Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda

Musoke, David; Ekirapa-Kiracho, Elizabeth; Ndejjo, Rawlance; George, Asha

doi:10.1016/j.rhm.2015.06.011

Cited by 32 publications

(27 citation statements)

References 43 publications

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“…The study was conducted in Bulwanyi parish, Ssisa sub-county, Wakiso district, located in the central region of Uganda. Bulwanyi parish was purposively selected for involvement in this study due to the earlier work done by the researchers in the area [ 19 ]. Ssisa sub-county is predominantly rural with a population of 94 238 (45 272 males and 47 966 females), 23 992 households, and an average household size of 3.8 [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda

et al. 2018

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BackgroundCommunity health workers (CHWs) are an important human resource in Uganda as they are the first contact of the population with the health system. Understanding gendered roles of CHWs is important in establishing how they influence their performance and relationships in communities. This paper explores the differential roles of male and female CHWs in rural Wakiso district, Uganda, using photovoice, an innovative community-based participatory research approach.MethodsWe trained ten CHWs (five males and five females) on key concepts about gender and photovoice. The CHWs took photographs for 5 months on their gender-related roles which were discussed in monthly meetings. The discussions from the meetings were recorded, transcribed, and translated to English, and emerging data were analysed using content analysis in Atlas ti version 6.0.15.ResultsAlthough responsibilities were the same for both male and female CHWs, they reported that in practice, CHWs were predominantly involved in different types of work depending on their gender. Social norms led to men being more comfortable seeking care from male CHWs and females turning to female CHWs. Due to their privileged ownership and access to motorcycles, male CHWs were noted to be able to assist patients faster with referrals to facilities during health emergencies, cover larger geographic distances during community mobilization activities, and take up supervisory responsibilities. Due to the gendered division of labour in communities, male CHWs were also observed to be more involved in manual work such as cleaning wells. The gendered division of labour also reinforced female caregiving roles related to child care, and also made female CHWs more available to address local problems.ConclusionsCHWs reflected both strategic and conformist gendered implications of their community work. The differing roles and perspectives about the nature of male and female CHWs while performing their roles should be considered while designing and implementing CHW programmes, without further retrenching gender inequalities or norms.

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Section: Methodsmentioning

confidence: 99%

Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda

et al. 2018

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“…This study was implemented in partnership with Omni Med, a NGO that has been training CHWs in Mukono District since 2009 with the support of the Mukono District Health Office and Ugandan Ministry of Health. A partnership was also formed with Makerere University School of Public Health, as they have previously undertaken photovoice studies with CHWs in Wakiso District of Uganda, and have significant expertise in this method of enquiry (Musoke, Ekirapa-Kiracho, Ndejjo, & George, 2015;Musoke, Ssemugabo, Ndejjo, Ekirapa-Kiracho, & George, 2018).…”

Section: Implementation Partnersmentioning

confidence: 99%

‘We are the people whose opinions don’t matter’. A photovoice study exploring challenges faced by community health workers in Uganda

O’Donovan

Hamala²,

Namanda³

et al. 2019

Global Public Health

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Understanding the experiences of community health workers (CHWs) through the use of participatory visual methods (PVMs) has been relatively underexplored. One such PVM is photovoice, which involves the capture of photographic images related to issues of social importance. In this study, we explore challenges faced by eight CHWs in Mukono District, Uganda through the use of photovoice. Over a six-week period, CHWs captured 62 relevant photographs. Subsequent individual interviews and group discussions were held with the CHWs regarding the content of the photographs. Using traditional content analysis, a range of themes related to perceived challenges faced by the CHWs were highlighted, including poor infrastructure, insufficient ongoing training and supervision, relationships with other health professionals and equipment supplies. Suggestions were raised as to why such challenges existed and how they could be addressed; mainly through increased roles of the government and supporting NGOs. Overall, photovoice was generally a feasible method to highlight the challenges faced by CHWs, however community acceptability regarding image capture and consent taking may prove challenging, given past historical experiences. The use of photovoice in this study highlighted the need to address the multiple and complex challenges faced by CHWs in order to help them fulfill their roles.

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“…It is important to note that, in addition to alcohol-use disorders, Photovoice participants identified two other major health issues in Kuc: water quality and sanitation and poor infrastructure. Water quality and sanitation emerge as prominent themes in other Photovoice studies of health in East Africa [57,58,85,86]. In rural Uganda, only 66% of villages have access to a source of safe water and 36.5% of households have hand washing facilities with both soap and water [87], and enteric infections account for 5.52% of deaths and 5.16% of DALYs in Uganda [74].…”

Section: Plos Onementioning

confidence: 99%

Setting a research agenda to improve community health: An inclusive mixed-methods approach in Northern Uganda

Dowhaniuk

Ojok²,

McKune

2021

PLoS ONE

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Background The United Nations Sustainable Development Goals stress the importance of equitable partnerships in research and practice that integrate grass-roots knowledge, leadership, and expertise. However, priorities for health research in low-and-middle income countries are set almost exclusively by external parties and priorities, while end-users remain "researched on" not "researched with". This paper presents the first stage of a Community-Based Participatory Research-inspired project to engage communities and public-health end-users in setting a research agenda to improve health in their community. Methods Photovoice was used in Kuc, Gulu District, Uganda to engage community members in the selection of a research topic for future public health research and intervention. Alcohol-Use Disorders emerged from this process the health issue that most negatively impacts the community. Following identification of this issue, a cross-sectional survey was conducted using the Alcohol Use Disorder Identification Test (n = 327) to triangulate Photovoice findings and to estimate the prevalence of Alcohol-Use Disorders in Kuc. Logistic regression was used to test for associations with demographic characteristics and Alcohol-Use Disorders. Results Photovoice generated four prominent themes, including alcohol related issues, sanitation and compound cleanliness, water quality and access, and infrastructure. Alcohol-Use Disorders were identified by the community as the most important driver of poor health. Survey results indicated that 23.55% of adults in Kuc had a probable Alcohol Use Disorder, 16.45 percentage points higher than World Health Organization estimates for Uganda. Conclusions Community members engaged in the participatory, bottom-up approach offered by the research team to develop a research agenda to improve health in the community. Participants honed in on the under-researched and underfunded topic of Alcohol-Use Disorders. The findings from Photovoice were validated by survey results, thereby solidifying the high prevalence of Alcohol-Use Disorders as the health outcome that will be targeted through future long-term research and partnership.

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Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda

Cited by 32 publications

References 43 publications

Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda

Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda

‘We are the people whose opinions don’t matter’. A photovoice study exploring challenges faced by community health workers in Uganda

Setting a research agenda to improve community health: An inclusive mixed-methods approach in Northern Uganda

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