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Participatory Action Research in Health Systems: Empowering people to lead change

December 2, 2014
A new publication, Participatory Action Research in Health Systems: a methods reader, was launched at the Third Global Symposium on Health Systems Research in Cape Town, South Africa in October 2014. The reader was published by the Regional Network for Equity in Health in East and Southern Africa (EQUINET), in association with Training and Research Support Centre (TARSC), Alliance for Health Policy and Systems Research (AHPSR), the World Health Organization (WHO), and Canada's International Development Research Centre. Research for change

Participatory action research seeks to understand and improve the world by changing it. It empowers and turns those who usually "participate" as subjects of research—those directly affected by problems—into active agents who can create new knowledge and act on it to produce change.

“If you have come to help me, you are wasting your time, but if you have come because your liberation is bound to mine, then let us work together,” said Lila Watso, an Aboriginal woman leader quoted in the reader.

For example, when staff at TARSC asked people in participatory sessions to form a human sculpture to illustrate their perception of how health systems operated in terms of patient care, the sculpture most commonly showed health workers, managers, and others turning away from the patient and looking up to the next level for resources and attention.  

The reader includes several examples of successful participatory action research. Co-author Asa C Laurell worked with employees in a Mexican steel factory to identify workplace risks to their health. The employees’ findings made their experiences visible but more importantly, strengthened their power to negotiate for changes in the workplace. The researchers were the workers, and the facilitators were academics. The research was carried out collectively, to validate facts across the group. Indicators were defined by the  workers drawing on their own experiences. Evidence included photographs, and a risk map made up of a easily understood symbols and pictures. The participatory action research seeks to create a more holistic vision of people’s understanding of their health and of their interactions with the health system.

Deepening understanding

The reader highlights the key features of participatory action research and its history. It also outlines the processes and methods used in implementing this research approach, and the reality of applying it in health systems.

“We produced this methods reader to inform, motivate, and strengthen the practice of participatory action research. Our struggle […] is to deepen our own understanding, our own learning about this, so that we can improve the quality of what we’re doing,” says co-author Rene Loewenson.  

Download a free copy of the Participatory Action Research in Health Systems Reader (PDF, 3.3MB)