Introduction:



The most important goals of community based participatory research are organizing and exploiting of relevant data in order to solve local problems. In this way Farokhshahr population lab, in Farokhshahr city, Chahar Mahal and Bakhtiary province of Iran, founded in 2004, to empower local community to recognize and solve their problems in a development based manner, and the final goal was health promotion.

In this center, running participatory research is an important fact that consists of community mobilization, needs assessment, priority setting, intervention and evaluation (1).

Following community mobilization, we should run needs assessment and then priority setting (2).

Needs is the gap between current status and ideal situation, and this is recognized via needs assessment project (2).

In Farokhshahr population lab, the main goal is development and health promotion for all local people (1).

In various international researches, rapid appraisal needs assessment was applied to identify different needs in social and health fields (3-10).

In this survey, needs assessment project was conducted in Farokhshsahr city, in order to perform applied research based on real community needs and not merely based on researcher ideas.

Methods:

This project is a community based participatory research that conducted using rapid appraisal needs assessment method.

Study population consisted of all 45000 residents of Farokhshahr city. Sample size was 40 groups and each group included 6-12 members. The sample size (400 persons) was then selected from study population using random sampling. These 400 persons were selected by systemic random method, with two variables:

Gender (male and female) -

Age-

(0-10 years: children, 16-19 years: teenager, 19-25 Years: young, 25-65 years: middle age, >65years: aging group)

These persons were invited to center and interviews made by team members, then FGDs performed to determine local needs. The question due to 0-10 years child, were asked from their mothers.

Rapid appraisal needs assessment method is a qualitative one that local knowledge; skills and researches are used. This method is based on 3 processes:

Observation-

Interview with different groups of local people-

Information gathering-

The advantages of this method are:

Informing local community,-

Identification of each person role and responsibilities-

Optimum utilization of information (data) and resources-

In all research phases, stake holder had a key and leading role, they gathered correct information that after analyzing should lead to set priorities, perform interventions and then evaluate the whole processes.

All of research phases were performed with, active participation of Farokhshahr research and development population lab members (located in Chahar mahal & Bakhtiari province) under Shahrekord University of medical sciences supervision.

In the population lab community mobilization formed in an organization named "Farokhshahr development team".

Research and development population center established in Farokhshahr in 2004 and consisted of authorities and all of stakehaloles.

In this team local people representatives, organized in 10 active work committees. These committees were including:

- Aging group committee

Youth committee-

Woman committee-

Cultural, artistic and religious committee-

Social security committee-

Health and food committee-

Sport & entertainment committee-

Construction committee-

The head of these committees was the members of research and development team.

Initially, the local information (community profile), including Farokhshahr population, age distribution, mortality causes, health care system, literacy indices, security occupation , culture, communication and housing, were collected by team members under supervision of academic researchers.

Information gathered from 3 sources:

Current local information (community profile)

Observation and record information

Interview with current local population groups in Farokhshahr (two variables: gender and age).

Finally, gathered information from mentioned sources organized and categorized in 9 groups, this process performed with active participation of team members and academic researchers' supervision.

Results

In this investigation, 40 problems were estimated and categorized in 9 groups ( problems of aging group, youth group, women group, construction group, sport and exercising group, health and food group, social security group , artistic cultural group and occupation group )(Table 1).

Discussion:

In this survey, using rapid appraisal needs assessment method, with active participation of Farokhshahr people, a wide range of social problems were recognized, the identified problem were not merely health based, but also included social and cultural issues.

Rapid appraisal needs assessment method was used in many researches and in all studies this method was the most proper and most cost - benefit one to obtain a wide range of problems with local people participation (3-10).

A common point in all these studies, is obtaining a wide rage of social to health needs.

In a research that conducted in northern Ireland , a wide range of social and health problems such as loss of sale locations , loss of aging group support to increase in psychiatric drugs , were obtained(3).

In the other study that performed in Buenos Aires with focus group discussions (FGDs), a wide range of problems such as air pollution, addiction to alcohol and opium recognized (4).

In a research conducted in Soweto's South Africans researchers concluded that in according to restriction of resources and necessity of efficient utilization of these limited resources, policy makers should apply methods that encompass health issues comprehensively, and this obtain via participatory research by all relevant community stake holders. Finally they concluded that, they can use this method in all regions of South Africa efficiently (5).

In a study conducted in socially deprived, multiethnic district in south east London with a population of over 700,000 to undertake a district wide review of primary health care services and identify the views of users and providers about current arrangements and options for development, Widespread dissatisfaction with current arrangement was identified, with specific problems relating to access, variability, demand for services, and interagency communication. Many of these problems are now being planned or piloted (4).

In a study conducted between 670 homes in Edinburgh, six priorities were identified, many of which were not health related. They conducted that an expanded primary care team can use rapid appraisal as a first step in identifying and meeting local health needs. It facilitates a multidisciplinary approach and complements quantitative methods of assessing needs (7).

Results of our study had a full coordination with mentioned researches and the common point of all is active participation of local people in all process stages, and determination of community oriented rather only health-oriented needs.

We recommended that since resource constraints are likely to remain in the foreseeable future, and therefore efficiency remains an important concern, methods should encompass health problems comprehensively, and this is possible through all local stake holder participation.

In this field rapid appraisal needs assessment is the most proper one. It is applicable in all country regions and has rapid and cost benefit impacts with involvement of all stake holders and policy makers.

TABLE 1: Farokhshahr local population problems derived by qualitative rapid appraisal needs assessment method in 2004

Occupation problemsSocial security problemsYouth problemsHealth problemsWomen problems

Loss of job opportunityAddiction , easy access to narcoticsPsychiatric disordersMental healthLack of women knowledge about health and nutrition

Incorrect leading of capital investmentIncreasing troublesome cyclistUnemploymentLack of health knowledge & trainingLack of place for doing art works

Loss of job securityInadequate police personnelAddictionBad environmental health & sanitationLoss of sport saloons

Lack of experienced experts in creating jobsInadequate light in passagesPuberty healthInadequate knowledge about nutritionWomen cultural limits and barriers

Cultural barriers on employmentImproper police station location--------Loss of part-time job for women

Sport problemsConstruction problemsCultural and

artistic problemsAging group problems

Lack of sport saloonsHigh cost of housing & lack of mass constructionLack of suitable saloon for ceremonies , restaurant & hotelLoss of aging group associated organization

Pour availability to sport saloon for many peopleNot revival of old building of cityLack of university centersLack of adequate knowledge of aging group needs

No completion of swimming pool projectHeavy trucks traffic in cityExpanded unnecessary grief ceremoniesLack of financial resources and aging group insurance

Cultural limitation for women sportWeak taxi services-----Not paying attention to emotional needs of aging group

Acknowledgment:

This project was financially supported by ministry of health, Iran, and Shahrekord University of medical sciences, Shahrekord, Iran.

References:

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