The educational value of participatory evaluation of primary health care programmes: An experience with four indigenous populations in Ecuador

A seminar with basic health workers of four Indian groups in Ecuador serves as an example for the participatory evaluation of Primary Health Care (PHC)-programmes. Discussions in small groups, interpretation of visual aids derived from research data on health care utilization and practical evaluation exercises with the participants favoured the perception of opportunities and limitations which exist in the actual PHC-schemes. Main topics of discussion were: health impacts of socio-cultural change, community support of health workers, links with the hierarchy of the health care system, differential use of traditional and modern medicine, planification of future programmes. The final discussion with health officials was important for the mutual conscientization. The need for the involvement of communities and PHC-workers in the evaluation of regular programmes is stressed.