Participatory action research as a strategy for empowering Aboriginal health workers

Objective Continuing education (CE) is essential for a healthcare workforce, but in regional areas of Australia there are challenges to providing and accessing relevant, reliable and low-cost opportunities. The aim of the present study was to collaborate with the local regional healthcare workforce to design, deliver and evaluate an interdisciplinary CE (ICE) program. Methods A participatory action research (PAR) model combined with an appreciative inquiry (AI) framework was used to design, deliver and evaluate an ICE program. A focus group of 11 health professionals developed an initial program. Evaluation data from 410 program participants were analysed using AI. Results The ICE program addressed the CE barriers for the regional healthcare workforce because the locally derived content was delivered at a reasonable cost and in a convenient location. Program participants identified that they most valued shared experiences and opportunities enabling them to acquire and confirm relevant knowledge. Conclusion ICE programs enhance interdisciplinary collaboration. However, attendance constraints for regional healthcare workforce include location, cost, workplace and personal factors. Through community engagement, resource sharing and cooperation, a local university and the interdisciplinary focus group members successfully designed and delivered the local education and research nexus program to address a CE problem for a regional healthcare workforce. What is known about the topic? Participation in CE is mandatory for most health professionals. However, various barriers exist for regional health workers to attending CE. Innovative programs, such as webinars and travelling workshops, address some of the issues but create others. Bringing various health workers together for the simultaneous education of multiple disciplines is beneficial. Collectively, this is called ICE. What does this paper add? Using PAR combined with AI to design an ICE program will focus attention on the enablers of the program and meet the diverse educational needs of the healthcare workforce in regional areas. Engaging regional health professionals with a local university to design and deliver CE is one way to increase access to quality, cost-effective education. What are the implications for practitioners? Regional healthcare workers’ CE needs are more likely to be met when education programs are designed by them and developed for them. ICE raises awareness of the roles of multiple healthcare disciplines. Learning together strengthens healthcare networks by bolstering relationships through a greater understanding of each other’s roles. Enriching communication between local health workers has the potential to enhance patient care.

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PENDAMPINGAN KELAS IBU HAMIL MELALUI LAYANAN BIMBINGAN DAN KONSELING ISLAM UNTUK MENGURANGI KECEMASAN PROSES PERSALINAN

Sawwa Jurnal Studi Gender ◽

10.21580/sa.v12i2.1545 ◽

2017 ◽

Vol 12 (2) ◽

pp. 277

Author(s):

Widayat Mintarsih

Keyword(s):

Action Research ◽

Pregnant Women ◽

Participatory Action Research ◽

Rating Scale ◽

Health Workers ◽

Integrated Services ◽

Counseling Services ◽

Guidance And Counseling ◽

Participatory Action ◽

Hamilton Rating Scale

Physical and psychological changes cause problems for pregnant women such as: lack of confidence, dependence on partner, even worried and anxious. To reduce the anxiety, women need assistance through the process of Islamic guidance and counseling services. It is an effort to help individual overcome such deviations of religious nature as well as accept his role as khalifah that create good relationship with God, man and the universe. The lack of Islamic guidance and counseling services provided by health workers from hospital or village midwives brings the enthusiasm to get Islamic counseling especially for pregnant women, their families, integrated services post (Posyandu) cadres, and society in general to be able to overcome their problems. Method of PAR (Participatory Action Research) through awarenes actions towards their condition was used in this research. Assistance through Islamic counseling services meets the needs of pregnant women to reduce anxiety in order to maintain physiological, psychological, and spiritual health. In addition, this kind of services gives an increasing knowledge and insight cognitively, affectively, and psychomotor for pregnant women. Internal cares both medically and through Islamic guidance and counseling services to reduce anxiety for pregnant women is done by themselves, their husband and family while external assistance can be done by the cadres of integrated services post, midwives, and community leaders. An increase and decrease in anxiety were measured by Hamilton Rating Scale for Anxiety’s theory (HRS-A) in Hawari. The result analysis showed that there were 11 clients experiencing decreased anxiety after receiving the Islamic counseling services. Before services, it was found a person suffering from slight category of anxiety, in which indicated the range of 14-20. Moreover, it was found 10 people suffering from medium category of anxiety, with total criteria of assessment from range 21-27._________________________________________________________Perubahan fisik dan psikologis menyebabkan problematika bagi ibu hamil, seperti kurang percaya diri, ketergantungan kepada pasangan, bahkan sampai merasa khawatir dan cemas Untuk mengurangi kecemasan dibutuhkan pendampingan melalui proses layanan bimbingan dan konseling Islam. Minimnya layanan bimbingan dan konseling Islam yang diberikan oleh petugas kesehatan dari Puskesmas atau bidan desa menyebabkan antusias warga khususnya ibu hamil menginginkan diadakannya layanan bimbingan dan konseling Islam khususnya ibu hamil, keluarga ibu hamil, kader Posyandu, dan masyarakat pada umumnya agar mampu mengatasi masalah yang mereka alami. Metode Pengabdian yang dilakukan berbasis PAR (Participatory Action Research) melalui penyadaran tindakan menuju perbaikan kondisi kehidupan mereka. Pendampingan melalui layanan bimbingan dan konseling Islam memenuhi kebutuhan ibu hamil untuk mengurangi kecemasan sehingga bisa menjaga kesehatan fisiologis, psikologis, dan spiritual, serta ada peningkatan pengetahuan dan wawasan dari segi kognitif, afektif, dan psikomotorik. Pendampingan secara medis dan melalui layanan bimbingan dan konseling Islam untuk mengurangi kecemasan internal ibu hamil dilakukan oleh diri sendiri, suami, dan keluarga sedangkan pendampingan eksternal bisa dilakukan oleh kader Posyandu, para bidan, dan tokoh masyarakat. Peningkatan dan penurunan kecemasan didiagnosa menggunakan alat ukur teori Hamilton Rating Scale for Anxiety (HRS-A) dalam Hawari yang menghasilkan analisis bahwa terdapat 11 klien yang mendapatkan layanan bimbingan dan konseling Islam mengalami penurunan kecemasan. Sebelum mendapatkan layanan, terdapat 1 orang mengalami kecemasan kategori ringan dengan kriteria total penilaian dari rentang 14-20 dan kategori kecemasan sedang ada 10 orang dengan kriteria total penilaian dari rentang 21-27.

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Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria

Health Research Policy and Systems ◽

10.1186/s12961-021-00719-9 ◽

2021 ◽

Vol 19 (S2) ◽

Author(s):

Ngozi N. Akwataghibe ◽

Elijah A. Ogunsola ◽

Oluwafemi A. Popoola ◽

Adanna I. Agbo ◽

Marjolein A. Dieleman

Keyword(s):

Action Research ◽

Local Government ◽

Participatory Action Research ◽

Health Workers ◽

Routine Immunization ◽

Participatory Action ◽

Government Officials ◽

Community Members ◽

Immunization Services ◽

Local Government Officials

Abstract Background In 2005, Nigeria adopted the Reaching Every Ward strategy to improve vaccination coverage for children 0–23 months of age. By 2015, Ogun state had full coverage (100%) in 12 of its 20 local government areas, but eight had pockets of unimmunized children, with the highest burden (37%) in Remo North. A participatory action research (PAR) approach was used to facilitate implementation of local solutions to contextual barriers to immunization in Remo North. This article assesses and seeks to explain the outcomes of the PAR implemented in Remo North to understand whether and possibly how it improved immunization utilization. Methods The PAR intervention took place from 2016 to 2017. It involved two (4-month) cycles of dialogue and action between community members, frontline health workers and local government officials in two wards of Remo North, facilitated by the research team. The PAR was assessed using a pre/post-intervention-only design with mixed methods. These included household surveys of caregivers of 215 and 213 children, respectively, 25 semi-structured interviews with stakeholders involved in immunization service delivery and 16 focus group discussions with community members. Data were analysed using the Strategic Advisory Group of Experts (SAGE) vaccine hesitancy framework. Results Collaboration among the three stakeholder groups enabled the development and implementation of solutions to identified problems related to access to and use of immunization services. At endline, assessment by card for children older than 9 months revealed a significant increase in those fully immunized, from 60.7% at baseline to 90.9% (p < .05). A significantly greater number of caregivers visited fixed government health facilities for routine immunization at endline (83.2%) than at baseline (54.2%) (p < .05). The reasons reported by caregivers for improved utilization of routine immunization services were increased community mobilization activities and improved responsiveness of the health workers. Spillover effects into maternal health services enhanced the use of immunization services by caregivers. Spontaneous scale-up of actions occurred across Remo North due to the involvement of local government officials. Conclusion The PAR approach achieved contextual solutions to problems identified by communities. Collection and integration of evidence into discussions/dialogues with stakeholders can lead to change. Leveraging existing structures and resources enhanced effectiveness.

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