Social sector

Using the example of a project in Sheffield intended to promote user-involvement and participation in planning healthcare services, the author criticises the failure of the project to actually provide any forum for user-participation. The structures used to set up these partnerships are often too prescriptive, he argues, setting out a framework in which consultation may take place, and leaving no room for legitimate local interests which may not fit this framework. This article also appears in the Development in Practice Reader Development and Management.

An examination in presented of a pilot project to strengthen Primary Health Care (PHC) in Sheikhupura District, which was initiated by the Department of Health, Punjab, Pakistan. The project seeks to create a viable PHC model, providing accessible and sustainable services. Community Development Workshops for Village Health Committees (VHCs) to promote local participation are being held, and several experiences have been gained, from conceptual shifts to implementation issues.

The author, formerly Director of the Clearinghouse Project, describes the aims, achievements and underlying philosophy of the Project, which was set up in 1979 by the American Public Health Association (funded by USAID) to improve access to information for health-practitioners in Asia, Africa and Latin America.

SatelLife was set up by the organisation International Physicians for the Prevention of Nuclear War (IPPNW) in 1985, with the aim of providing a forum for the involvement of medical colleagues in the South in discussion of health and peace issues. SatelLife set up and run a satellite linking service (HealthNet) providing email and a medical information network for organisations and communities world-wide, integrating people working in countries with limited communications infrastructure into the debate. The author provides an overview of the system and the ethos behind it.

Fundamental conceptual tensions underlie current debates regarding the implementation of psychosocial interventions with war-affected populations. Three particular tensions structuring current discourse concern the generalisability versus uniqueness of relevant knowledge, the valuing of technical versus indigenous understandings, and the planning of targeted versus community-based intervention. The implications of working out these tensions in the implementation of programmes are explored, leading to the proposal of a model of phased response to psychosocial needs.

The author presents the views of Thailand's Population and Community Development Association (PDA - Thailand's largest NGO) about how to provide women attracted to the commercial sex industry (CSI) with economically viable alternatives to this accepted (in Thailand) type of `manual labour'. Research has shown that poverty is the major factor cited by voluntary commercial sex workers (CSWs) as influencing their move into the industry, and that economic development is their way out.

The author provides a summary of important lessons learned from adult educational activities and research in Latin America. Basic learning skills are defined as the skills needed in order to provide for ones basic needs, in turn based on the current understanding of human rights, and while literacy training is often regarded as the primary developmental tool in this respect, illiteracy is only one symptom of inequality and poverty. Schmelkes makes values the central element in her notion of competence.

Regenerated Freirean Literacy through Empowering Community Techniques (REFLECT) is an approach to adult literacy programmes which borrows from Paolo Freire's `active dialogue' method and Participatory Rural Appraisal (PRA) techniques. Developed by ACTIONAID, the authors describe and assess the use of REFLECT in pilot studies in Uganda and in Bangladesh, providing very positive feedback on this learning methodology; they argue that it allows for a synthesis of empowerment and literacy, although its flexibility - whether it will work in urban areas, with refugees etc - needs to be tested.

A notable absentee from the ten-point action plan set out by the 1990 World Summit for Children was the issue of street children. Yet such children are a common sight in cities of the developing world, and live in some of the most extreme conditions of poverty. The article looks at the experience of street children in the Mexican city of Puebla. It argues that current research neglects the moral and geographic dimension of work with street children.

It is increasingly being recognised that many survivors of trauma are not best helped by psychological intervention based on the common Western patient/analyst relationship. Radda Barnen commissioned research into a variety of approaches to working with children who have been victims of conflict and/or displacement.