We have been using participatory appraisal techniques to design better health and care services for the past few years, including in the Northstowe Healthy New Town project (see Designing a healthy future with citizens at the heart)[i][ii]. We are working with local healthcare organisations to build it into their patient and public involvement (PPI) strategies, with a focus on co-development of services around the needs of local populations. You may not have heard about it, but you may already be practicing some elements of participatory appraisal within your own service design process.
Participatory appraisal is a community-based approach to research that values people as experts in their own lives, builds community knowledge and encourages grassroots action. [iii][iv] It provides a better way to activate and co-design new health and care services with the public. Participatory appraisal was developed in Africa and Asia and is now used across the globe. It uses a flexible, accessible approach that draws on a range of visual tools which means that anyone can join in, regardless of background. A facilitating organisation listens and learns, with public engagement being carried out in a place where people already spend their time in their local area. It’s the method of drawing out the experiences, knowledge and ideas of local experts that makes participatory appraisal unique.
You can use participatory appraisal in many ways. It can be used to map local priorities and understand issues. It can be harnessed for ongoing research, learning and development and it can also be effective as part of empowering and enabling people to analyse and tackle their problems themselves. It is a community approach, which means that it doesn’t rely on specific events but instead reaches out to as many individuals in the community as possible. Using facilitators who live in and understand the area, it taps into networks that organisations aren’t usually able to reach. It asks the question, ‘who is not involved that should be?’ in order to includes those often don’t participate in consultation.
The strengths of participatory appraisal are numerous. They include:
You should use this approach when you are willing to let the community take control, when you want to base your actions on local knowledge and when you want to reach out to very diverse members of a community. It can deliver empowered participants, better relationships between participant groups, reliable and valid mapping of local knowledge and priorities, action and energy, as well as being a good tool to make decisions.
Examples of ways participatory appraisal can be used include:
It shouldn’t really be used as a one-off activity, but rather as a process of engagement that should lead to action; as a way to enable exploration of issues and experiences, and to develop community insights.
To find out more about participatory appraisal and how Health Innovation East can help you with strategic patient and public engagement, contact Helen.Oliver@healthinnovationeast.co.uk.
Helen Oliver is the chief operating officer and deputy chief executive for Health Innovation East. She is responsible for overseeing our company’s operational processes, including corporate functions, and leading the development of business strategies, patient engagement and reporting. She also leads on the NHS England Test Bed programme on behalf of the the Health Innovation Network.
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