I. NEEDS ASSESSMENT

If an intervention is to be effective and properly adapted to a particular community and situation, it must be based on an initial needs assessment which will allow decision-makers to identify and agree on intervention priorities and required resources. The process of needs assessment allows us to develop an understanding of a community situation that is essential to the planning of ethical and acceptable interventions. Often, you will be entering into a situation in which the needs assessment has already been carried out and a program or project is already underway, but it is important to understand the basic principles and methods involved.

The main objective of any needs assessment is to provide information which allows the following questions to be answered:

1. Should we intervene? – is an intervention required? Is it feasible in view of the context and the abilities of our organization?
2. How should the needed interventions be prioritized?
3. What is the best strategy for implementation – how can we be most effective in our implementation?
4. What is a realistic timeframe for implementation?
5. What resources will we need to implement the strategy?

Health needs assessments are worthwhile undertaking only if they result in changes that will benefit the population. It is therefore essential to be realistic and honest (with yourself and the community) about what you are capable of achieving.

A comprehensive Needs Assessment, such as the initial assessment of a displaced camp population, should cover as objectively as possible, the qualitative and quantitative aspects of the wider community situation, including:

1. Geo-political context
2. Description of the target population (demography, socio-cultural characteristics, vulnerable groups)
3.Environmental characteristics (physical surroundings, water and sanitation, presence of vectors etc)
4. Major Health issues (mortality, morbidity and major causes of.., prevalence of malnutrition, vaccination coverage, presence and history of diseases which are endemic or have epidemic potential)
5. Resources – those currently available, and those needed (human and material e.g. food, shelter, health personnel and facilities, transport, energy sources)
6. Stakeholders in the community – including other organizations working with the community, government involvement etc

An organization with a particular mission or skill base may conduct a targeted needs assessment to collect information only on those aspects which are of relevance to their activities e.g. an organization offering HIV/AIDs testing and treatment may focus their assessment on major health issues, available health resources and socio-cultural aspects of the community. However, lack of information about the wider community context, and particularly failure to use community participatory methods, can result in failure to identify community priorities which may overshadow or thwart the priorities set by the intervening organization. For instance, basic priorities such as food security and access to primary healthcare may need to be dealt with prior to instituting HIV intervention strategies. For this reason an initial general needs assessment may be conducted to identify the broader range of issues in a community. This information can then be used to identify the priority issues, and to decide how the services offered by the given organization can best be utilized.

Setting Priorities

ASSESSMENT TECHNIQUES

Secondary data

Field Assessment

Participatory Methods

Bias

Countering Bias

II. PROBLEM STATEMENT

Once the final decision has been made regarding which issue or issues your particular organization will tackle, it is important to clearly define the problem to be addressed. This is often done by creating a Problem Statement.

A good problem statement does the following:
• Concisely states a situation that needs to be changed.
• States who/what is affected.
• Quantifies the problem (how many).
• Addresses an issue related to the organizational needs/purpose.

At this time the causes and consequences of the chosen problem should also be considered and articulated…

Causes
• Why does the problem exist?
• Is there more than one cause?
• Are the causes interdependent?

Consequences
• What are the consequences of the problem?
• How many people does it affect?
• Are there political, cultural, and economic effects?

Using this information, we can move onto …

III. PROJECT PLANNING USING THE CASUAL PATHWAY

The Causal Pathway provides a planning framework that places an emphasis on logically linking project activities to a final desired impact.

Plan this way

Inputs Activities Outputs Effects Desired Impact

Implement, monitor, and evaluate this way

Desired Impact

Effects

Outputs

Activities

Inputs

IV. MONITORING AND EVALUATION: Developing Objectives and Indicators

In the Causal Pathway framework, the “Project Objectives” are what the project promises to accomplish and measure. Objectives are developed for the farthest point along the Causal Pathway for which you will have evidence or data. In most projects this point will be one or more of the Effects, and in some cases it will be the Impacts.

Project Objectives should be developed using the SMART acronym:

S Specific
M Measureable
A Attainable
R Relevant
T Time-bound

Developing clear objectives will make it possible for us to Evaluate how successfully the program is accomplishing its intentions by reviewing the objectives at given intervals and evaluating whether we are on target with our intended accomplishments and timeline.

Ongoing Monitoring of the process also requires that “indicators” are identified for each step. For example…Input Indicators should provide a way of tracking “how much” resources are going into the program, e.g. hours of training time, number of dollars spent etc. Activity Indicators should provide a way of quantifying how productive the project activities were e.g. number of sex educators trained, number of wells constructed. Indicators should be formulated precisely (usually as numbers or proportions) so that the measure is consistent from one time to the next.

Systems to collect the data on indicators and objectives must be built into the project from the design phase, and will help to answer the questions:

Did we have the inputs we needed? Was our expenditure of inputs appropriate?

Were our activities carried out as planned?

Were the planned outputs achieved?

Did the effects occur? Within the time allotted?

Was the desired impact achieved?