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Filtering by Category: participatory methods

Including marginalised people in ‘people centred health systems’

Future Health Systems

At the upcoming Global Symposium on Health Systems Research, we will be running a participatory session that builds on research from Uganda, Bangladesh and Nepal, entitled Amplifying Marginalised Voices: Towards Meaningful Inclusion in Social Accountability Mechanisms for Health. This session applies an intersectional lens to accountability mechanisms, asking about the inclusion of specific, marginalised categories within communities in mainstream accountability initiatives.

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Community scorecards: addressing the maternal and newborn service related needs of the marginalized?

Future Health Systems

Caroline Namugwere (not real name) is a 27 year old disabled woman and resident of Kibuku District in Eastern Uganda. Her pregnancy experience was laden with challenges right from attending antenatal clinic appointments to delivery. Inquiry into the plight of the marginalised is part of what the Community Score Cards study of Makerere University School of Public Health in partnership with the Future Health Systems Research Consortium intends to explore over the coming months in Kibuku District in Eastern Uganda. Specific to the case of Caroline and other marginalised groups, the following research question is being pursued: To what extent does a community scorecard process incorporate and address the maternal and newborn service related needs of marginalized populations?

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Racing the clock to save mothers and protect newborns in Uganda

Future Health Systems

Stefan Peterson, Chief of Health, UNICEF, highlights the contribution of a maternal and newborn health implementation project in Uganda led by Future Health Systems partner, the Makerere School of Public Health, to improvements in early antenatel care attendance, facility deliveries, newborn care practices, birth preparedness, and awareness of obstetric danger signs.

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Pathways to scaling up interventions: Reflections from Delivering for Success at Scale

Future Health Systems

“Scaling up” is considered as a pertinent and scientific pathway recognized by academia and policy makers to reduce inequalities, to achieve the Sustainable Development Goals (SDGs), and for universal health coverage. To build upon and learn from the longstanding partnership between Bangladesh Rural Advancement Committee (BRAC), International Centre for Diarrheal Disease Research, Bangladesh (ICDDR,B), and the Institute of Development Studies (IDS), a two day conference was held on 7 -8 February in Dhaka, Bangladesh to  share diverse perspectives, pathways and learnings from contextual settings to achieve successful scaling up of interventions and collaborations. The conference, in addition to throwing light on the pathways of scaling up of programs through our learnings, also acted as a potential accelerator for collaboration. This blog post shares five critical reflections from the conference mentioned below. 

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Ensuring sustainability through working with local resources: lessons from a maternal and newborn study in Eastern Uganda

Future Health Systems

How sustainable is your intervention? If someone wanted to replicate it, how easy would it be? What happens when the study ends? Will the communities be able to continue with this initiative after the implementers have gone? Ayub Kakaire, FHS PIRU Officer for Uganda, blogs about what working on the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study has taught him about how to ensure an intervention is sustainable. 

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Research methods for people-centred health systems: Photovoice

Future Health Systems

By Jeff Knezovich, FHS Policy Influence and Research Uptake Manager, Institute of Development Studies

In our previous blog post introducing how FHS approached the Third Global Symposium on Health Systems Research, we highlighted the thematic focus of the symposium is 'people-centred health systems'.

FHS has been working for some years to put people first when it comes to health systems, whether it be through understanding how people actually use new technologies, such as in our project on health information seeking behaviour in Bangladesh, or working with communities in Afghanistan to rate and improve their health services through community scorecards.

But putting people at the centre of health systems also means finding different research approaches to studying health systems strengthening. We're profiling a few methods during the symposium. And today's focus is on photovoice.

A bit about photovoice

Photovoice is a visual research methodology through which people can represent, and enhance their community by photographing their daily lives and the lives of those around them. It is a qualitative and participatory research method that aims to capture what occurs when researchers are not necessarily present. 

Following a range of trainings – on how to use digital cameras, how to approach a picture subject, and getting people’s consent – study participants use the cameras provided to them to capture photographs and moments that are relevant to the research study. These photos are then discussed, often in a group, to highlight particular photos and to explain their particular relevance to the topic at hand. In many cases, these photographs then also serve as a key part of the communication strategy of the research project.

How FHS has employed photovoice

Although this is a relatively new approach for us, The Future Health Systems consortium has already used the photovoice technique in two of our focus countries: Uganda and India.

In Uganda, as part of the FHS young researcher grant, David Musoke worked with select youth in a community in rural Uganda to document issues related to maternal and childhood health in the community. Study participants used the cameras provided to them to capture aspects and situations in their community where youth can contribute to improving maternal health for a period of five months. Monthly meetings were held between the youth and research team to discuss the photos and to identify collectively emerging themes and areas for action. See the Uganda photovoice slideshow below, or download the booklet, to see some of the results.

In India, researchers worked with women's groups in the Indian Sundarbans of West Bengal to document the interplay between climate, health and resilience there. The focus remained mainly on maternal and newborn health. The participants mainly sought to capture images that explain how a changing climate affects their daily livelihoods, barriers that exist to accessing health services, and ways that locals are adapting to these challenges. The results are available for download in our FHS India photovoice booklet and for viewing in the slideshow below.

Giving photovoice a try at HSR2014

On Thursday, 2 October 2014, FHS invited participants at the Symposium to take pictures with Instagram and Twitter and to tag them with #HSG2014PV, #HSR2014PV or #HSR2014. These were collected via Evenstagram to form our own snapshot of the Symposium for the day.

You can review the photos below or online. Let us know which ones are your favourite and why!

How participatory is participatory modelling for complex adaptive systems?

Future Health Systems

At a recent workshop on methods for understanding complex adaptive systems (CAS) in the context of health systems strengthening, we looked at a number of modelling techniques, like agent-based modeling and causal loop diagrams, some purporting to be participatory in nature. But is the idea of participatory approaches to complex systems thinking inherently contradictory? Inherently confusing? Or are they revolutionary, altering how we see the world and empowering us to transform health systems radically?

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