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Sequencing of assessment tools
Sequencing or using assessment tools in a logical order can make a significant contribution to the understanding of vulnerability. In general, NGOs sequenced their use of assessment questions and exercises to move from general issues to specific sexual health concerns, and from less sensitive to more sensitive issues. There were two reasons for this; to relax and involve people in the assessment process and to help people make the links between the general reality of their lives and HIV and other sexual health concerns.
In this sense, sequencing of the tools becomes a part of the analysis of the assessment. This was most apparent in the work of Cambodian NGOs whose sequence of assessment tools began with those focusing on general life contexts (such as mapping and seasonal diagrams). They then looked at trends related to the epidemic - such as labour migration or drug use - and then focused on factors of vulnerability, their causes, effects and possible responses. Finally, these were ranked according to their potential impact and degree of difficulty in implementing. Significantly, this sequence was carried out with the same group of people. In the other countries, different exercises and questions were posed to different groups, which lost the continuity of the sequence and thus its facilitation of community analysis.
Sequencing assessment tools
The Institute of Vocational Health (IVH) conducted an assessment with garment factory workers in the Rathmalana Industrial Zone, Sri Lanka. It used lifelines to identify the most significant events in group members’ lives and to isolate those events of most concern, such as the break-up of love affairs and the delay of marriage. It then used cause/effect diagrams to explore the reasons and consequences of these events.
As the report notes: “Young women coming to a city environment from the villages become easily involved in love affairs. … These love affairs become transformed to sex relationships and then they easily break-up. … The background situation concerning sex relationships of these women does not permit the recourse to the use of or demand for the use of protective devices. … Many female workers become easily subject to mental worries and sex-related diseases as a result of such break-up prone relationships.”
Finally, IVH used a pairwise ranking exercise to identify the most appropriate strategies for working with this community to help reduce their vulnerability to HIV.
Experiences did show that an alternative that can be effective is to start with a large group, and to gradually break it down into smaller sub-groups – especially for dealing with sensitive issues, such as gender relations. Afterwards, the large group can be reformed to assess overall community issues and perspectives.
The importance of involving the community in not only providing information but analysing the meaning of that information was recognised by all the NGOs involved in the assessments, though it was approached differently in different places. In Bangladesh, NGOs arranged feedback sessions at which the findings of the assessment were presented back to the community and discussed with them. In some cases, these feedback sessions served to continue and deepen the dialogue with the community about problems and appropriate responses. In Cambodia, in contrast, the use and sequencing of PRA tools encouraged communities to participate in the analysis of the information that they were sharing with the NGOs, as described above.