Revealing gender differences through well-being ranking in Uganda.
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Background
During a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza, northern Tanzania we used participatory research tools to facilitate open dialogue and partnership between researchers and study participants.
Methods
A community-based sexual and reproductive health service was established in ten city wards. Wards were divided into seventy-eight geographical clusters, representatives at cluster and ward level elected and a city-level Community Advisory Committee (CAC) with representatives from each ward established. Workshops and community meetings at ward and city-level were conducted to explore project-related concerns using tools adapted from participatory learning and action techniques such as listing, scoring, ranking, chapatti diagrams and pair-wise matrices.
Results
Key issues identified included beliefs that blood specimens were being sold for witchcraft purposes; worries about specula not being clean; inadequacy of transport allowances; and delays in reporting laboratory test results to participants. To date, the project has responded by inviting members of the CAC to visit the laboratory to observe how blood and genital specimens are prepared; demonstrated the use of the autoclave to community representatives; raised reimbursement levels; introduced HIV rapid testing in the clinic; and streamlined laboratory reporting procedures.
Conclusion
Participatory techniques were instrumental in promoting meaningful dialogue between the research team, study participants and community representatives in Mwanza, allowing researchers and community representatives to gain a shared understanding of project-related priority areas for intervention.
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The Afar people of Northern Ethiopia live in what can be considered the very definition of ‘challenging contexts.’ Largely nomadic pastoralists, they navigate a harsh and unforgiving landscape, often having to travel great distances for water. They have been described as living on the frontline of climate change. The Covid-19 pandemic and emerging peace and security issues in Ethiopia have only compounded challenges around poverty, nutrition and sanitation as markets are disrupted and entire communities are displaced.
It can still be incredibly challenging to ensure that the most marginalised members of a community are included and actively engaged in the process . In the case of Afar, this encompasses women, those with little to no formal schooling and those with very low levels of literacy. With this learning paper the authors want to share their experiences of using a methodology designed to include the voices of those most marginalised – in particular, women’s voices – in a nutrition and WASH participatory research project in Northern Ethiopia.
Fostvedt-Mills Consulting (FMC) was contracted by the German Society for International Cooperation (GIZ) as part of their Improved Food security through Transitional Aid for Resilience Project (IFTAR), which aimed to improve the nutritional status of vulnerable groups and the nutritional and hygiene behaviours of caregivers. They were asked to investigate the attitudes and practises of target communities in Afar relating to nutrition and water, sanitation, and hygiene and then to design a subsequent intervention that was contextually relevant to the communities.
For the study, FMC sought to answer the questions:
In designing the approach, FMC wanted to ensure that they carried out their research with the communities, rather than on the communities, in a way that would build trust and create a shared understanding of the future intervention and generate interest and a sense of ownership in its potential outcomes.
The full study carried out by FMC included a desk review as well as primary quantitative and qualitative data collection. In this learning paper they share the findings from the qualitative research. Specifically, FMC examine how the use of photovoice and Community Action Planning methods worked to amplify the voices of women and ultimately engage a more diverse group of community members in the research process. They will share our most important findings and discuss some of the advantages and challenges of using these methods in Afar, as well as the potential for application of these research methods in other challenging contexts.
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This is a participatory toolkit for understanding unpaid care work and its distribution within local communities and families.
Together, these tools provide a way of ascertaining and capturing research participants’ understanding of women’s unpaid care work – giving special attention to the lived experiences of carrying out unpaid care work and receiving care. Please note that these tools were developed and used in a pre-Covid-19 era and that they are designed to be implemented through face-to-face interactions rather than online means.