Assessing felt or expressed health needs

What is a felt/expressed need?

Contrary to a normative need, a felt need is a lack or shortage felt subjectively by members of a particular population group and it expresses their point of view regarding the need for intervention. Felt needs are strongly influenced by the particular setting in which they occur. If the settings are not at all or insufficiently accounted for, there is a risk of planning an intervention which will not fulfill the intended target group’s felt needs and will therefore not find an echo.

Imagine that a climbing wall is installed in a neighbourhood without prior consultation with the local youths. Intended as a meeting point and for promoting physical activity, once installed the climbing wall is hardly used. A needs assessment would have shown that football remains the most popular form of activity in this neighbourhood and that the local youths would have preferred a football pitch to a climbing wall.

Consequences for implementation

There are various ways to know about the needs of a particular target group: in discussions, with written questionnaires or in individual or group interviews (e.g. focus groups). In some settings, assemblies, health circles or future workshops (ideas laboratories) are also possible. The fundamental principle for successful needs assessment is participation, i.e. the active and early involvement of the target group in the planning and the implementation of the project.

It is important to handle the results of any needs assessment in a transparent way. In a neighbourhood, the results of a written questionnaire could be presented at the community centre, for example, and be prioritized in consultation with the attendees. If an assembly is organized it is important to choose the time and place according to the possibilities of those invited to participate. It is particularly important to reach out to those whose voices are not usually heard. Generally, the following points should be taken into consideration in a needs assessment:

  • contact people in the community must not become passive informants
  • results must be clearly and understandably communicated
  • the needs assessment must be meaningful

Example

Considering available data, managers in a company have decided to ask a group of external consultants to help them establish health management strategies for their company (cf. normative need). The ultimate goal of the expert group is to reduce absences from work and cases of burn-out. The experts propose establishing a framework for implementation together with the employees so as to give them the chance to make suggestions. As a first step an employee survey is done and the results presented in a meeting. As a next step, a working group comprising two employees from each level of hierarchy in the company is established. Priorities are decided in this group, on the basis of the survey results and the meeting.

  • You assume that a normatively established need is a need that is also felt by the target group.
  • You dispense with a needs assessment, because the target group is hard to reach and prior assessment would slow down your project.
  • Success is more likely if you know the needs of your target group and if you associate its members in your project.
  • You will learn that people with different cultural backgrounds will reach an objective in different and unexpected ways.
  • Choose an appropriate method to familiarize yourself with the wishes and concerns of the target group.
  • Think carefully about the handling of your results and of the way that you start the dialogue with your target group.
  • Are the needs of the different groups within a particular setting known and documented and have the target groups been identified?
  • What are the expected benefits of the project for these groups and for others who are concerned with the project?
  • At the end of the project is there an assessment of the project’s effort and benefit from these groups’ point of view and compared to what they envisaged at the beginning of the project?
Last modification: 31 August, 2010 08:39