Training objectives should promote good health in communities and reduce or eliminate illness and disease. It is therefore very important at the outset to identify major health problems that exist in the target communities. These can be determined from the already established priorities and goals of the local health agency as well as from what community members feel are their needs for health services. From this information, you can then establish relevant training objectives.

One way to organize this information is to develop a table listing, on one side, the conditions of poor health that exist in the community or region and, on the other side, specific PHC services that should be provided to promote good health and eliminate these inadequate conditions.

For example, the following table contains a list of poor health conditions which were found in some of the communities in the evaluation study. Opposite each condition is a list of specific PHC services which healers were trained to provide. This table can serve as a guideline to develop a plan that reflects conditions specific to your own region.

One way to get baseline information is to conduct a rapid assessment of community health problems. You can identify peoples' problems and priorities by talking with community leaders and traditional practitioners and, through small focus groups, with community members. Gathering specific information in this manner can be very helpful, not only in assessing present problems but in stimulating enthusiasm for implementing activities to resolve health problems.

When talking with community members, including THPs, there are several kinds of information that are useful to collect:

1. Information about local community needs

• What are the local health problems and their causes?

• What other problems affect people's well-being?

• What do people feel are their most important problems and needs?

• What are the local beliefs, customs, and habits that affect health?

2. Information about social factors

• What are the main family and social structures in the community?

• Who are the leaders of the community, i.e., men, women, youth?

• What traditional forms of healing and problem solving exist?

• What kinds of relationships do people in the community have with each other?

• Who has power over other people, and who owns resources?

• What kinds of foods do people in the community traditionally eat?

3. Information about community resources

• Which people in the community have special skills, such as leaders, healers, teachers?

• What natural resources exist in the area, for example land, crops, sources of food, sources of fuel and water?

• How do people earn a living?