Reflection tools

The reflection period of the project is a time when the team can step back and take stock of whether, and to what extent, problems have been solved or have evolved over the period of the action research project.

A final situation analysis can create an endline to enable comparison with the initial situation analysis. By comparing initial and final situations, changes can be identified and measured. Just as with an initial situation analysis, you should aim to make best use of routinely collected data to simplify the collection process and minimize disruption to the daily work of the District Health Management Team. In principal, the final situation analysis should mirror the initial situation analysis. Use the same approach to both data collection and analysis and add further information as required, based on learning during the project.

An additional option is to include an external group as observers in the final situation analysis to gain an additional view of the changes during the project. This could be conducted by presenting results to a variety of stakeholders in a district or national workshop, or by inviting a group to observe the process of conducting a final situation analysis.

It is best to mirror the initial situation analysis, however the methods that you use need to be appropriate to the resources available: teams change; researchers with different skills sets leave and arrive; documentary information may not be available due to changes in personnel, organisational changes or disastrous events. Tools used in the initial situation analysis will inevitably need to be adapted somewhat to fit the new situation. In other words, some flexibility is required.

The human resources/health systems bundles will keep changing during the course of action research spirals and the baseline data collected during the initial situation analysis may not be relevant to the final bundle. When this happens, we suggest a meta-comparison such as comparing type of issue/problem addressed (easy versus complex), planned versus actual results and ensure that the justification for changes in the human resources/health systems bundles is clear and convincing. Finally, additional data may need to be collected to gain a useful picture of the final situation and to enable change to be measured.

This is an example of a Power Point presentation that we used to test our findings with stakeholders.