Organising People’s Power for Health: Participatory Methods for a People-Centred Health System
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The toolkit shows how participatory methods can be used to raise community voice, both through health research and by training communities to take effective action and become involved in the health sector. Generally, this toolkit aims to strengthen capacities in researchers, health workers and civil society personnel working at community level to use participatory methods for research, training and programme support. The toolkit uses experiences from different countries in the east and southern African region.
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This blog originally appeared on the Institute of Development Studies website.
Do we really need debiasing, yet another word? Yes, unless anyone can improve on it, because we need a word to describe a rigorous discipline we development professionals need for grounded realism. This has been coming on me slowly. But now explorations and ‘aha!’ moments in India have accumulated and combined into an epiphany. For me, things will never be the same again. Let me explain.
The biases of rural development tourism are old news. These are biases in brief rural visits from urban centres. They were a collective discovery and articulation at IDS in the early 1980s. They have now receded into the mists of history and been largely forgotten. Few in later generations of development professionals have heard of them. But with rapid change, they are now more relevant than ever.
The biases are spatial (main tarmac road, roadside, accessible from an urban centre…) , project (special villages and places where there are projects, good things to show, contacts…..), person (males, elite, adults, government and NGO staff….), seasonal (during the dry season, not the rains…), professional (questions and curiosity limited to specialised professional mindsets and interests) and diplomatic (being tactful, not inquiring about sensitive subjects) and (an addition since the 1980s) security (confined to places considered safe, and limited to those accessible in daylight….).
The biases interlock and reinforce each other to exclude those people who are most remote, powerless, vulnerable, poor, stigmatised, discriminated against – those whom the SDGs are not to leave behind. With the intensifying capital trap – being stuck in a capital city or urban centre by meetings, emails, visitors, demands for accountability, reporting, and the like – the biases combine now more wickedly than ever.
And there is a new distorting influence to add: competitive campaigns. This is high profile campaigns in which districts and organisations compete to achieve, and to be seen to have achieved, more than others. This last bias is striking with the Swachh Bharat Mission-Gramin in India, the impressively massive and hugely ambitious campaign driven by political commitment and priority which seeks to make rural India open defecation free by 2 October 2019.
Systemically, with almost every brief rural visit, there is a special reason for where the visitor is taken, who is met, what is said and what is shown. This is most brazen with atypical model communities such as the Millennium villages in African countries. It is also manifest in visits to successful projects, or where the Government or an NGO works or has contacts, somewhere easily accessible and so on. This leads to a scattered archipelago of islands of special cases and contacts that are seen, studied, quoted, and then quoted again and again back and forth by visitors, with the authority of their personal experience of rural, or for that matter urban, reality.
Visiting these islands is better than not visiting at all. But it results not in representative ground truth but in a take-off through repetition into sustainably biased myth. The expanses of sea between the scattered islands are overlooked, unvisited and unexplored, but are many times larger, and more typical, than the islands. Even those who demand representative rigour in statistics are themselves through such visits systemically vulnerable to grossly unrepresentative views of reality. And all this is accentuated when there are competitive target-driven campaigns.
We need a systematic, timely and cost-effective approach offsetting the biases and for finding and exploring the seas between the islands. Here is what, again and again, I have found works astonishingly well, and far better than one might suppose.
Using this approach here is a tiny sample of what I have stumbled on in India. All happened to be in States or Districts that had been declared open defecation free (ODF). Except for one that was affluent and exceptional being on a main road, all were very far from ODF.
The point of these is not to denigrate the programme but to illustrate how the vast sea can differ from the scattered archipelago normally visited.
So let me invite all, yes all, development professionals who see this to look in the mirror and be wary of visits which systemically reinforce misperceptions and generate and sustain myths. Ring fence days for you to ground truth through de-biasing. It is fulfilling, informative, fascinating and fun, to explore, to meet people casually, to wander, observe, ask, listen and gain new insights. Every single de-biasing visit I have done has made me wonder – will it happen again? Will I learn anything new this time? Will there be aha moments? Or will this be a wasted day? And every time, every single time, I have been startled and provoked by unexpected revelations. This has always happened. The insights have been intense and memorable, and the implications for policy, practice and research significant. The use of time has been extraordinarily cost-effective.
So let me challenge all fellow professionals who are engaged with rural or urban development – in government organisations, NGOs, training and research institutes, academics, the media, and funding agencies – all who have the scope to do so – to de-bias. Let me challenge all who can to encourage or require others in their organisations to do likewise. Escape the cognitive trap and help your colleagues to escape theirs. Be a devil. Straight away ring-fence a de-biasing day for yourself. Be systematically rigorous. De-bias, enjoy and tell others what you did and what you learnt.
Inspired to take up the challenge? For a useful reminder, download and print A systematic approach to debiasing, instructions from Robert Chambers
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An intentional focus on gender equality and social inclusion (GESI) is key to sustainable and effective Water, Sanitation and Hygiene (WASH) projects.
This guidance is for staff of WASH implementation and research projects and organisations, who are committed to improving the practice of GESI in their projects and organisations.
What is this tool for? To support individual and collective reflective practice among staff on the extent and quality of gender equality and social inclusion work in their WASH projects and organisation.
Who should use this tool? Anyone working on WASH implementation or research projects that wants to improve (GESI) practice.
Who needs to be involved in the process?
How long does the process take?
This publication is also available in French and Portuguese: