Community health volunteers as mediators of accessible and responsive community health systems: lessons from the Health Development Army in Ethiopia

Lead Research Organisation: London Sch of Hygiene and Trop Medicine
Department Name: Public Health and Policy

Abstract

Many low (and some middle) income countries face critical shortages of health workers. Governments have sought to compensate by mobilising community health workers (CHW), who can often be trained and deployed quicker than traditional health workers and can take over some of their roles. Their presumed advantages include a good understanding of their communities (particularly of remote, marginalised, and hard to reach populations) and greater community involvement and accountability. While there is some evidence that their introduction can be successful, less is known of how they are perceived, the challenges they face, how the health system can maximise their potential and, if shown to be effective, how they can be scaled up and linked most effectively to formal primary health care (PHC) structures.

Ethiopia offers a unique opportunity to understand the role of the CHWs and their potential to both fill skills gaps and develop a model of accessible and responsive PHC. The needs are huge, reflecting historical under-investment in training, exacerbated by migration of health professionals. The problem is compounded by the need to reach out to remote areas in a large, complex, and multiethnic society with urban and rural, settled and nomadic populations, all with low service utilisation. However, what makes Ethiopia different from many similar countries is its commitment to community-led PHC, with a high priority placed on improved access to essential services, and the creation of two distinct but, at least in theory, complementary types of community health workers. The first comprise the Health Extension Workers (HEW), a flagship national programme initiated in 2003, comprising individuals who have been given basic training to work in their own communities providing basic health services. The programme has attracted international interest but its success in facilitating access to PHC has been moderate. The second group, initiated in 2010-11, comprises volunteers in the Health Development Army (HDA), who act as agents and mobilisers to bridge the gaps between front line services (often perceived as inaccessible) and communities, cultivating trust and supporting participatory health systems. The HDA works across sectors reflecting a paradigm of PHC that addresses the broader social determinants of health.

We seek to know whether, when faced with scarce resources, community health volunteers can make a meaningful contribution to better health and, if so, under what conditions, and how can their contribution be optimised. Our objectives include exploring what the different types of community health workers actually do, their relationship (in terms of trust, power and knowledge) with their local communities, the barriers to them doing more, both in terms of scope and quality of practice, and what they might do with appropriate support. To answer these questions, we will first develop an analytical framework in which access is seen as a social process, and then fill it in as far as possible with data and information from policy documents. This will be used to refine the study design and develop appropriate tools to collect qualitative data. The research will give voice (including via video diaries) to the different types of CHWs, the communities they serve, and the policy makers on whose decisions they depend.

The project will generate timely, policy-relevant information, identifying bottlenecks to improving access to key services and promoting partnerships with communities, as well as developing plans for a subsequent evaluation of the HDA, working in partnership with health authorities at all levels. Although focused on Ethiopia, the findings will be relevant to those planning CHWs initiatives in resource-poor settings elsewhere.

Technical Summary

Faced with chronic health worker shortage, many LMICs have invested in community health workers to extend and enhance health care in low-resource settings. This project examines the role of the Health Development Army (HDA), a large multi-purpose cadre comprising locally-recruited and trained community volunteers in Ethiopia, intended to mobilise communities, that complements the existing cadre of more highly trained Health Extension Workers (HEW), with the HDA acting as intermediaries between formal PHC services and the communities they serve.

A better understanding the HDA experience offers a means to gain important insights into ways to use community volunteers, working across sectors, to support participatory models of grassroots PHC that both enhance access to care and address the social determinants of health.

The project asks first: what role does the HDA play (who are they? what roles do they assume in their communities? How are they perceived by their communities and the health care providers with whom they interact, including the HEW (examining trust, power and knowledge imbalances)? What factors - within and beyond -health systems facilitate or obstruct their activities)? Second, what are the conditions that may increase their potential to improve access to care and address health determinants, including those that lie within the purview of other sectors? Based solidly on theory, it employs a mix of qualitative research methods and is set in one of the Ethiopian regions that pioneered the HDA concept.

Evidence generated by the project will exploit a window of opportunity to inform policy in Ethiopia, addressing a recognised need to understand the contributions of the HDA and their relation with the HEW and PHC structures, as well as the scope for expansion to support hard-to-reach populations. It also addresses a growing international interest in the role of community health workers as part of a package of low cost, responsive PHC models.

Planned Impact

The project offers a potential for significant impact both in terms of generating new evidence and influencing policy and practice in Ethiopia and beyond. Project impact will be maximised by employing an appropriate Theory of Change model, based on collaboration and engagement with a broad range of stakeholders, paying attention to their concerns.

Impact will be sought, initially, at regional and national level, where decisions are being made about the Health Sector Development Programme despite the scarcity of available evidence. Prospects for success are enhanced by the ability to elicit the challenges facing the HDA programme, capturing the perspectives of frontline staff and their communities and giving them voice (via video diaries) that maximise audience impact. The findings will be framed in ways that speak to the concerns of policy makers, elicited from our close interactions with them at all stages of the project, from problem definition to choice of settings and format of results. Our familiarity with the complex policy environment in Ethiopia, as well as established links to policy makers based on mutual respect and trust, will enable us to ensure that our findings are salient to their needs.

The research will take place in Oromia region. Although Jimma University already has excellent existing partnerships with regional authorities, engagement in this project will further strengthen their links with the Regional Health Bureau, whose collaboration on study design, interpretation and dissemination of the results with strengthen their understanding of research and how they can maximise its value to them. Practically, an advisory board including managers and planners at regional level and key policy actors at federal level will support shared understanding between the centre and the periphery. These processes will be facilitated by the extensive experience that team members from both LSHTM and Jimma University have in policy engagement and knowledge brokering at national and international level, as well as their in-depth understanding of the Ethiopian policy context and knowledge of key stakeholders.

Impact is also envisaged regionally (in Africa) and globally. The issues are of significant interest to many LMICs countries seeking to cover poor, rural and hard to reach populations with essential front line services as they progress toward universal coverage. Given that the HDA programme is backed by the government, rolled out nationally, and seeks to operationalise the political commitment to extending access to key services in poor settings, the project offers a unique learning opportunity. Understanding the role and potential of the HDA workers alongside other PHC cadre, is likely to motivate further work on developing people-centred health systems.

Academic audiences will also be engaged through journal and policy papers, with an emphasis on open-access formats including conference presentations, policy briefs and infographics, videos, social media. This will link to existing networks and communities of practice such as Health Systems Global and its Thematic Working Group on community health workers) which includes practitioners and policy makers interested in sharing experience. All team members have extensive networks: the PI Balabanova is Board Member of Health Systems Global and McKee chairs the Global Health Advisory Committee of the Open Societies Foundations.

Project impact will be further catalysed through teaching programmes in Jimma University and LSHTM on health systems and other capacity building opportunities including training and sensitising of community volunteers from other African countries in Ethiopia; an idea championed by the MoH. For all these reasons, we are confident that the proposed research and further evaluation (under a subsequent call) will be of great value to decision makers as well as to community workers and volunteers in Ethiopia.
 
Description Ethiopia has achieved remarkable improvements in reducing maternal and child mortality. A major strategy that led to this was the establishment of the Health Extension Program, which has led to the training and deployment of community-based primary health care (PHC) staff in the form of health extension workers (HEWs). However, rural health care coverage in the country remains poor. The work of the HEWs has been challenged by vast catchment areas with highly dispersed populations.
Major health reform plans have focused on strengthening local PHC systems. Thus, a new initiative was launched in 2010/11, comprising community volunteers known as the 'Health Development Army' (HDA). While similar to community health workers (CHWs) in other low- and middle-income countries (LMICs), these volunteers (primarily women) differ in that they are 'multi-purpose', and are not formally integrated within the health system. In addition, their activities are often seasonal and time-limited. Most importantly, they see themselves as representatives of their communities, rather than the health system itself.

The initiative is now estimated to involve some 3 million women, who promote the uptake of key programmes by mobilizing the population and supporting the HEWs. The model reflects the government's vision to devolve responsibilities for health to individuals and local communities. There is an intention to professionalize selected HDA leaders so that they will become HEWs. The overall aim is to improve the motivation of community-based staff and ensure that PHC involves individuals at the grassroots
level.

Key messages from research
¦¦ HDA volunteers have significant potential to improve access to PHC in Ethiopia, and support the work of the HEWs in a context of vast catchment areas and
dispersed populations.
¦¦ HDA volunteers are 'multi-purpose' and cohesive, enabling community participation in improving their health and wellbeing in a holistic manner.
¦¦ HDA volunteers are not institutionalized into the health system; they regard themselves as community representatives.
¦¦ Barriers to the success of the initiative include illiteracy, lack of training, resources and time, some opposition from local communities, poor supervision and weak
collaboration between some sectors.
¦¦ Overcoming these barriers would involve a management and human resource policy rethink. This is particularly critical given the plans to professionalize key
HDA leaders to develop their capacity and become HEWs.
¦¦ Urgent research in more than one region is needed to capture geographic variations in operating practices among HDA volunteers and identify context specific
strategies and opportunities.
¦¦ This work has demonstrated that intersectoral models can work at grass roots level but that they require commitment to intersectorality at higher levels of administration as well.
Exploitation Route Findings were widely discussed by policy makers in Ethiopia as well as at international fora - contributing to policy development of inclusinve community-led models of PHC in a variety of settings. The analytical work is ongoing and further publications are to be submitted which would strengthen the reach of the findings. We are still analysing the data from Videovoice which has the potential to explore a wider audience.
Sectors Communities and Social Services/Policy,Healthcare

 
Description The award has led to a wide range of contributions to, and influences on, current policy in the area of PHC and people-centred health systems worldwide, in Ethiopia and worldwide. These are reflected in the listed outputs, impacts and engagement. Finding are increasingly used and this will be reported in future years.
First Year Of Impact 2016
Sector Communities and Social Services/Policy,Healthcare,Other
Impact Types Policy & public services

 
Description Contributing to evidence base and primary health care strenghtening in Ethiopia. The project involved close collaboration with the Federal Ministry of Health in Ethiopia and regional health authorities in Oromia.
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Developing and providing training in qualitative methods and audio-visual methods for studying close-to-community health systems for researchers at Jimma Univervisity. There are plans to develop open-access training materials and provide them to other researchers in low and middle income countries conducting health systems research on community based services.
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact Training was provided to 6 researchers, and materials and guidance made available to any MSc students conducting health policy and systems research at Jimma University via the lead Ethiopian investigator, Prof. Mirkuzie Woldie. The University is a centre of excellence and students come from all over Ethiopia to pursue post graduate training. We envisage that providing this training will help to advance the skills of public health and health care management students in conducting qualitative health policy and systems research.
 
Description Influence on knowledge and practice of managers & implementers (subnational level/Ethiopia)
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Prof.Woldie provided briefing sessions for the Deputy Director of the Health Extension Programme and other implementers acting at regional level. This included dissemination of project policy briefs, condensed findings and recommendations to policy and these were used in policy documents and training materials for implementers. The activities included series of conversations (formal and informal).
 
Description Influencing evaluation and development of strategic plans for Primary Health Care in Ethiopia
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Training of community health volunteers in Ethiopia (Health Development Army) to use of mobile phone technology to capture their experience of contributing to primary health care, and to co-produce recommendations for practice
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact Community health volunteers in Ethiopia (Health Development Army) play a critical role as promoters of effective and responsive primary health care, but are often illiterate and working with limited support. The participants in the study in the Oromia region have been sensitised, supported and trained in the use of mobile phone technology to capture their experience. Furthermore, they have been trained and enable to identify challenges and solutions, and working with the researchers, to co-produce recommendations for practice. The latter was achieved through co-production workshops and continued engagement. The study participants have retained the phones and will be able to continue to apply the acquired skills to improve their routine practice and better articulate their problems.
 
Title Video-voice diaries for policy analysis 
Description Background___The use of audio and video-voice diaries to collect data on daily routines of study participants is extensive in sociology and anthropology but relatively new to health systems research. These are thought to have significant advantages: a) participant-led and therefore authentic in reflecting unique individual experiences; b) capturing experiences in real time, thereby minimizing recall bias; and c) reflexive, stimulating the maturation of respondents' ideas over time, and d) motivating for respondents-in particular video, which is seen as more interactive. Outcome___The outcome sought it to capture community volunteers's perspectives of reality compared to the formal policies and understand better their own needs, and those of their community using Videovoice diaries. The community volunteers (Health Development Army) are expected to facilitate accessible and responsive primary health care in Ethiopia. Development and outputs___Footage is obtained over 3-4 months, from 30 Health Development Army cell leaders (each covering five families) in 3 woredas (districts) with diverse health system performance and population contexts. Following community engagement and training, participants receive an encrypted phone with recording capability. They are supported by experienced researchers through regular communication and visits, to establish trust and monitor preferences (e.g. for audio), ensure data validity and reduce social desirability of responses and other biases. We developed a checklist for researchers to support and elicit information from the respondents. We have developed a protocol for a co-production workshop with participants and researchers aims to support interpretation. Participants view their diaries, interpret and prioritise reoccurring themes, identify 'blind spots'. They are interviewed about their experience of participating in the study. The videos and qualitative data are being analysed and compared using Atlas ti. The work will conclude with a development of a methodological guidance and narrative review exploring the potential added value of the Videovoice diaries and the ways to maximise its benefits: ability to capture individual perspectives, better recall, emergence of new ideas or follow-up of previously discussed issues, respondent motivation, and complementarity with other methods. Strategies to reduce social desirability are identified, especially where there are concerns about anonymity and data confidentiality and clashing social norms and expectations. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2016 
Provided To Others? Yes  
Impact The outputs of the project include expanding the evidence base about the use of audio-visual and diary methods in health systems research. The tools and resulting studies have been widely disseminated and discussed through presentations at major conferences (4th Global Symposium on Health System Research in Vancouver, 4th African Health Economics and Policy Association conference in Rabat and the 3rd UCL Qualitative Health Research Symposium 2017: Engagement, Co-production, and Collaborative Meaning-Making: Collaboration in Qualitative Health Research). The ideas behind the methods, and the methodological guidance on data analysis including co-production have underpinned a newly funded 4-year project (Creating building blocks for better treatment & control of NCD in poor & vulnerable households in Malaysia & Philippines, Wellcome Trust/Newton Fund). We will also seek to develop a narrative review reflecting on the use of audio-visual methods in health systems research. Tools, methodological guidance notes and other supportive documentation will be provided to interested researchers as well as opportunity to enter conversations with the Ethiopian and UK teams that led the work. 
 
Title Community health volunteers as mediators of accessible and responsive community health systems 
Description Qualitative data from interviews and focus groups. Data is currently being anonymized and will be made available in spring 2018 on the LSHTM research repository. 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact The expected impact with be through enabling further analysis by researchers based in Ethiopia. There have been requests to provide data in order to enable comparative analysis by researchers in other countries and regions. 
 
Description Developing a collaboration to further strengthen the role of community based cadres in Ethiopia 
Organisation University of Oxford
Country United Kingdom 
Sector Academic/University 
PI Contribution The collaboration involved joint working and developing a proposal for Wellcome Trust clinical PhD programme in Global Health Research on: 'Training Ethiopian Health Extension Workers to prevent and control noncommunicable diseases: a hybrid type 1 cluster RCT'. The PI Dr Balabanova, Prof.Martin McKee and Prof.Woldie provided technical support to Dr Luke Allen who is the applicant for the WT fellowship. Prof. McKee and Dr Balabanova will be supervisors. Prof. Woldie who is now working with the Ethiopian Federal Ministry of Health played a key part in the proposal design, ensuring buy-in by key stakeholder nationally and in the Oromia district where the study will take place. Country-level stakeholders that have been involved with the project, engaged and provided input and this was critical for the successful proposal submission.
Collaborator Contribution Dr Luke Allen, a GP Academic Clinical Fellow at the University of Oxford, developed the proposal and travelled to Ethiopia to design the study and explore its technical and political feasibility through discussions with key stakeholders. He also developed a plan for dissemination and achieving policy impact. Overall, Dr Allen devoted a significant amount of time (over 9 months) with some small-scale travel funding from the Wellcome Trust, to ensure that the proposal is viable and addresses key issues of relevance to PHC development in Ethiopia.
Impact The proposal that was developed was submitted to the Wellcome Trust in March 2020.
Start Year 2019
 
Description Community volunteers as mediators. Presentation at the 4th African Health Economics and Policy Association conference, Sept.2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was oral presentation at the 4th African Health Economics and Policy Association conference, Rabat, Morocco. 25-29 Sept. 2016. During and following the presentation, analytical briefs were distributed to increase the reach of the findings to diverse audiences.

Woldie M, Feyissa G, Alaro T, Admasu B, Mitchell K, Mayhew S, McKee M, Balabanova D. Community health volunteers as mediators of accessible health systems: The case of Ethiopian Health Development Army. 4th African Health Economics and Policy Association conference, Rabat, Morocco. 25-29 Sept. 2016, http://afhea.org/docs/presetationspdfs/Garumma%20Feyissa%20-%20Community%20health%20volunteers%20as%20mediators%20of%20accessible%20health%20services.pdf
Year(s) Of Engagement Activity 2016
URL http://afhea.org/docs/presetationspdfs/Garumma%20Feyissa%20-%20Community%20health%20volunteers%20as%...
 
Description Engagement in a strategic review of PHC in Ethiopia 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Prof. Woldie participated and made specific contributions to a national review meeting (January 2020) and to an ongoing evaluation of the Health Extension Programme and Women's Development Army (August.2019-January 2020) which led to a strategic rethinking of how PHC in Ethiopia need to be reorganised in order to meet the current demands. It provided interim recommendations and led to strengthening the evaluation of key PHC programmes. The work is ongoing.
Year(s) Of Engagement Activity 2020
 
Description Evolution of village-based health systems in Ethiopia: lessons for progressing towards SDGs in low and middle income countries? Presentation at the 5th Global Symposium on Health Systems Research, Liverpool, 8-12 Oct.2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an oral presentation in a session on health policy and systems research at the 5th Global Symposium on Health Systems Research, Liverpool, 8-12 Oct.2018. Prof. M.Woldie was awarded full funding to present, by the conference conveners. The talk explored the Ethiopian Health Extension Workers and Health Development Army (community volunteers) initiative which has attracted much interest internationally, applying a novel historical lens, providing insights for many countries implementing volunteers' programmes. It provoked a debate among the audience which consisted of researchers, NGOs, practitioners and policy makers, led to requests for further analysis of the project data. Many participants saw the approach as proising for other settings and shifting the current investment paradigm from short term approaches to fill gaps with reliance on volunteers to volunteer programme being one component of building PHC systems. A journal publication is currently developed.
Year(s) Of Engagement Activity 2018
 
Description Facilitating accessible community-oriented health systems: the Health Development Army in Ethiopia. Project dissemination workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The event represented a policy dialogue involving key actors engaged in strategic reform of primary health care in Ethiopia, including high-level policy makers, regional authorities/managers, representatives of the PHC institute, NGO, academic researchers. There were several rounds of focused discussion of current problems in PHC, gaps and the (current and potentially scaled up) role of HDA, followed by presentation of evidence generated from the project, and debating feasible recommendations for policy and practice.
Year(s) Of Engagement Activity 2017
 
Description Lectures for the Health Systems module at the London School of Hygiene and Tropical Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Lectures to MSc students on the Health Systems module at the London School of Hygiene and Tropical Medicine (an oversubscribed module in the Faculty for Public Health and Policy) by D.Balabanova and M.McKee. The audience comprised students from a variety of high, middle and low income settings. Many of them include practitioners and policy makers, and have held key positions in their country or internationally.
Year(s) Of Engagement Activity 2017,2018
 
Description Lessons from the Health Development Army in Ethiopia Development Army in Ethiopia. 4th Global Symposium on Health Systems Research, Vancouver, 14-18 Nov.2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an e-poster presentation at the Fourth Global Symposium on Health Systems Research, Vancouver, 14-18 Nov. 2016. The poster is now available online, thus maximising dissemination to those unable to attend the conference.

The details are:
Woldie M, Feyissa G, Alaro T, Admasu B, Mitchell K, McKee M, Mayhew S, Balabanova D. Community health volunteers as mediators of accessible, responsive and resilient community health systems: lessons from the Health Development Army in Ethiopia Development Army in Ethiopia. Fourth Global Symposium on Health Systems Research, Vancouver, 14-18 Nov. 2016. http://epostersonline.com/gshr2016/node/4389
Year(s) Of Engagement Activity 2016
URL http://epostersonline.com/gshr2016/node/4389
 
Description Seminar - Developing village-based health systems in Ethiopia: new horizons for progressing towards SDGs in low and middle income countries? - at LSHTM 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The seminar ('Developing village-based health systems in Ethiopia: new horizons for progressing towards SDGs in low and middle income countries?') was part of the Faculty of Public Health and Policy Seminar Series at the London School of Hygiene and Tropical Medicine, and was presented by Professor Mirkuzie Woldie, Jimma University. It was attended by MSc and research degree students and staff at LSHTM.

The Faculty of Public Health and Policy Seminar Series provide a forum for presenting current research on health systems and policy in low-, middle- and high-income countries. The series cover empirical research, theoretical and methodological issues, and gives an opportunity for staff and students to participate in debate and learn about new developments in health systems and policy research.
Year(s) Of Engagement Activity 2017
 
Description The role of community (health) volunteers in promoting improved, responsive and equitable primary health care in LMICs: an umbrella review. Presentation at the Prince Mahidol Award Conference, Bangkok, 29 Jan.-3 Feb.2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was a poster presentation summarising the findings of a literature review with relevant to LMICs seeking to strengthen their primary care especially in rural areas. Travel grant was awarded.

The details are:
Woldie M, Feyissa G, Hassen K, Admasu B, Mitchell K, McKee M, Mayhew S, Balabanova D. The role of community volunteers in promoting improved, responsive and equitable primary health care in LMICs: an umbrella review. The Prince Mahidol Award Conference, Bangkok, 29 Jan.-3 Feb.2017.
Year(s) Of Engagement Activity 2017
URL http://healthsystems.lshtm.ac.uk/files/2017/03/Umbrella-review_role-of-community-volunteers2c-PMAC2c...
 
Description Use of self-directed Videovoice diaries. Presentation at the 4th Global Symposium on Health Systems Research, Vancouver, 14-18 Nov. 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an oral presentation in a session on health policy and systems research at the 4th Global Symposium on Health Systems Research, Vancouver, 14-18 Nov. 2016. Prof. M.Woldie was awarded full funding to present, by the conference conveners.

The presentation demonstrated the use of an innovative method, self-directed Videovoice diaries. During and following the presentation, analytical briefs were distributed to increase the reach of the findings to diverse audiences. The session generated considerable interest, ideas for further research and new collaborations with organisations working on similar issues.

The details of the presentation are:
Woldie M, Feyissa G, Alaro T, Admasu B, Mitchell K, Mayhew S, McKee M, Balabanova D. Use of self-directed Videovoice diaries to understand the perspectives of community health volunteers in Ethiopia, Fourth Global Symposium on Health Systems Research, Vancouver, 14-18 Nov. 2016.
Year(s) Of Engagement Activity 2016
URL http://healthsystems.lshtm.ac.uk/files/2017/03/pp-video-voice-diaries-1.pdf
 
Description Video-voice diaries for policy analysis. Presentation at the 4th African Health Economics and Policy Association conference, Sept.2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was oral presentation at the 4th African Health Economics and Policy Association conference, Rabat, Morocco. 25-29 Sept. 2016. During and following the presentation, analytical briefs were distributed to increase the reach of the findings to diverse audiences.

Woldie M, Feyissa G, Alaro T, Admasu B, Mitchell K, Mayhew S, McKee M, Balabanova D. Using self-directed Video-voice diaries for policy analysis in Ethiopia. 4th African Health Economics and Policy Association conference, Rabat, Morocco. 25-29 Sept. 2016, http://afhea.org/docs/presetationspdfs/Garumma%20-%20Using%20self-directed%20Video-voice%20diaries%20for%20policy%20analysis%20in%20Ethiopia.pdf
Year(s) Of Engagement Activity 2016
URL http://afhea.org/docs/presetationspdfs/Garumma%20-%20Using%20self-directed%20Video-voice%20diaries%2...
 
Description Videovoice diaries and collaborative research. Presentation at the 3rd UCL Qualitative Health Research Symposium 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact This was an oral presentation at the 3rd UCL Qualitative Health Research Symposium 2017: Engagement, Co-production, and Collaborative Meaning-Making: Collaboration in Qualitative Health Research, in the session 'Using novel visual methods to support participant engagement', 7 February 2017, London. Dr. Admassu was awarded full funding to present, by the conference conveners.

The conference sought to promote discussion on state of the art qualitative methods and field building. Following the conference, the abstract was published in BMJ Open and has been widely disseminated,

The details of the presentation are:
Woldie M, Admassu B, Feyissa G Tolu, Alaro T, Mitchell K, Mayhew S, McKee M, Balabanova D. Videovoice diaries to understand the perspectives of community health volunteers in Ethiopia: insights from collaborative qualitative research. Oral presentation at the 3rd UCL Qualitative Health Research Symposium 2017: Engagement, Co-production, and Collaborative Meaning-Making: Collaboration in Qualitative Health Research, in the session 'Using novel visual methods to support participant engagement'. 7th February 2017, London.

The abstract was published in BMJ Open. March 2017 - Volume 7 - Suppl 2. 3rd UCL Qualitative Health Research Symposium 2017, http://bmjopen.bmj.com/content/bmjopen/7/Suppl_2/bmjopen-2017-016492.12.full.pdf
Year(s) Of Engagement Activity 2017
URL http://healthsystems.lshtm.ac.uk/files/2017/03/Videovoice-3rd-Qualitative-Health-Research-symposium-...