Community Assessment and Planning for Maternal and Child Health Programs: A Participatory Approach in Ethiopia

This paper describes the use of a participatory approach to community assessment and planning in Ethiopia. The purpose of the assessment was for government health staff and community members to jointly identify and prioritize maternal and child health problems and develop a plan to solve them. Activities were conducted in five woredas (districts) in the Southern Nations and Nationalities People's Region (SNNPR) of Ethiopia. Some of the key features of the approach were: 1) use of a limited number of maternal and child health behaviors as a "menu" to guide planning; 2) use of an integrated household survey that measures indicators of caretaker behaviors which must be changed to reduce the most important causes of childhood morbidity and mortality; 3) implementation by a team of community volunteers and health staff; 4) collection of data that can be used at the community level for planning and at district, zonal, and regional levels for project monitoring and evaluation; and 5) an emphasis on immediate use of information by community members and health staff to produce joint action plans. The community planning process resulted in:1) community action plans for the communities in five districts; 2) baseline data on key behaviors for monitoring and evaluation; and 3) trained staff at regional, zonal, and district levels. Community action plans included activities at both the facility and community levels, such as training of health workers, integration of health facility services, health education, and involvement of community organizations. The quantitative data were aggregated to provide baseline indicators for monitoring and evaluation. Follow-up data show changes in key child health behaviors.