Participatory evaluation of primary health care programmes: an experience with four Indian populations in Ecuador

A seminar with primary health care workers from 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 helped participants understand the opportunities and limitations which exist in the PHC schemes. The main topics of discussion were: health impacts of sociocultural change, community support of health workers, links with the hierarchy of the health care system, differential use of traditional and modern medicine and planning of future programmes. The final discussion with health officials was important for the mutual respect and understanding. The need for the involvement of communities and PHC workers in the evaluation of their own programmes is stressed.