My Program Manager recently asked me to lead this summer’s training sessions on medical center work for the new health volunteers. Thus, while the events of this post took place a couple of months ago now, it constitutes one of my bigger successes here in Moldova and is something I’m thinking about a lot while preparing to teach the new volunteers.
One of the hard parts of the Health Education program is that we straddle worlds – we must work in both the highly structured educational system, and the much more fluid world of community medical centers. Work at the school begins very quickly after arriving at site, and similar to English Education (EE) volunteers, the fruits of our labors become quickly visible.
Facilitating a needs assessment session at the med center. |
At the medical centers, however, our job is much closer to that of Community Organization and Development (COD) volunteers – work at the organization goes in fits and starts depending on how busy they are and how effective we are at identifying projects they are motivated to collaborate on. These two cultures can often be hard to bridge, with the fast pace of the school making it harder to be patient with the incremental change at the medical centers. This is one reason I think so few healthies work at their medical centers for the entire two years of service.
As a result of the less structured environment of medical centers, the needs assessment stage is a much longer process. Facilitating good needs assessment, in fact, is not just necessary to choosing the best health education topics, but is in of itself a key skill we need to transfer. Good needs assessment is also the first step of any long term planning process.
After coming up short for months in trying to get my medical center to write a one year health education plan, we’d had a number of needs assessment discussions that fizzled. I finally decided it was time to try a different approach, and reached out to my COD friend Craig. One of the downsides of bridging programs is it doubles the number of competencies a successful volunteer needs to possess; one of the upsides of Peace Corps is that we have colleagues like Craig who bring the perspective of a different program.
As part of its heavy emphasis on local sustainability, Peace Corps teaches the PACA approach to needs assessment, (Participatory Analysis for Community Action). More than a set of tools, PACA is a whole philosophy that calls for empowering community members instead of the development worker to set the agenda through participatory activities. It also includes a toolkit of creative needs assessment activities. The results are better needs assessments and thus an increase in the number of stakeholders, which lays a stronger foundation for resulting actions. The analysis itself helps build consensus amongst participants by demonstrating that the agreed upon needs were not a foregone conclusion.
For my medical center, Craig recommended we try an approach known as Pairwise Group Ranking,