Time budget analysis as a tool for PHC planning (with examples from Ethiopia)

Few health or development programs take into account the way in which real life communities structure and value their own time. Many programs are 'time stealing', and when communities find time inputs are too expensive, many adverse effects on community health and development appear. Even the spare time produced by leisure and seasonality may be mitigated by time costs related to sickness, and taking long journeys needed to reach areas of services like clinics, markets, churches, weddings.... One effective way of introducing time, in health and social development, is to prepare a community time budget or more precisely a balance sheet of community activities, where alternative uses and effective allocations of time become a primary concern of community planning. This paper, by applying a time budget analysis with examples from Ethiopia, aims to demonstrate what the problem is and how it might be solved. One of the major bases of the social goal of 'health for all by the year 2000' is community enthusiasm and participation in Primary Health Programs. This paper aims to show that the way to achieve self-reliant development, appropriate to local conditions and aspirations, is by employing time budget analysis for activity planning in rural areas.