1. Action Research Action Research Juma Lungo University of Oslo 29 th December 2005 1

2. Action Research Motivations –To make academic research relevant, researchers should try out their theories with practitioners in real situations and real organizations –The emphasis is more on what practitioners do than on what they say they do Key Assumptions –Social settings cannot be reduced for study, and –Actions brings understanding 2

3. Action Research Action research has been typified as a way to build –theory, –knowledge, and –practical action by engagement with the world in the context of practice itself 3

4. Action Research Is a research approach, which has the dual aims of action and research –action to bring about change in some community or organisation or program; –research to increase understanding on the part of the researcher or the client, or both 4

5. Action Research Action research aims to contribute both to the practical concerns of people in an immediate problematic situation and to the goals of social science by joint collaboration within a mutually acceptable ethical framework 5

6. Essence of Action Research Diagnostic Stage –Analysis of the social situation by the research and the subject of the research –Theories are formulated concerning the nature of the research domain Therapeutic Stage –Involves collaborative change experiment –Changes are introduced and the effects are studied 6

7. Phases of Action Research The most prevalent description of action research details a five phase, cyclical process which can be described as an ‘ideal’ exemplar of the original formulation of action research 7

8. Phases of Action Research This ideal approach first requires the establishment of a ‘client-system infrastructure’ or research environment Then, five identifiable phases are iterative: –(1) diagnosis, –(2) action planning, –(3) action taking, –(4) evaluating, and –(5) specifying learning 8

9. Phases of Action Research DIAGNOSING Identifying or Defining a Problem ACTION PLANNING Considering alternative courses of action ACTION TAKING Implementing a course of action EVALUATING Studying the outcomes of an action SPECIFYING LEARNING Identifying general findings CLIENT SYSTEM INFRASTRUCTURE Specification and agreement that constitutes the research environment

10. Ministry of Health Province District Health posts, dispensaries, health centres,and Hospitals CBD, TBA, VHW Routine health delivery services –Basic health services at community level, health posts, dispensaries, health centres, and hospitals Decision-making and health planning take place at the top (Ministry, and provincial levels) RESEARCH PROBLEM AREA 10

11. - Health planner at the Ministry of Health, “ah! the number of clients has increased this year. The health facility needs one more Nurse” - Patients/clients at a remote health facility. - How does health planners at the Ministry of Health plan for these health facility clients Why HIS?

12. RESEARCH QUESTIONS What are the existing problems of the health information systems in Tanzania? How can a computer database be implemented at the district level in order to serve as a Health Data Analysis tool? 12

13. RESEARCH OBJECTIVES To assess problems of the district health information system To design, develop and implement a prototype, DHIS, at the district level To identify how learning gathered in HISP network can be useful in Tanzania 13

14. Five districts in Tanzania Mainland –Bagamoyo, Kibaha, Temeke, Ilala, and Kinondoni Four districts in Zanzibar –Micheweni, Chakechake, North A, and North B Two Hospital –Mnazi Mmoja and Chakachake RESEARCH SETTINGS 14

15. ACTION RESEARCH CYCLE Establishment of a ‘client-system infrastructure’ or research environment HISP memorandum signed between University and Ministry of Health (identifications of HISP pilot sites) 15

16. PhaseSpecific Activities Diagnosing Semi-structured interviews with health staff Observations on health data collection and analysis Use of checklists by inspecting data registers, analysis tools, and health workers staffing level Assessing available computers and computer programs Action planning Acquiring DHIS Software from HISP network Developing strategies for importing baseline data to DHIS Acquiring sample health indicators ACTION RESEARCH CYCLE 16

17. PhaseSpecific Activities Action taking DHIS database setup and Data importation Translating DHIS in Swahili language Reviewing health data collection forms Designing new health data collection forms Training health workers on Computer Literacy Training health workers on Health data analysis Evaluation Group Discussions with health workers DHIS demonstration Testing newly designed data collection forms Calculating indicators Comparative with baseline data Retrospective testing ACTION RESEARCH CYCLE 17

18. PhaseSpecific Activities Specifying learning Presentations and Fieldwork reports Publications: Theses and Scientific papers ACTION RESEARCH CYCLE 18

19. Balancing Action and Research Organize the actions into small units which can be completed in short time Take field notes on every action –Actions includes: fieldwork entrance letters, fixing computers items, meetings and workshops Anything that consumes our time in the field is part of the action Use some known data analysis techniques –Align our field notes empirical material in those techniques Think and make sense of the actions and results –Sometime is required to be away from the field 19

20. Field notes Field notes should be written as soon as possible after leaving the field site, immediately if possible Plan to leave a block of time for writing just after leaving the research context 20

21. METHODOLOGY Data Collection Methods –Semi-structured interviews –Participant observations –Analysis of documents –Use of checklists: data registers, analysis tools, and health workers –Software prototyping process –Group discussions and Training workshops –Video/still pictures –Analysis of press media reports 21

22. Data Analysis and Presentation Empirical materials are presented in –Descriptive statistics (quantitative data) –Excerpts of encoded user reactions –Screen shots of programs –Field documents –Photos 22

23. Data Analysis and Presentation 23 Example: qualitative excerpts of encoded user reactions “No EPI data set, no HIV data, it is missing a lot of information” (DHIS User, Bagamoyo district, February 17, 2005)

24. Data Analysis and Presentation 24 A model and measurement instrument for the formation of Information Systems satisfaction (7-point semantic differential)

25. Data Analysis and Presentation 25 Example: Software evaluation

26. Data Analysis and Presentation 26 Example: Software evaluation

27. Data Analysis and Presentation 27 Screen shots

28. Concluding Remarks Knowledge created in action research is not sometime utilized immediately –Does not bring up radical changes Interviews, Observations, Questionnaires, and site documents work together to support the research claims. 28

29. Concluding Remarks Secondary Sources of Data –Documents from the fields –Photos and video taking –Excerpt from interviewee Depict originality of the research Acknowledgement –Try to write somebody’s name correctly 29

30. Thanks The End 30