Tetui Moses, Coe Anna-Britt, Hurtig Anna-Karin, Ekirapa-Kiracho Elizabeth, Kiwanuka Suzanne N
a Department of Health Policy, Planning and Management , Makerere University College of Health Sciences, School of Public Health (MakCHS-SPH) , Kampala , Uganda.
c Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.
Glob Health Action. 2017 Aug;10(sup4):1346038. doi: 10.1080/16549716.2017.1346038.
To achieve a sustained improvement in health outcomes, the way health interventions are designed and implemented is critical. A participatory action research approach is applauded for building local capacity such as health management. Thereby increasing the chances of sustaining health interventions.
This study explored stakeholder experiences of using PAR to implement an intervention meant to strengthen the local district capacity.
This was a qualitative study featuring 18 informant interviews and a focus group discussion. Respondents included politicians, administrators, health managers and external researchers in three rural districts of eastern Uganda where PAR was used. Qualitative content analysis was used to explore stakeholders' experiences.
'Being awakened' emerged as an overarching category capturing stakeholder experiences of using PAR. This was described in four interrelated and sequential categories, which included: stakeholder involvement, being invigorated, the risk of wide stakeholder engagement and balancing the risk of wide stakeholder engagement. In terms of involvement, the stakeholders felt engaged, a sense of ownership, felt valued and responsible during the implementation of the project. Being invigorated meant being awakened, inspired and supported. On the other hand, risks such as conflict, stress and uncertainty were reported, and finally these risks were balanced through tolerance, risk-awareness and collaboration.
The PAR approach was desirable because it created opportunities for building local capacity and enhancing continuity of interventions. Stakeholders were awakened by the approach, as it made them more responsive to systems challenges and possible local solutions. Nonetheless, the use of PAR should be considered in full knowledge of the undesirable and complex experiences, such as uncertainty, conflict and stress. This will enable adequate preparation and management of stakeholder expectations to maximize the benefits of the approach.
为了持续改善健康结果，健康干预措施的设计和实施方式至关重要。参与式行动研究方法因能够培养当地能力（如健康管理能力）而受到赞誉，从而增加了维持健康干预措施的可能性。
本研究探讨了利益相关者运用参与式行动研究来实施旨在增强当地地区能力的干预措施的经验。
这是一项定性研究，包括18次知情者访谈和一次焦点小组讨论。受访者包括乌干达东部三个农村地区使用参与式行动研究的政治家、行政人员、卫生管理人员和外部研究人员。采用定性内容分析法来探究利益相关者的经验。
“被唤醒”成为一个总体类别，涵盖了利益相关者运用参与式行动研究的经验。这在四个相互关联且依次递进的类别中得到了描述，包括：利益相关者的参与、受到激励、广泛利益相关者参与的风险以及平衡广泛利益相关者参与的风险。在参与方面，利益相关者在项目实施过程中感到参与其中、有主人翁意识、受到重视且负有责任。受到激励意味着被唤醒、得到启发和支持。另一方面，报告了冲突、压力和不确定性等风险，最后通过宽容、风险意识和协作来平衡这些风险。
参与式行动研究方法是可取的，因为它为培养当地能力和增强干预措施的持续性创造了机会。利益相关者被这种方法唤醒，因为它使他们对系统挑战和可能的当地解决方案更具响应性。尽管如此，在充分了解不确定性、冲突和压力等不良且复杂的经验的情况下，才应考虑使用参与式行动研究。这将有助于充分准备和管理利益相关者的期望，以最大限度地发挥该方法的益处。
