Participatory rural appraisal for community assessment of health needs in rural Haiti: A pilot study

Abstract

<p><strong><strong>Purpose: </strong></strong>The country of Haiti has a population of 10 million people and is the poorest country in the Western Hemisphere. The nation ranks 168 out of 187 on the Human Development Index (WHO.int; MidwivesforHaiti.org). While there has been limited research in Haiti, the majority of previous work focuses on specific disease topics, such as Human Immunodeficiency Virus (HIV) transmission and prevention (Conserve et al., 2014). What is missing from the literature is a comprehensive review of the significant health issues affecting Haitians, especially in the rural areas, and an opportunity of empowering the locals to participate in identifying their greatest health challenges and prioritizing their health needs. The purpose of this study was to gain a better understanding of the comprehensive health needs of a rural village in Haiti. Knowledge gained from this study will be utilized for the development of a community health nursing program, which will embed healthcare workers into remote Haitian communities.</p> <p><strong>Methods: </strong>The Conceptual Model for Partnership and Sustainability in Global Health served as the framework for this study (Leffers &amp; Mitchell, 2010). The Participatory Rural Appraisal (PRA) methodology, as endorsed by the World Health Organization as a best practice (Loewenson et al., 2014), was utilized to identify particular health needs of the community and develop strategies and priorities for health needs and interventions. This type of participatory action research generates knowledge of a social system with the aim of bringing about change (Sethi &amp; Belliard, 2009).</p> <p><strong>Results: </strong>Results from the PRA mapping, scoring, transect walk and focus group discussions were analyzed for trends and themes. Findings from this study prioritize the overall health and community needs as determined by the community members. A desire for mutual goal setting and community ownership of strategies to improve health was discovered. Additionally, sustainable partnerships with mutual health and education goals are needed to optimize the health of the community.</p> <p><strong>Conclusion: </strong>This research provided partnerships with community leaders to empower them to identify and develop strategies to address their own health needs. This completed pilot study will be replicated into other rural communities and knowledge gained from this community assessment will be used to assist in training of community health nurses. A follow-up PRA of the selected community will be conducted after a community health nurse initiative has been embedded in the region to determine effectiveness of the program.</p>