Appropriate research for primary health care: an anthropologist's view.

In Primary Health Care (PHC) projects, it has become customary to conduct all-purpose surveys early in the project. These are usually based on questionnaires administered to a relatively large sample of the population and elicit information on demography, living conditions, health status, sanitary facilities and socio-economic attributes of the population, in addition to providing baseline data on the indicators of program success. It is recommended that a distinction be made between different types of data collection efforts and that consideration be given to the timing of such surveys so as not to raise community expectations. Early in the project a survey of demographic characteristics and health indicators may be appropriate. However, major surveys of living conditions and health problems are better delayed until the program is in operation and such surveys can be used as mechanisms for community participation, motivation and education. The limitations on the use of questionnaires is discussed. Because anthropological methods are more suited to the skills of health promoters and yield valuable behavioral data, it is suggested that anthropologists encourage the use of these alternatives to questionnaires. The use of participant-observation, life stories, interviews, mapping and essays are discussed in the context of PHC programs.