A critical assessment of the use of rapid participatory appraisal to assess health needs in a small neighbourhood
This study by an expanded primary health care team suggests that as a method of needs assessment rapid appraisal has a number of benefits and constraints. Major benefits include that it brings a community orientation to primary care; it is community participative; it is multi-sectoral and promotes networking; it promotes equity; as an action research method it facilitates change and that it can be satisfying to carry out. Major constraints include the possibility of researcher bias; that training is necessary for interviewing and understanding the method; that the results are not generalisable; that little health service data is produced; that only "proportionate accuracy" is obtained and that it can only be applied to a "community" in some sense of that word. The other methods highlighted shortcomings of using rapid appraisal as a sole means of health needs assessment. Each method yielded particular insights into both health and health care needs. A method mix is likely to give the most comprehensive picture. Rapid appraisal offers a practical way of involving local people in decision making about their health services and as an action research method facilitates change. As a training process it promotes the attitudes and skills which professionals need to work effectively in the community. Its value will depend on whether the data it generates is seen to be of use for purposes of resource allocation and community participation. At worst it has the potential to be a misused tool to collect poor information for supporting poor decisions. At best, it has the potential to give substance to the rhetoric of community participation by providing tools, techniques and data useful to planners and the public to be co-producers of health.