The benefits of participatory methodologies to develop effective community dialogue in the context of a microbicide trial feasibility study in Mwanza, Tanzania
During a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza, northern Tanzania we used participatory research tools to facilitate open dialogue and partnership between researchers and study participants.
A community-based sexual and reproductive health service was established in ten city wards. Wards were divided into seventy-eight geographical clusters, representatives at cluster and ward level elected and a city-level Community Advisory Committee (CAC) with representatives from each ward established. Workshops and community meetings at ward and city-level were conducted to explore project-related concerns using tools adapted from participatory learning and action techniques such as listing, scoring, ranking, chapatti diagrams and pair-wise matrices.
Key issues identified included beliefs that blood specimens were being sold for witchcraft purposes; worries about specula not being clean; inadequacy of transport allowances; and delays in reporting laboratory test results to participants. To date, the project has responded by inviting members of the CAC to visit the laboratory to observe how blood and genital specimens are prepared; demonstrated the use of the autoclave to community representatives; raised reimbursement levels; introduced HIV rapid testing in the clinic; and streamlined laboratory reporting procedures.
Participatory techniques were instrumental in promoting meaningful dialogue between the research team, study participants and community representatives in Mwanza, allowing researchers and community representatives to gain a shared understanding of project-related priority areas for intervention.
This is the report of a study designed to reach some broad conclusions about social, economic and cultural change in rural and peri-urban communities of mainland Tanzania. It draws on previous accounts and on group interviews and other RRA methods. Substantive findings concern the responses of members of rural communities to the process of economic liberalisation and their reception of constitutional reforms leading to the adoption of a multi-party political system. Regarding methodology, the study confirmed the value of combining existing literature with fresh fieldwork, although problems of generating generalisable conclusions from location-specific material are acknowledged. Focus-groups were found to be particularly useful, when combined with the possibility of drawing on the long-term field experience of researchers.
In order to obtain detailed information about project participants's daily tasks, particularly in a gender context, 139 calenders were constructed for one specific day. The timeline focused on all the activities undertaken during that day, including agricultural work. Men did more agricultural work than women, although women worked harder overall. Of the 103 agricultural workers surveyed, the men spent more time with livestock, both were involved in nursery work, and men carried out slightly more work in the fields. The other projects studied were water and santitation, women's income generating projects and education. The gender difference in perception of agricultural tasks is noted, which relates closely to time spent talking, resting and in 'reproductive' chores.