to evaluating a peer education programme for sex workers
Kate Butcher, Sumi Baral, Krishna Bista and Rajendra Adhikary
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Abstract
Two years ago, a peer education programme was developed in Nepal to equip urban sex workers with the skills to help their fellow workers practice safer sex, to update their own knowledge of risks from unsafe sex and to provide a forum for sex workers to discuss imaginative approaches to safer sex beyond the condom. In order to evaluate the success of the programme, the 'Mala' system was developed. 'Mala' means necklace and is a popular accessory for all women. Each participants was provided with a set of different coloured beads, and during the workshop, and, in consultation with the group, allocated different colours to different activities relating to their role as peer educators as well as their own sexual practice.
16. Introducing participatory methods to HIV prevention workers in the south west United States
Kim Batchelor
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Abstract
The philosophy behind participatory research was presented in workshops for HIV prevention workers in Dallas, Texas and for health educators taking on HIV as a new issue in New Mexico and Arizona. The workshops incorporated several activities, including mapping exercises, Chapati diagrams, causual flow diagrams and problem-solving techniques.
17. Mapping the effects of vasectomy
Ann Sturley
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Abstract
This article describes the process of using body mapping to explore the men's experiences of vasectomy. It illustrates just one example of how participatory techniques may contribute to deepening our understanding of the issues involved in the acceptance of contraception, clearly an urgent matter in countries such as Nepal.
18. Evaluating sexual health services in the UK: adapting participatory appraisal tools with young people and service providers
Martin Westerby and Tilly Sellers
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Abstract
In 1997 Trent Regional Executive of the UK National Health Service funded a project called 'Evaluating Sexual Health Services: a Community Approach'. The project worked with health service providers and young people to evaluate local sexual health services and built on several years experience gained whilst developing participatory appraisal tools and techniques with young people in order to learn about sexual health issues from their perspective.
19. 'Safety through the night': a review of behaviour change in the context of HIV/AIDS
Ann Smith and John Howson
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Abstract
'Safely through the Night' is a review prepared for the Department for International Development (DFID), UK, by CAFOD and four of its partner organisations in 1998. Organisations participated in a preparatory workshop where questions for the review were formulated and participatory techniques for exploring these questions were designed and practiced. The fieldwork findings were shared at a second workshop and in written reports. The fieldwork was conducted by each organisation among one community where they work and within their own organisation, between March and May 1998. This article illustrates the results of this fieldwork.
20. Learning to relearn givens
Jill Lewis
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Abstract
Living for Tomorrow is a three-year action/research pilot project at The Nordic Institute for Women's Studies and Gender Research (NIKK). It is working for HIV prevention with a key focus on gender issues affecting sexual beliefs and behaviour. It is actively engaged with people from countries belonging to the former Soviet Union.
21. Putting breast cancer on the map
Helen Lynn, Diana Ward, Cathy Nugent, Laura Potts, Liz Skan and Nicola Conway
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Abstract
'Putting Breast Cancer on the Map' grew out of the work the Women's Environmental Network (WEN) has done on polluting chemicals in the UK over the last ten years. The project developed out of a need identified by women to participate in positive action to bring about change in the minds of the government and medical establishments, as well as society at large, about the way in which breast cancer is viewed, treated and politicised in the UK. The project focused on new ways of collecting information in a participatory, non-threatening and empowering way, using the network that had already begun to form.
Preference ranking: a cautionary tale from Papua New Guinea
William J Fielding, Janet Riley and Robert Chambers
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Abstract
William J. Fielding and Janet Riley discuss some ways in which ranking techniques can be misleading and limiting, and suggest some solutions. Robert Chambers points out that the discussion process involved in any scoring/ranking method may be more informative than the numbers which are collected.
Analysing personal dilemmas
Randini Wanduragala
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Abstract
The exercise described in this article should help staff members to link a theoretical understanding of the issues involved in HIV to the personal dilemmas of individuals in the communities with whom they are working. This can help them to use their theoretical knowledge to address practical issues; it can also help them to recognise that HIV is far more than 'just' a health problem.