Community aspects of Peer Participatory Rapid Health Appraisal for Action (PPRHAA) - Ghana, Nigeria and Tanzania

In Ghana, Tanzania and Nigeria we have used an innovative appraisal process, Peer Participatory Rapid Health Appraisal for Action (PPRHAA), to assess how well health facilities and health departments are functioning. PPRHAA has proved to be an effective tool for managing change, even in contexts where health systems are widely perceived to be dysfunctional. PPRHAA provides a formal mechanism through which client and community views of services, and their preferred solutions to identified problems, can feed into the appraisal process. Clients and communities are routinely consulted during the annual appraisal process, and community representatives are invited by regional or local governments to attend ‘appraisal summits’, where action plans for improving service delivery are agreed. In contexts where few opportunities previously existed for communities to have a say about the quality of health services, PPRHAA has established a formal and practical mechanism through which health managers, providers and communities can engage in dialogue on how to address priority health challenges.