Title: Need assessment techniques
Course: Level 3 - Health Education and Promotion > Section: Health education need assessment

As we discussed in the above section, need assessment encompasses date collection and analysis. The data sources may be from primary sources or secondary sources. Primary sources are the date which collected by you while needing assessment by interview, discussion and any other ways. Secondary data sources are data that is already collected and documented by anybody else at the deferent area. You may also be able to review data which has already been collected by other people to identify local health problems.

- Imagine your surrounding and identify primary and secondary sources of data that may exist in your health centre.
- You could collect primary information by conducting some interviews with key people in your community, or hold focus group discussions. Secondary sources of information about the health issue may be available from your local health centre, or health post data.

This section describes different data-collecting techniques available for carrying out the needs assessment. Various techniques can be used to collect data from the community. The techniques are discussed under four categories: individual, group and secondary source.

Individual Techniques

Individual techniques involve collecting data from people one at a time. The people from whom the needs assessment data are collected do not interact with one another in the course of providing data. Individual techniques include in-depth interviews, key informant interviews, questionnaires, informal personal observations, and personal observations.

A. In-Depth Interview

An interview is an "interview", is an inter change of views between two persons conversing about a theme of mutual interest. This technique is appropriate when dealing with fewer literate audiences or complex issues about which there is little available information.

An in-depth interview is an individual based interview used to explore individuals' beliefs, practices, experiences and attitudes in greater detail. Using this methods health extension worker can identify health information needs of the community as well as their feeling, attitude, and motivation towards health education messages. The major aim of the in-depth interview is to assume enough exploration of the issue at hand.

A good time to do an in-depth interview is when the subject matter is sensitive; for example, gathering health education need about unsafe sexual practice and abortion. During the in-depth interview, it is preferable to use open-ended questions rather than close-ended questions with yes or no responses. While conducting in-depth interview you the following steps should be followed:-

- Select participants. Identify an individual with whom you are going to conduct an in-depth interview, obtain their consent and arrange a time.
- Prepare your interview guide. This is a list of questions you can use to guide you during the interview. You can generate more questions during the interview if other issues arise that you want to follow up.
- Write down the responses truthfully. You can also use a tape recorder to record the responses. However, you should ask permission from the respondent to use a tape recorder.
- Prepare report. After the interview is completed, review your notes or listen to the tape and prepare a detailed report of what you have learned.

Fig 5.2. In-depth interviews can help you gather a lot of information that will help you plans y health education activities. Make sure that you have accurately recorded each individual's response.

B. Key Informant Interview

Key informants are people who are considered experts in a given area because of their professional knowledge or their position of influence in the community or organisation. Examples include teachers, religious leaders, grass-roots workers, and traditional and political leaders.

These community members are with their particular knowledge and understanding, represent the views of an important sector of the community. They can provide you with detailed information about the community, its health beliefs, cultural practices, and other relevant information that might help you in your work. Key informants are particularly useful if the needs assessment has to be done fast.

- Take a moment to keep on some time with local or religious leaders of your community and ask them some beliefs on health issues.
- You may get large information from them. You also have a chance to find out some answers to questions about "the bigger picture" of your community when people are public figures.

C. Questionnaires

This needs assessment technique tends to be more structured than interview schedules and can be administered to each participant. We use questionnaire when we are dealing with literate communities. The questionnaire is a list of question to be asked our participants about the selected problems. It may include different types of questions; both open ended and close ended questions. For illiterate people data collector fill it by asking them.

D. Observation

All the above three methods including interviews provide information about people's beliefs, attitudes, values, and reported behaviour. But observation provides information about actual behaviour. To carry out an observation, you watch and record events as they are happening.

Observation is important to see people's cultures, norms and values in their social context and hidden peoples behaviour. This needs assessment technique is based on using rating forms, checklists, or observation schedules for collecting information.

You cannot observe everything at the same time, so the checklist will help you prioritise what to observe, and how to record what you have seen. A checklist is a very helpful tool for observation, and more generally with planning. For example, Helen is health extension worker, and she wants to assess environmental condition of household in her kebele. She prepared a checklist to help organise her observations when she visits each household.

The checklist includes the following points:

- Is the household surroundings neat? Yes/No
- Does the house have a waste a disposal site? Yes/No
- Is the toilet and hand washing area clean? Yes/No
- Do they have a separate space for the animals? Yes/No
- Does the house have an adequate ventilation? Yes/No

You have probably already gathered a lot of information by using observation within your community. Systematically observing and recording what you see is an important technique that you can use to identify health problems and their possible causes.

Group Techniques

Group techniques allow participants to interact with one another during needs assessment activities. Information can be collected in writing. Successful needs assessment depends on competent leadership and on having participants who have both the knowledge and willingness to participate actively in the interactive group process.

A. Focus Group Discussion

Focus group interview is defined as a technique in which a group of people who possess certain characteristics provide data of a qualitative nature in a focused discussion.

Focus group is a group of 6 to 8 individuals who have been selected because they share certain characteristics which are relevant for the topic to be discussed. In each case, the moderator raises various issues relevant to the needs assessments, following an outline is commonly known as the questioning route/ focus group discussion guide. Steps in arranging focused group discussion:-

- Selection: -Choose 6-12 individuals for your focus group discussion. This selection of participant is based on specific criteria from the total population. For the discussion of some sensitive issues, it might be necessary to lead one focus group of men only and another of women only. For other issues, a mixed group could lead to interesting and informative discussions.
- Focus group discussion guide preparation: This is a set of questions which are used to facilitate the discussion. While the discussion is going, you can also generate more questions to ask the participants.
- Assign facilitator: There should be one person who facilitates the discussion, and another person who takes notes during the discussion. If possible, it is also useful to record the discussion using a tape recorder, so that you can listen and analyse it later.
- Data analysis and reporting: Data analysis and reporting followed the interpretative summary format, whereby the data were not only described but also interpreted. The analysis started with a debriefing immediately after the interview ended. If the tape was recorded during the interview, you could play it and summarise your data.

- In wich situations are focus group discussions important? When group interaction might produce better quality data and here resources and time are limited. Focus group discussions are quick and less expensive than interviews.

B. Delphi Method

In this technique, people with exceptional knowledge about a given subject area are involved in repeated questioning and feedback, using written questionnaires, until a consensus is reached on the subject. Three to four rounds of questionnaires are used to collect the data. For example, if we address the problem of female genital cutting (FGM). After preparing the questionnaires on FGM, you can distribute them to the religious and traditional leaders and anyone who are engaged in this practice. By repeated questions and answers you can make these people have a consensus on this issue.

C. Informal Group Methods

This category includes gathering information at group meetings and social gatherings. It is common for participants at meetings to talk about issues and problems in their family, community, or organisation even when they are not part of the agenda. During this time you can collect data on their health condition.

Secondary Sources Review

Secondary data is defined as "information gathered for other purpose than the immediate or first application". Secondary data sources include census reports, previous studies, and administrative records and reports. Extension staffs rarely use these data sources in needs assessment, probably because their application is not clear-cut.

In your area of secondary data will indicate the progress the problem in the past period. This may be reached by assessing records and reports in health posts, heath centre, local administration office and other related areas.

Sometimes, using a combination of the above need assessment techniques is recommended to have a clear area of concern or the problem.

A. Health Needs Assessment

It identifies health problems prevalent in your community. In other words, you look into any local health conditions which are associated with morbidity, mortality and disability. The local problems may include malaria, TB, HIV/AIDS, or other conditions. In line with this, you need to identify the possible causes and the overall distribution of the health problems in the community which may be related to behavioural factors( for example knowledge, skill and practice) and environmental factors (for example favourable place which facilitates mosquito breeding, socio-economical status of the local people..., etc.)

B. Community Resource Need

It involves identification of a disease, or any other health condition is not a final result of the need assessment. The local community needs to be equipped with the necessary resource to tackle the identified health problems in your community, as well as to bring about the desired behavioural change. Therefore, you need to check the availability of resources to the local community in line with the health need assessment.

For instance, a mother may have good knowledge about malaria and its prevention methods, and want to use Insecticide Treated Bed Nets (ITNs). However, if ITNs are not available, her knowledge by itself cannot prevent malaria. Therefore, a bed net is a resource which is required to bring about behaviour change. Similarly, a woman may intend to use contraception. However, if contraceptive services are not available in her locality, she remains at risk of unplanned pregnancies.

C. Community Resources

As a health extension worker, you need to recognise the local community is a resource. The people or any organisations in the community have some contribution for any community health activities. Therefore, during a needs assessment, you also need to identify the resources available in the community. This includes the help from the community leaders, religious leaders, and volunteers. Also, local materials, local information, and spaces/places in which to conduct health education sessions are very important resources that need to be considered in need assessment.