Rapid rural appraisal: its role in health planning in developing countries

Abstract

There is an urgent need for a quick inexpensive and reliable method for identifying groups and individuals most in need of primary health care. The Rapid Rural Appraisal (RRA) is the most appropriate approach. It is a method by which resources can be quickly deployed to alleviate the problems of the poor. If properly used it can play a major role in identifying community health needs thereby aiding the health planning process and improving the health of the people. Nevertheless, RRA techniques should not be regarded as separate and apart from other research methodologies but complementary to them.

PIP: Rapid Rural Appraisal (RRA) is an approach used for identifying quickly, inexpensively, and reliably groups and individuals most in need of primary health care. The method has been used primarily in agricultural research. Techniques may involve review of existing records, key informant interviews, focus group interviews, direct observation, wealth ranking, flow diagrams, and games and role plays, depending on available resources and objectives. A team of no more than 6 people should perform the review, including a social scientist, a health specialist, and an experienced team leader. The time frame for data collection and analysis is expected to be no more than 1 month. Useful sources of background information are previous survey final reports and monthly and annual health department reports. Key informant interviews are in-depth discussions of a single topic of interest with individuals with pertinent knowledge. The informants should reflect a diversity of opinion. Topics should be preselected and interviews conducted by trained personnel. A typical sample would involve 20-30 persons for 30-90 minutes each, in a quiet location. The least controversial questions should be introduced first. Focus group interviews with 6-10 individuals, who do not know each other, should be conducted by a facilitator for 60-90 minutes in a quiet and comfortable location. Notes should be taken and the discussion taped. The facilitator explains the purpose of the session and directs the topics of conversation. Important themes should be summarized near the end of the session and final comments asked for. Focus groups can be used to pretest education materials; to assess attitudes, behaviors, and concerns; and for program planning or formative evaluation of community projects. Direct observation of a particular phenomenon is systematic, guided by checklist, and usually takes 3-4 weeks. Wealth ranking is helpful in determining the basic needs of the community and special groups. The main advantages of RRA are its holistic approach, short duration, flexibility, and low cost. Limitations are the lack of precise or comprehensive data, and the potential for misunderstanding sensitive and complex community issues.