Partnerships and participation - Synthesising methods to improve the quality of planning and training for primary health care services at district level in Nepal

Participation has been encouraged for many years in health development work , as a means to involve populations in improving the appropriateness and qu ality of their local health services. This article is an attempt to highlig ht a new approach to participation which moves away from a purely community focused activity and seeks to engage a broader partnership between health service providers, managers and users for a more accountable and sustainabl e end product. It takes inspiration from the Client Oriented Provider Effic ient process (COPE) which has been proved an effective tool to improve the qualify of reproductive health services. Mixing some of its core components with Participatory Learning and Action (PLA) methods we have developed a n ew model of participatory planning and training. Preliminary results show t hat including all stakeholders in the process can work as long as the exerc ises are accessible to all. This accessibility is achieved through a range of visualisation methods. As with any tool for Human Resource Development t he crucial issue continues to be the need for effective follow up which can maintain levels of enthusiasm and quality in resource-poor settings.