Using action research to improve the availability of safe drinking water; case study: Nsangi Health Centre III, Wakiso district

Abstract

Health care organizations like hospitals are highly resistant to change because of professional role behaviors, hierarchical structures and the influence of hidden curricula that inform organizational culture. Action research (AR) or Participatory Action Research (PAR) has been identified as a promising bottom-up approach that has the potential to address the significant barriers to change. PAR can be defined as a study design that treats the communities of inquiry as part of the generators of knowledge. PAR provides practitioners with new knowledge and understanding about how to improve educational practices or resolve significant problems in classrooms and schools. During participatory rural appraisal, key informant and group interviews were conducted, participatory mapping and modelling and transect walking done through the facility premises. Vital information was obtained by observation, asking questions, listening and discussions. Reports, photographs and audio recordings were also used for vital information collection. A participatory community diagnosis was carried out to identify the health problems faced by the staffs and patients/clients of Nsangi Health Centre III and these were prioritized to come up with practical solutions. The community diagnosis successfully identified several health challenges and prioritized lack of drinking water. This was because it was ranked highest and had many challenges associated with it among which were possible outbreak lack of water borne diseases like cholera, typhoid and dysentery among others. Safe drinking water is not only important but essential because it helps to keep our bodies healthy, quenches thirst and helps in swallowing of prescribed medicines. The identification of this health challenge with the community engagement guided the study to formulate interventions to ensure that safe clean drinking water was made available to the community. This was done by mobilizing little money from stake holders to buy jericans from Joint Medical Stores (JMS) in which treated water was put and made readily available to the staff and patients at large. It was agreed upon that water was to be treated with aquasafe/waterguard by a member of staff of the HC who would then fill it into these jericans. The water would then be dispensed by consumers using a tap provided on these jerricans. This innovation was overwhelmingly embraced by the community and it helped patients avoid drinking unsafe tap water which could expose them to sicknesses. It was recommended that continuing medical education (CME) should be done on weekly basis to create and sustain awareness about the dangers of consumption of unsafe water.