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37. Synopsis of the training panel from the international conference on rapid assessment procedures for planning and evaluating health and nutrition programmes
The RAP conference devoted a full session to issues related to training. The major issues discussed centred on, "Who can be trained to use RAP; how should training be organized and conducted; and could the current RAP training be less fragmented and better organized." While there were no papers presented specifically on training, there was a lively discussion. The highlights of this discussion are provided on the following pages. However, because training issues were raised at each conference session, often in the context of other topics, the main issues are summarized in this introduction.
Mainly through previous conference presentations, and as illustrated in this volume by several of the authors, RAP training of one type or another has become diverse. It ranges from the well-developed national and regional workshops organized by the United Nations University mainly for anthropologists with an interest in health and nutrition, to orientation sessions for staff of the World Bank and UNICEF organized by proponents within those organizations. For consideration also are training of donor programme officers and government officials who participate in qualitative data gathering at neighbourhood and village levels.
The training of national level personnel by those who have participated in UNU-type RAP workshops often is guided by the RAP Guidelines and training materials published by the UNU. There are a variety of other training aids for RAP in specific topic areas. There are also a set of papers and less official guides on a wide variety of RRA methods available through the International Institute for Environment and Development, London.
However, while the majority of participants at the RAP conference agreed that more training was needed, there was no effort made to improve available materials in RAP and RRA or to generate agreement that training sponsored by the variety of organizations represented should be mutually reinforcing by better coordination. Indeed, even the training materials which were noted are not available in one place. Activities by the IIED, the UNU, and the IDRC had begun to alleviate these problems by the end of 1991 and a major effort to better coordinate training and improve materials was planned for 1992.
The issue of "insiders" and "outsiders" was also raised in this session, not only in terms of the perspective from which to view a community but also from evolution of the technique. The original developers of RAP were outsiders trying to acquire an insider's perspective. However, others attempting to use the qualitative participatory techniques embodied in what is now identified as RAP methodology involved community insiders in the actual collection of data. This is particularly true of those who developed what is now identified as RRA.
Another issue discussed was that of the "level" of training required of those who would actually use RAP in the community. Many of those who had attended RAP training saw their role as primarily that of organizing and training field workers strongly familiar with a given community and culture to do the actual data gathering. In RRA, method training was seen as ultimately belonging to the community, with people taking an active and pro-active role analyzing their problems, assessing behaviours, and planning development projects appropriate to their resources and needs. Far from this perspective, other conference participants argued that the most appropriate domain for practical RAP studies was with marketing specialists.
None of these issues was resolved at the conference. Several points however, were raised in either formal and informal sessions which are worthy of note:
1. RAP training should be multilevel.
2. While social science training, particularly with a specialty in anthropology, is useful when training is to be directed toward community level data gathering and analysis, others trained in a relatively wide range of disciplines have made excellent use of RAP.
3. The planning, monitoring and evaluation staff of international and bilateral donors, foundations and national level programme evaluation groups need first to be oriented in the roles of qualitative methods and major techniques, and a subset of such staff should receive at least introductory training in RAP and RRA.
4. While it is neither necessary nor desirable to standardize orientation and training in RAP, the major developers and users of these qualitative methods need to form a joint working group whose function it would be to draw together orientation and training resources and see to it that they are shared.
5. With a few notable institutional exceptions academia appears to be significantly behind the professional field and donors in contributions to the development and use of Rapid Assessment Methodologies and RRA.
6. Training in the use of RAP-type skills at higher organizational levels inside and outside of government for purposes of gathering information for problem identification, programme planning and for development of advocacy strategies is needed and as yet poorly developed. Current tendencies are to informally use a few of the basic principles found within RAP. (RAP is now too often used to "legitimize" what is often referred to as "development tourism.")
RAP training, while expanding in diversity and levels of
"students," is an area that needs systematic analysis
and strategic thinking at the highest levels. RAP training may
well be the focus of the next international conference dealing
with qualitative research for health and nutrition.
1. How did RAP training evolve?
2. Is RAP training needed by everyone wishing to use the methodology?
3. How have researchers and others come to know and begin using concepts and skills associated with RAP?
4. Who should be trained in RAP?
5. What training materials exist for RAP?
6. Why has the training manual taken so long to produce?
7. Who are the most difficult groups to train in RAP?
8. How is training of those with a professional background in anthropology, sociology or public health different from training community level personnel?
9. How can training be improved?
10. Issues raised and comments made by the audience of the training panel:
Panel members: Susan Scrimshaw, Elena Hurtado, David Nyamwaya, and Clarice da Mota. Synopsis by Gary Gleason.
panel member dealt with core questions regarding RAP and
training. A synopsis of the main questions posed and comments of
the panelists follows. - Eds.
RAP started as a set of experiments, to see if there was a useful application of a condensed form of anthropological investigation in primary health care and nutrition programmes. It has grown out of an international effort. There are, after eight years of work in which RAP has been used in over 20 countries, some areas of agreement. The main agreement is that RAP can be useful in improving such programmes.
The experience of these eight years has resulted in the development of a body of concepts and skills. These have been published in a variety of publications and are available and being used by many people from several professional fields.
However, as RAP and the RRA have both grown in the field out of practical needs and through the work of relatively small groups of people, there was no anticipation of the need to develop formal training protocols, publish training manuals, or run workshops in several regions of the world.
There have been many who have understood well these concepts and skills and used them without formal training. Others, who have not had any training, but have heard of the power of RAP and its potential, have decided to go ahead and use these methods without thoroughly understanding them. This tendency has led in some cases to the RAP methodology being associated with several strange products including some which were simply the trip reports of consultants who visited communities and held informal talks with a few officials and community members.
Although RAP is now associated with an identifiable qualitative research "tool box," it is not enough to simply apply one or more of the tools to gather data and then call the resulting report a RAP. There are theories and concepts drawn from several fields, particularly anthropology, which make up the structure of the RAP "toolbox" itself. The RAP toolbox is community-oriented, participative, flexible and open ended. In order to appropriately use the tools the toolbox itself should be understood.
RAP has grown beyond anthropology. The roots may have been in anthropology, but the procedures are now being used by anthropologists, programme managers, social workers, physicians, nurses, health educators, psychiatrists, sociologists, community health workers and many others. There is no way to control who uses RAP and who trains in RAP procedures. There will, as a result, be some inappropriate use.
Different people will use RAP differently for different purposes. However, there is a need for some basic principles. For non-anthropologists there is a need to communicate within the training some anthropological theory and background. There are also some levels of analysis that are not going to be possible without anthropological training.
There are basic types of RAP users: One is someone with some anthropological background who is involved and guides the RAP, works on the RAP and works on the analysis. The second are those who use RAP for problem solving exercises. Often those using RAP in this way do not have any anthropological training. For those who use RAP for specific problems, i.e., learning why people are not using immunization services fully, they may not require any anthropological training.
The original RAP developers have met several times to compare notes and discuss the applicability of various methods and techniques to various problems. In this way RAP and its originators have continued to develop the methodology and train themselves.
A network of RAP users has formed throughout the world and they communicate among themselves informally. There is a newsletter, that has not yet been successful.
There have been a series of training workshops held throughout the developing world on RAP through which many from different backgrounds have been trained.
Many professionals and researchers, particularly those with sociology, anthropology and public health backgrounds have used the RAP guidelines and then experience to train themselves.
The RAP training manual in its various draft forms has also assisted in training.
There has also been a form of RAP "apprenticeship," where people have attached themselves or been attached to one of the original twenty or so RAP developers, and thus become well trained themselves.
The video on RAP has also helped.
Briefing sessions for donors have been conducted by several of the original RAP developers. During the past eight years there have been several groups for training.
The clientele for orientation and training in RAP is diverse; thus the training methods and approaches to using RAP needs to be diverse as well. The following are groups which have had one form or another of RAP orientation or training.
1. Donors who are asked to put money into RAP use and RAP training.
2. Programme managers who schedule RAP and use the results in PHC.
3. University students in some anthropology courses.
4. NGOs staff who plan programmes and who work in communities.
5. Social scientists.
6. Higher level government programme decision makers and staff.
7. Medical doctors.
8. Community workers.
The RAP Guidelines are available in English, French, Chinese and Spanish. Versions in Arabic and Portuguese are in production. A training manual, which has been developed and revised based on successive uses in training workshops, will be printed in 1992. A RAP training video is available in English and Spanish. A French version is in preparation.
The manual grew out a need to facilitate RAP training in settings where none of the experienced RAP researchers and trainers could participate. Originally, RAP was a methodology of interest to a small group of researchers with backgrounds in anthropology and sociology. This group developed the original concept of RAP and the RAP Guidelines. They also participated as lead trainers in RAP workshops whenever they were held. They hoped to maintain the quality of training by forming an international network of RAP advisers which would back up regional RAP training specialists and national level training and research teams. However, as the acceptance of RAP has grown so has the need to expand training resources beyond the guidelines and the participation of members of this small group. A grant was provided by Plan International to develop a Training Manual.
The manual contains a series of modules, exercises and concepts. The first draft was tried in East Africa and resulted in numerous revisions. The manual should be available in 1992. The manual will be flexible. Users will be encouraged to choose from the examples provided, discarding and choosing as is appropriate, and always adapting the exercises to the culture. The manual is designed to provide trainers with ideas rather than to provide a set of strict procedures.
The training manual has been used for workshops in Cairo and Nairobi. It has well-formulated contents, with several strong exercises that facilitate people learning essential RAP methods for collection of data. However, it is weak in the areas of data analysis, use of research results, and in the need for community participation in data collection.
Key exercises in any RAP training should be in the areas of observation, conducting interviews, and focus group sessions. When participants begin with these types of exercises, they quickly realize they do not know as much as they think they do.
The most difficult have been traditional anthropologists, particularly those who are against applied anthropology.
The second most difficult group to train are the practitioners; that is, anyone whose job it is to try and change people's behaviour. It is hard for them to stop trying to change behaviour while simultaneously asking opinions.
Dr. Chambers and his colleagues have demonstrated clearly that you cannot listen to people if you are busy telling them what to do. Thus, for many, though not all practitioners, there are difficulties in accepting and practicing RAP procedures.
Quantitative researchers who take a hard line on the necessity of quantitative methods are a third group who are difficult to train.
In general, it appears that people's methodological background or professional area is not the main limitation on their willingness and ability to accept RAP and RAP training. Rather it is their individual personal characteristics. If they are flexible, if they like people and working with people, and developing rapport with community people, they will learn RAP easily. If they can relax, sit on the ground, do some farming with the people, carry water with them, join them at meals, etc., they are more likely to do well with RAP.
There are people who have picked up the guidelines with no training who have done wonderfully with RAP. Others who have attended full workshops continue to have difficulty.
For professional people, RAP is seen as a method. When training is done at community level RAP is seen more as a process. Because, in most cases, RAP takes the community as the focus and consists mainly of listening to people in an iterative fashion, answers to initial questions tend to become new questions that are more culturally relevant. This continues. These same procedures when shared with people in the village become a process for them. The goal at this level is not data analysis and publication or feeding interpretations into a programme design but rather, improving community participation.
It is important to understand the needs of various groups. Donors and many senior programme staff do not need methodological training per se, but an orientation in RAP, its potential, its uses, and its potential abuses. Social scientists need to be provided with such methodology.
A key to improving training is for those skilled in RAP to be humble enough to understand and admit that they are often not specialists in training and to ask those with skills in training design and training process evaluation to assist.
There is considerable abuse of RAP. A global network with regional groups of people who really understand RAP can help to reduce abuse and improve the ways in which RAP is used.
The question of RAP as a process in development needs to addressed in the training sessions. RAP is a methodology, but it also has a role in the development process itself. It can be used as a key tool for programme effectiveness. There is also a need to evaluate RAP methods that have developed.
There appears to be no general consensus on who are the target audiences for training. This should be clarified.
It is important to better describe within RAP training what it is that is being taken from the field of anthropology. There should be a list of key cultural variables. For example, what are the short cuts that allow you to get close to and investigate the crux of cultural patterns in a given setting in a very brief period of time?
Participation in RAP planning can be and is a form of training itself. There is capacity building involved both for researchers and also for the community when RAP studies are planned with the community.
While the training priorities should not be rigid, training should concentrate on those who are actually working with projects and need information to plan or improve them.
Training manuals can empower people. There is a need to assure that manuals do not constrain RAP training to only a few, but rather that they generate a multiplier effect. There should be choices and flexibility built in. The state of the art with manuals allows for them to be designed in an open format. They can be improved and updated.
Many of the highest level experts, most of whom are extremely well trained in their own professions are unskilled, shy, and hesitant to step into the home of a rural or urban citizen and start a dialogue about his or her problems. They may be excellent administrators, but often have no skills at gaining important data from the beneficiaries of the programmes they plan and advise. There is little training in RAP-type skills for technical experts during their formal education. They often have very little training in social skills.
Based on the assumption that RAP is a utilization, an action-oriented tool, it seems obvious that there is a need to give RAP tools more credibility and to better institutionalize RAP. This leads to emphasis on training two types of audiences. Top decision makers must be convinced and believe in the use of these sorts of tools to inform them in the making of policy. If they don't overtly approve of RAP, it will not be used or approved by middle level staff. If the action happens at community level, and RAP is a process that allows communities to go through a thinking and problem identification process, community level people should be a primary audience for RAP training.
Training in RAP should deal not only with skills and knowledge, but also with the attitudes of those who are being trained. There should be an explicit set of exercises in which training participants examine their own attitudes toward the people who they will be working with and gathering data from.
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