6-7
For local health workers and their communities,
the need is not to
gather information...
but to gather everyone together
and look at what they already know.
People in a village or community already know most of the essential facts from
their own experience. (Not exact numbers, perhaps, but these are usually not
needed.) What they need to do is ask themselves:
• How do the combined facts of our situation—needs, social factors, and
resources—affect our health and well-being?
• How can we work with these facts—using some, changing or reorganizing
others-to improve our health and well-being?
The process of looking at these questions in a community group is sometimes
called community analysis or community diagnosis. At best, this means not only
a diagnosis of the community, but a self-analysis by the community.
Community diagnosis—whom does it serve?
Ideally, a community diagnosis is a self-analysis by a community of the
problems that concern people most. But watch out! The term community
diagnosis is used quite differently by many of the larger health programs. To
them it has come to mean a detailed survey, which health workers are required
to conduct in their communities after training. Often the information collected
through these surveys serves the needs of the health authorities, but means little
to the people themselves.
To require a new health worker to conduct a long, complicated community survey
can turn people against him from the first. Many people dislike or distrust surveys. This
is especially true for the poorest of the poor, who are repeatedly studied but seldom
see any real benefits.