5 Case Studies presenting an account of the experiences and challenges faced by participatory practitioners in Kenya in the health and agricultural sectors
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Condensed version of the IDS Topic Pack "Using Participatory Approaches in Health", containing a selection of readings on participatory methods and methodologies, abstracts of related readings, and information on other resources.
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Handwashing is a vital part of good sanitation and hygiene. When Community-Led Total Sanitation (CLTS) and its aim of ODF (open defecation free) communities are fully understood and put into practice it is clear that handwashing is implicit in the approach. Without addressing handwashing and other hygiene practices, communities can never become fully ODF since CLTS aims to cut all faecal-oral contamination routes. However, in practice, the degree to which handwashing is integrated into triggering and follow up, depends on the quality of facilitation. This guide, developed in Malawi, addresses the need for specific tools that help to incorporate handwashing into CLTS.
The World Health Organisation estimates that between 7 and 10 per cent of the world’s population live with disabilities. This means between 2.5 and 3.5 million of the worlds displaced people also live with disabilities, and research shows they are among the most hidden, neglected and socially excluded of all displaced people. This resource kit provides practical ideas on how to improve services and protection for people with disabilities and enhance their inclusion and participation in community affairs. It is designed as a companion publication to the report “Disabilities among Refugees and Conflict-Affected Populations".
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This reader aims to inform, motivate and strengthen the practice of participatory action research. In the 21st century there is a growing demand to channel collective energy towards justice and equity in health, and to better understand the social processes that influence health and health systems. Communities, frontline health workers and other grass-roots actors play a key role in responding to this demand, in raising critical questions, building new knowledge and provoking and carrying out action to transform health systems and improve health. This reader promotes understanding of the term ‘participatory action research’ (PAR) and provides information on its paradigms, methods, application and use, particularly in health policy and systems. It seeks to explain:
• key features of participatory action research and the history and knowledge paradigms that inform it;
• processes and methods used in participatory action research, including innovations and developments in the field and the ethical and methods issues in implementing it; and
• communication, reporting, institutionalization and use of participatory action research in health systems.
As a tool to support understanding and learning, the reader uses explanatory text backed by references and resources. It includes examples of participatory action research across high, medium and low income settings and across all regions globally. It provides a selection of readings on the subject (in Part five).
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The case study discussed in this Evidence Report explores the value and limitations of collective action in challenging the community, political, social and economic institutions that reinforce harmful masculinities and gender norms related to sexual and gender based violence (SGBV). As such, the concept of structural violence is used to locate SGBV in a social, economic and political context that draws histories of entrenched inequalities in South Africa into the present. The research findings reinforce a relational and constructed understanding of gender emphasising that gender norms can be reconfigured and positively transformed. It is argued that this transformation can be catalysed through networked and multidimensional strategies of collective action that engage the personal agency of men and women and their interpersonal relationships at multiple levels and across boundaries of social class, race and gender. This collectivity needs to be conscious of and engaged with the structural inequalities that deeply influence trajectories of change. Citizens and civil society must work with the institutions – political, religious, social and economic – that reinforce structural violence in order to ensure their accountability in ending SGBV.
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This third edition of the The Sage Handbook of Action Research presents an updated version with new chapters covering emerging areas in healthcare, social work, education and international development, as well as an expanded ‘Skills’ section which includes new consultant-relevant materials. Building on the previous editions, Hilary Bradbury has carefully developed this edition to ensure it follows in their footsteps by mapping the current state of the discipline, as well as looking to the future of the field and exploring the issues at the cutting edge of the action research paradigm today.
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Engaging men and boys in addressing gender-based violence has grown in attention over the past 20 years. However, the emerging field predominantly focuses on the issues as a problem of individuals, neglecting the role of the institutions and policies that shape norms of gender inequality and perpetuate violent power asymmetries between men and women in people’s everyday lives (Cornwall, Edström and Grieg 2011).
Men’s engagement in addressing GBV has therefore tended to be relatively depoliticised, focusing predominantly on individuals’ attitude and behaviour change, and less on accountability of the structures that uphold patriarchal power relations and male supremacy, such as macroeconomic policies and the governance cultures of many formal and informal institutions.
This movement mapping report thus introduces a collaborative research project between the Centre for Health and Social Justice (CHSJ), India, their local activist partners in the Men’s Action to Stop Violence Against Women (MASVAW) campaign and the Institute of Development Studies (IDS) to explore the effectiveness of men’s collective action in addressing GBV. CHSJ is working across India on the issue of mobilising men to transform discriminatory norms into those based on equity, equality and gender justice to ensure the fundamental human rights of all people.
The research is premised on the notion that challenging patriarchy and working towards gender equality must include working with men and boys to understand their privileges as well as the co-option, coercion and subjugation that they also face within a patriarchal system. In turn, we aim to improve understanding and knowledge of the changing roles of men in addressing GBV and how and why collective action holds possibilities as an effective strategy to support this in the Indian context. This research is exploring the actors, strategies, challenges, collaborations and pathways for future engagement of the MASVAW campaign that works across the state of Uttar Pradesh.
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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 report is based on the experience and findings of a group of 113 people who took part in a two-year participatory research project. This was known as the Community-Based Learning, Information & Communication Technologies (ICTs) and Quality of Life (CLIQ) project. The aim of the project was to find out if ICTs can have an impact on people’s quality of life.
Participants came from four poorer communities in KwaZulu-Natal, South Africa. Through their local telecentres, CLIQ provided free computer training and use and alongside this, participants discussed their quality of life and their life goals at different stages of the fieldwork. Some telecentres were not operating as well as others and some people were not able to participate as fully as others. The CLIQ research showed that when people use computers, they can improve their lives.
Training is important and should be linked to the needs of people who should be supported in their use of computers to help them reach their goals. For this to succeed it is essential that they have good access to computers that work.
The report is in memory of Nonhlanhla Gema.
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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.