Exploring the scale-up of prevention, care and support in Zimbabwe:

A place for narrative inquiry

Diane MarshallSIM International / University of Technology, Sydneyinternational.aids-consultant@sim.org

Exploring the scale-up of prevention, care and support in Zimbabwe:

A place for narrative inquiry

Outline� Background� Narrative Inquiry

o Strengthso Challenges

� Research methodology� Findings � Conclusions

Caring nothing for the division between good and bad literature, narrative is international, transhistorical, transcultural:

It is simply there, like life itself.(Barthes 1977, p79)

Narrative Inquiry

� Orders and explores the interplay between individual, institutional, cultural, and social contexts (Clandinin & Rosiek 2007)

� Embedded in context and time� Focuses on the relationship of the

researcher & the researched

� Multiple ways of knowing

Narrative Inquiry

Story telling is not just about work.

It is work (Orr 1996).

Narrative inquiry � greatly under utilized to improve

understanding of problems be a part of a flexible organizing effect

� mainly used to tell stories of illness, grief & death

Strengths� Well suited in the context of community

development� Exposes tacit knowledge, spiritual beliefs &

values� Facilitates local control over the research� Enables input and analysis from a variety of

sources� Participants are co-producers of meaning &

more able to control public representation

Challenges

� Stories may minimize the collective-social dimension

� Subtle aspects of context and social discourse, which shape what can and cannot be said

� Tension between between forming generalizations and context specific cases

� Requires time, trust, and respect

Methodology

Three dimensional narrative inquiry space (Clandinin and Connelly 2000)

1. Person-social dimension2. Backward and forward dimension3. Outward dimension

Interviews + social mapping + observation

1. Examine narrative segments

2. Identify the person-social dimension, the backward and forward dimension, and the outward dimension of the overall narrative

3. Ask why the story is being told in the way it is

4. What stories are difficult to tell

Narrative Analysis

Findings

Learning to scale-up is conceptualised as a contextualised, collectively constructed experience

Tension exists between recognised’training and and traditional life-long learning

Requires synergistic partnerships, the backing of community leaders, & space to experiment

Engaging effective, competent volunteers is critical

Findings

Collective competency and a sense of identity

Facilitating factors• Participatory leadership & healthy team

relationships, • Prayer • Favourable financial arrangements, and

effective monitoring & evaluation

Findings

Findings

Inhibiting factors• Perceived ‘de-personalising of services’• Volunteer turnover• Political restrictions• Lack of food security• Safety• Lack of male volunteers• Lack of access to comprehensive antiretroviral

services

Conclusion

� Narrative inquiry provides a relevant and effective approach to social research

� Possibilities for new organic collaboration and coproductiono Beyond delivery to health itself o Adaptable to personal-social situations,

context, perceived spiritual dimensions, & the political environment

Diane Marshallinternational.aids-consultant@sim.org