Participatory action research in health systems : a methods reader

Participatory action research seeks to understand and improve the world by changing it. It transforms the role of those who usually 'participate' as the subjects of research. Instead, those directly affected by problems become active researchers and agents of change who collectively act, produce change and create new knowledge. In the 21st century there is a growing demand to channel collective energy towards justice and equity in health, and to better understand the social processes that influence health and health systems. Communities, frontline health workers and other grassroots actors play a key role in responding to this demand, in raising critical questions, building new knowledge and provoking and carrying out action to transform health systems and improve health. There is a widening array of methods, tools and capacities – old and new – to increase social participation and power in generating new knowledge through participatory research. At the same time, we need to be clear about exactly what participatory research is and what it can offer. This reader promotes understanding of the term 'participatory action research' (PAR) and provides information on its paradigms, methods, application and use, particularly in health policy and systems. The result of team work, the reader draws on experience and published work from all regions globally and explains: • key features of participatory action research and the history and knowledge paradigms that inform it; • processes and methods used in participatory action research, including innovations and developments in the field and the ethical and methods issues in implementing it; and • communication, reporting, institutionalization and use of participatory action research in health systems. The Reader is a very well written and useful publication. We share the spirit of the Reader and the attempt to democratize research and make it more inclusive, by making it participatory, in local people's control, and ensuring, in particular, that the voices of the poorest people and communities are included.