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RAP and rapid anthropological methods applied to public health


Cahiers d'études et de recherches francophones / Santé . Volume 2, Number 5, 300-6, Septembre-Octobre 1992, Synthèse

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Author(s) : Alice Desclaux

Summary : The rapid assessment procedures used in international health circles to conduct short-term research for applied purposes have become the object of a discussion between health professionals and social scientists. During the last 19 years, attempts at a multidisciplinary approach have raised several kinds of questions : a different understanding of the individual and social dimensions of illness, differences between a comprehensive and an analytical approach, incompatible requisite conditions of work (long-term research and rapid interventions) and several epistemological and ethical questions still under debate. The construction of a dialogue between disciplines also requires an understanding of each other’s language and concepts. With Chambers Rapid Rural Appraisal (1980), and Scrimshaw and Hurtado Rapid Assessment Procedures for Nutrition and Primary Health Care (1987), new tools appeared in international health programs. The adaptation of this methodology to different fields - diarrheal diseases, tropical diseases, HIV and AIDS, epilepsy, etc. - led to the publication of methodological field guides by international agencies. Articles reporting the results of anthropological research based on this methodology were also published. « Rapid Assessment Procedures for Nutrition and Primary Health Care », one of the most widely diffused guides amongst French-speaking health professionals, deals with the anthropological approach and its place in health programs, key concepts in anthropology of health and sickness, relevant scopes and data-gathering techniques. The main questions explored through « RAP » have been popular taxonomies, traditional treatments, patterns of health-seeking and nutritional habits. In January 1991, a workshop on rapid assessment methods was organised in Baroda, India, with the participation of TDR / SER (Social and Economic Research / Special Programme for Research and Training in Tropical Diseases of the World Health Organization), to review existing rapid assessment methods in health and related fields, assess their strengths and weaknesses, investigate the validity and applicability of the techniques and consider their applications. Several methodological articles were published following this workshop which provided fruitful insights into the limits and scope of these techniques. Another approach has led to the use of rapid assessment guides as teaching materials for health professionals. The extensive use of initials (RAP, REA, etc.) and the lack of published articles on the evaluation of programs using rapid assessment methods have often led French public health professionals to confuse the different methods with KAP quantitative surveys. In spite of the epistemological problems they raise, rapid assessment methods provide a first step towards communication between anthropologists and health professionals for multidisciplinary collaboration.

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