Reflective learning in action research - SAGE Journals

Action Research Volume 8(1): 53–70 Copyright© 2010 SAGE Publications Los Angeles, London, New Delhi, Singapore and Washington DC www.sagepublications.com DOI: 10.1177/1476750309335210

Article

Reflective learning in action research A case of micro-interventions for HIV prevention among the youth in Kakira-Kabembe, Jinja, Uganda Eddy Joshua Walakira Makerere University, Uganda

ABSTRACT

Key words • Community

Dialogue • HIV/AIDS/

behaviour change • micro-projects

The Community Dialogue (CD) approach is considered to be significant in teasing out the realities, concerns, priorities and challenges of meeting the needs of young people, which can form the basis for more appropriate preventive interventions. Community dialogue approaches were used in our study, which involved a broad participation of different stakeholders as part of understanding the social contexts of the youth and sexuality, as well as reflecting on what actions the different stakeholders could undertake to reverse the current HIV and AIDS infection trends among the youth. The strategy underscored the community priorities as the basis for intervention/action. After thinking through and discussing the various intervention options, women and girls within their groups reached consensus to implement selected micro-projects which would be combined with HIV/ AIDS education activities. This article describes the key lessons learnt from implementation of these micro-projects through reflection. It describes and analyses the processes and nature of participation, the experiences of participants and facilitators, the challenges and issues relevant to address HIV/AIDS focusing on personal, social and economic considerations within the context of interventions.

• participation • youth/women

53

54 • Action Research 8(1)

Introduction HIV/AIDS remains an important subject of consideration in Uganda despite the reported decline in infection rates within the youth and adult population aged 15–59. Infection rates have declined from over 30 percent in the early 1980s (Ministry of Health [MoH], 1997; United Nations Development Programme [UNDP], 2002; United Nations Joint Programme on HIV/AIDS [UNAIDS], 2005) to just over 6 percent in 2005 (MoH & ORC Macro, 2006). Stabilizing at around 6 percent in the last four to five years, there is rising fear of possible resurgence in infection. Already new infections for 2006 were 135,000 compared to 55,000 in 1996 (New Vision, 2006) and youth aged 15–24 accounted for half of all the new infections (UNAIDS, 2006, cited in Ministry of Health & ORC Macro, 2006). According to the 2004–2005 Uganda HIV/AIDS Sero-Behavioral Survey [UHSBS] (see MoH & ORC Macro, 2006), infection rates are lowest among young people below 25 years, ranging between 1.5 percent and 4.7 percent for ages 15–19 and 20–24 respectively. However, infection rises with age and it is apparent that young people below 25 years (including children), who account for over 60 percent of the population (Uganda Bureau of Statistics [UBOS], 2005), increasingly face the risk of infection with HIV/AIDS as they grow older. Between 25 and 34 years, infection rates rise to between 7 and 10 percent and remain at this high level up to 44 years. Girls and women have higher infection rates within all age groups. The national peak for HIV infection estimated at 10.3 percent is concentrated in the 30–34 age cohort. Within this age bracket, women’s infection rate is reported at 12.1 percent compared to that of men at 8.1 percent. In Jinja District (East Central), which is the intervention site, infection rates stand above the national average at 6.5 percent. While HIV infection rate has declined over the years, young people aged 15–24 still perceive a higher risk of HIV infection (Neema & Bataringaya, 2000; Walakira, 2002a, 2002b; Walakira, Bukuluki, & Sengendo, 2006). The UHSBS (see MoH & ORC Macro, 2006) further shows that girls who perceived the chance of contracting HIV to be ‘very likely’ varied between 14 percent and 22 percent in the age groups 15–19 and 20–24 respectively. Higher percentages were reported for boys in the respective age groups at 19.7 percent (15–19) and 23.8 percent (20–24). The higher perception of risk owes largely to lack of protected sex among young people as condom use at last sex was only 26.7 percent among girls aged 15–19. It reduced by two-thirds to 9 percent among girls aged 20–24. In comparison, more boys used condoms at last sex with a reported 46.5 percent and 32.8 percent among those aged 15–19 and 20–24 respectively. These indicators reveal some improvement in protective sexual behaviour among young people. However, they remain unacceptably low and show that many sexually active young people still face the risk of contracting HIV. This is more worrisome given the fact that for over two decades, the government and Civil Society

Walakira Reflective learning in action research • 55

Organizations (CSOs) have largely targeted sexual behaviour change underpinned by the ‘Abstinence, Be Faithful and Condom use’ (ABC) model. It is against this background that a two-phased action research project was developed under the Faculty of Social Sciences of Makerere University in collaboration with Social Science and Medicine network (SOMANET) and the Swedish International Development Assistance (SIDA) to investigate the personal, social, cultural and environmental factors that continued to impede behaviour change thereby predisposing young people to HIV infection (first phase), and to make an intervention that would make a contribution to safe behaviour change (second phase). The details concerning what happened in each phase and the inter-linkages are discussed later. The purpose of this article is to reflect on the participation of the young girls and women in the intervention activities meant to address the risk to HIV infection through micro activities and to draw learning lessons relevant for responding to concerns, needs and priorities of young people in the fight against HIV/AIDS.

The struggle for behaviour change to avert the risk of HIV/ AIDS infection Studies by Klein, Eastern, & Parker (2002), Melkot, Muppidi, and Goswani (2000, cited in Parker, 2004) and Parker (2004) have each noted that behaviour change approaches grounded in cognitive theories such as the Health Belief Model by Becker & Joseph (1988), the Theory of Reasoned Action by Fishbein & Ajzen (1980) and the Social Learning Theory by Bandura (1986, 1991, 1994) are insufficient in providing a framework for behaviour change in the wake of fighting the HIV/AIDS epidemic particularly in developing countries. Their undoing lies in the false assumption that individuals will exercise total control over their behaviour on the basis of rational thinking and action. Since rationality is socially constructed, the theories fail to adequately account for the decision-making of local populations, which may be guided by factors other than those propagated under the prevailing model of rationality. For example, local people may risk HIV infection through unprotected sex, for the purpose of either producing children, or as a profound gesture meant to preserve or elevate a relationship. Their interpretation or assessment of risk in this case may represent concerns that differ from behaviourist and bio-medical assessments of risk. The way they make sense of their circumstances may be informed by daily interactions, their experiences and other considerations within their environment. As Klein et al. (2002) have noted, By the end of 1980s, research findings and practical experience in several countries had demonstrated that a far more complex set of social and cultural factors inevitably mediate the structure of behaviour risk in all population groups and that the

56 • Action Research 8(1) dynamics of individual psychology could never be expected to explain (or stimulate) behaviour change without taking these broader issues into account. (p. 19)

Owing to this, ‘attention turned to the social and cultural structures and their meanings that shape and construct sexual experience and drug use in different settings’ (p. 19). This change of focus was further embraced, resulting from ‘a shift from investigation of risk, perceived typically in individualistic and behavioristic terms, to the analysis of vulnerability, understood as socially structured and conditioned’ (p. 21). As a case in point, in the presentation of findings from the first phase of the study (see Walakira et al., 2006) we pointed out that women and girls’ risk to HIV infection was associated with their poor economic situation, which made them dependent on men for survival and also limited their prerogative to negotiate for safe sex. Because women and girls (out of school) tend to be bound to the household and engaged in a full schedule of domestic chores, they lack regular access to correct information and services relevant for HIV prevention. Therefore, owing to the interplay of social, cultural, economic and other contextual factors in predisposing young people to the risk of HIV infection, HIV/AIDS programs in addition to providing information are now targeting social structures and collective behaviours and practices that may shape sexual experiences. Programs increasingly target norms, beliefs and practices through community based interventions. Prevention efforts are increasingly oriented toward holistic and multi-sectoral approaches, taking into account the relevant issues of poverty and the rights to health and non-discrimination (Bernett & Whiteside, 2003; Casale & Whiteside, 2006; Holden, 2003; Sengendo, Bukuluki, & Walakira, 2001). Hence, being aware of many of these issues, we designed a research project encompassing phases 1 and 2 involving both research and an intervention. A brief outline of each phase may provide a better insight into the overall process.

Phase 1 of the research The entire design of this action research was based on use of Community Dialogue (CD) underpinned by participatory approaches both in the first and second phase. CD is defined here as a continuous mutual exchange of views, ideas and opinions between people or groups of people aimed at developing mutual understanding and seeking a solution (see Canadian Rural Partnerships, 2002; Sengendo, Walakira, & Bukuluki, 2006; United Nations Children Fund [UNICEF], 2004). The process was facilitated by use of Appreciative Inquiry. According to Cooperrider & Whitney (1999), Appreciative Inquiry seeks out the exceptional best of ‘what is’ to help ignite the collective imagination of ‘what might be’ (p. 11). The aim is to generate new knowledge which expands ‘the realm of the possible’ and help members in a community or organization envision a collectively


desired future and to carry forth that vision in ways which successfully translate images into possibility, intentions into reality and belief into practices. Hence, the study used participatory research approaches, grounded within the experiences of the participants (see Denzin & Lincoln, 1994; Gergen, 1985; Gergen & Gergen, 1991) and provided room for learning and action (Bryman, 1988). The approaches allowed community members to exchange information face-to-face, share personal stories and experiences, express perspectives, clarify viewpoints, and develop solutions to community concerns (Canadian Rural Partnerships, 2002). Within the study sites, 14 CD meetings were conducted. Some were organized during the initial data collection phase, while others were scheduled during validation dialogue meetings. The steps involved in the use of the CD included; i) Setting the stage: Making an entry into the district, community and community structures; ii) Channel identification, community mapping and duty bearer analysis. Identify the channels in the community, where they are and their roles; iii) Making visible the unexpressed concerns. Through probing and encouraging discussions. Within these stages, the following activities were undertaken: i) Training of research team involving four persons. ii) Gaining entry into the communities. This involved establishing contacts with local authorities, youth and women leaders and service organizations. A local partner organization involved in provision of HIV/AIDS services, The AIDS Information Centre (AIC), was identified as a key partner. iii) Working with the staff of the AIC, local authorities and leaders of youth and women, appointments were made with local communities and health workers. iv) Collecting data through dialogue on HIV/AIDS. During data collection, considerable effort was made to stimulate discussions about the issues concerning the community where HIV/AIDS, poverty and social service concerns were expressed. We recorded and afterwards transcribed their interpretations or the meanings they attached to the HIV/AIDS issues identified. These were subjected to further discussions. We also made sense of their interpretations and gave our viewpoints which they in turn evaluated. The proceedings from the discussions were transcribed and organized into common thematic areas around which particular sections of our work were reported. A few of the issues identified in the data collection phase related to HIV/ AIDS prevention among young people centred on the following:

• The view among older persons that HIV/AIDS posed a serious health risk; the growing tendency for young people not to be ‘scared’ by AIDS which we termed ‘normalization’ (‘youth know that there is fire but they go ahead and play with the fire . . .’ the youth were quoted in the meetings); sexually active youth largely perceived themselves to be already infected with HIV even without first testing for HIV (the ABC messages did not seem to


make sense to this category of young people); HIV/AIDS was increasingly viewed a commonplace part of life, like any other health problem, and in their opinion, getting infected or remaining infection free depended almost entirely on luck. • A number of factors led young people to have unprotected sex. These included the desire to have children and the belief that condoms cause cancer. While abstinence and virginity (particularly among girls) represent traditional values that are held in high esteem, abstinence was also believed to cause impotence among boys. • Women and young girls were identified to be more vulnerable to HIV infection because of their social and economic situation. They had no power to negotiate for safe sex if they were economically dependent on men. Many lacked ownership of productive resources like land and personal business undertakings. Poverty was pointed out as a significant risk factor among young girls and single mothers. Single mothers felt they had no choice but to engage in risky sexual activities in order to provide for the children; lack of skills to enter gainful employment led to sexual exploitation of women and young girls. It would seem that there are combined economic and social vulnerabilities which intersect and make women and girls more susceptible to risky sexual behaviour, and thereby infection. • Interestingly, pregnancy was feared much more than AIDS because of the stigma attached to pregnancy outside of marriage, the punishments that accompany pregnancy such as forced withdrawal from school and expulsion from home, along with the accompanying punishment for the males who impregnate them. Virginity was perceived to represent backwardness although losing it through unprotected sex always reminded girls and boys the consequences of pregnancy and the risks of getting sexually transmitted infections (STIs). These and other issues formed the bulk of concerns for consideration during the intervention phase.

The intervention phase The intervention phase involved a series of planning meetings which were informed by reflection on the key findings from the data collection phase and a proposal of the way forward. The need to address the economic and social vulnerability of young girls and women became a major point of consideration during these meetings. Additionally, it was agreed that young girls and women needed to deepen their understanding on issues of HIV/AIDS and gain skills to competently counsel their peers in the community about the problem while encouraging them to take protective actions. A detailed discussion on suggested interventions is made after this section.


During this phase, the research team mobilized the groups to participate in selecting two project activities to be supported to the tune of US$3000 each. We extended technical support to the groups and further assisted by taking on the role of facilitator. We attached a community worker and a research assistant to continue working with the groups. For purposes of supervision and continued learning, we undertook occasional visits to the sites. We were particularly keen on observing and learning about the nature and process of participation within the activities, the motivation of participants, expectations and challenges of team working. Learning more about participation was crucial because it underpins the CD approach that was carried through to the second phase. The CD approach allows participants to take charge of their situation (Sengendo et al., 2006). Being a participatory process, it presented an opportunity for participants to transform themselves. This does not necessarily mean that every participant would experience a profound transformation and suddenly be able to take charge of their lives and prevent the risk of HIV infection. Rather, as Wright & Nelson (1995) point out, that participation as a process enhances the capacity of individuals to improve or change their own lives. It was interesting to explore how this would work out. It is this process that I attempt to understand through application of reflective learning, to reflect or look retrospectively on the processes involved so as to draw learning lessons. Within the intervention phase, the fourth and fifth stage of community dialoguing were applied: iv) Making channel action plans – where the community makes plans on how to achieve its desired goals; and v) Ensuring sustained dialogue – linking communities and services, supporting sustainability. It is within these stages and with use of some principles of appreciative inquiry that participants were allowed to ‘discover’ what they needed to do to address the problem of HIV infection; and to ‘design’ the necessary interventions to lead them to the desired situation.

Identification and selection (channel action plans) and implementation The process of identifying intervention activities and developing action plans involved six meetings. The project team participated in five of the scheduled meetings and allowed members continue dialoguing with the help of a research assistant and community worker. These meetings allowed participants to think through all identified options before final selection of activities was made. The participants and research team were all in agreement concerning the implementation of HIV/AIDS related activities targeting women’s vulnerability to HIV infection (whatever the limitations of the projects and the concept of vulnerability). This had been and continued to be identified as a major problem among women and young girls. However, it was still clear that the problems affecting women


and girls were enormous and were beyond the reach of any single intervention of this size. For example, married women as argued could still face the risk of infection even with the implementation of the micro-projects. The idea of working hand-in-hand with an HIV/AIDS service provider was therefore proposed. We had already identified the AIDS Information Centre as a reliable partner during the first phase and participants viewed this as a chance to have some members trained as counsellors. The trained counsellors would in turn talk to partners both men and women about the need for testing for HIV and protecting themselves against infection in marriage. Still participants felt that their key to empowerment was to start up activities that would help them acquire skills and some money to start up their own income generating activities (IGAs). As to how this was to be achieved, participants argued that once a viable activity was initiated, it would then operate as a training centre. The centre would thereby be made sustainable and in case it generated profits, members would be helped in successive stages to acquire support in starting up their own activities. Also, members were optimistic that having acquired some skills, they would be able to mobilize some funding from their spouses or from microfinance organizations. There were no assurances that the IGAs would necessarily succeed. However, it was felt that the attempt itself provided the best option, and the hope that the activities would succeed was very high. If the projects would contribute to their social and economic empowerment – they argued – ‘it would help us the single mothers and out of school girls not to be dependent on men for economic survival which makes us vulnerable to [gender based violence which increases] HIV infection’. Having discussed quite a number of issues and coming to some consensus, they proposed the activities from which only two were to be supported for implementation in Table 1.

Management and implementation of the micro-IGAs Following the advice of the research team, each group formed a committee that would take responsibility for running the agreed upon activity. Each committee was made up of 10 persons as indicated in Table 2. There was concerted effort from committee members in the series of discussions which followed, to identify suitable venues for the projects, estimation of the costs involved and purchasing the necessary materials or equipments. Suitable salon and poultry houses were identified by committee members. Materials necessary for each project were procured by the treasurers working together with a community worker. The project team played more of a supportive, supervisory and a learning role. We continued to link the groups to technical support involving identification of veterinary officers, specialist hair dressing trainers and service providers such AIC and Health Child. We continued to learn more about particular sources of vulnerability to HIV infection. These included video halls

Walakira Reflective learning in action research • 61 Table 1 Reasoning for selection or rejection of proposed activity Participants

Proposed activity

Status of activity Selected Dropped

Reasoning of participants

Women Vegetable P group cultivation

Land for cultivation was scarce and costly. Participants could not afford the cost of hiring land. The project also could not afford the costs of accessing land. Other options for vegetable cultivation were not explored

Considered viable, more rewarding and offered a lot of learning

P Poultry keeping

Pig rearing P

Dropped for religious considerations. Some participants were Muslims

Land for cultivation was scarce

Horticulture

P

Bakery P

The market was already crowded, making it difficult for new and inexperienced comers to effectively compete

Youth Hair salon P group and pay phone

Salon was considered attractive, provided more skills and income prospects. Pay phone was expected to attract customers to the salon and could support meeting some operational expenses for the groups

Tailoring P

Dropped because of competition from second-hand clothes imported into the country

Hotel/ restaurant work

P

Limited market

Vending/shop keeping

P

Not attractive/limited market

Table 2 Committee members Position

Responsibility/reasoning

Chairperson Vice chair person Secretary Treasurer Two committee members Two voluntary representatives from youth/women group Two advisors from health unit

Convening, chairing meetings and ensuring that decisions are implemented Providing support to chairperson Documenting committee decisions Managing project finances and participating in procurement Supporting the work of the committee Facilitating learning and sharing of skills with members in the represented group Offer advice on integration of HIV/AIDS issues in project implementation


which screened pornography to young people, bars which employed young girls who constantly faced the risk of sex abuse, water collection points where women at certain times would be assaulted, and sugar cane plantations where school children constantly feared getting abducted or assaulted. Women and youth groups targeted these areas during implementation, by providing education and advocating for protection of the affected youth and children.

Perceived benefits accruing from the micro-interventions After about a year of projects implementation (June 2006–June 2007), the groups felt they had registered significant successes in the implementation of project activities – particularly with respect to behaviour change, increasing awareness about HIV/AIDS, and even modest economic benefits related to skills acquisition and income generation. During reflective discussions, the youth pointed out that the projects had reduced a significant portion of idleness which they experienced prior to implementation. They were now invigorated by project activities. They no longer had time to engage in sexually risky activities such as spending the entire evenings in night clubs. They claimed that they had become patient. Some had acquired management and customer care skills by participating in salon activities. Additionally, their activities had raised awareness about HIV/AIDS and had attracted service organizations into the area.

Girls and women becoming agents of change As part of the preparation for reaching out to members of the community, over 25 girls and women had successfully trained in HIV/AIDS peer education and elements of counselling through AIC organized activities. Over 20 participants had become well acquainted with social protection issues for children and about eight continue to work with Health Child in the area. They had conducted doorto-door sensitization activities which covered over 200 households both individually, and through joint efforts. Since its establishment, the poultry project has inspired over 10 women in the village to undertake chicken rearing. Over 30 women had been trained in chicken rearing through the project. The salon project initially faced hardships involving leadership and challenges of team work. These challenges were addressed in time. The salon is currently being managed by the trainer. Over 20 young girls have acquired skills in hair dressing, treatment and plaiting among others. Some have secured employment outside the project site, while others continue to work within the salon. The youth participants felt that the projects had made a significant contribution in a number of ways, including raising the social status of participating girls and women as many have become involved in


community activities of service organizations such as Health Child. They also continue to provide education on HIV/AIDS, child related issues, and on economic empowerment. They believed that their work was well-received by the community and appreciated. Others are accessing microfinance services from Foundation for International Community Assistance (FINCA) to start up their own income generating activities.

The challenges of participation and behaviour change One of the contradictions of community-driven interventions relates to the establishment of rules by community members (leaders), aimed at fostering commitment and participation in voluntary activities. While the rules can be very useful, if not carefully evaluated, they can be stumbling blocks to inclusive participation. At some stage during the implementation of activities, the youth project committee explained to us that some youth were not particularly interested in certain salon activities such as cleaning the equipment, mopping and fetching water, yet the activities were part of the training. They were also not turning up regularly and did not respect the trainer. They invited group members and agreed to set up rules to foster commitment and discipline among members. Apart from the rules that divided responsibilities and those that emphasized discipline, other rules they established bordered on exclusion and perpetuation of vulnerability, which were the very issues the project had sought to address. One of the rules required members to make a contribution of Ug. Shs 5000 (US$3) as a commitment fee. While this fee was perceived to be small among the majority of members, it had the potential of alienating those who could not raise it. It also created a possibility of driving those who could not raise it into risky sexual activities. In the short term, the rules promoted at least some form of exclusion and could have easily promoted sexually risky behaviour if we had not addressed the issue directly through dialogue. As expected, this rule requiring a contribution did not go down well with some group members. However, by not openly raising it in the meetings, it implies that there was a growing gap between the committee members and some participants who never freely or openly expressed their feelings. Here the spirit of dialogue appears to have disappeared at least for some time. Hence, during one of our follow up meetings, this issue came up and some participants had this to say: Youth mobilizer: . . . there are group members who come to me secretly, they say, ‘tell us muna [colleague], didn’t you give these things free of charge’ . . . yet they are asking for 5000/=. They themselves did not pay, we have evidence. I tell them that the 5000/- is taken as membership fee because no one can give everything with no body contributing. When you are given without any contribution you will spoil it because you are just given. This calls for some responsibility. Another one said, ‘let

64 • Action Research 8(1) me make my contribution to the poultry project and then wait for eggs’. I told him that is not how things are done and please stay with your Uganda Sh 5000. Youth participants: . . . Yes, they refuse to pay the contribution explaining that the projects were for free and that they do not have the money.

Listening to these vignettes, we realized that there were voices that had been silenced and which needed to be given room for expression. We advised the youth mobilizer to always listen to the views of those who are not happy with decisions made and bring them for discussion so that 1) their concerns may be addressed, and 2) a consensus would be reached. Youth who appear to have been silenced had additional issues to raise. They pointed out that the committee was discriminating against some persons when it came to attending training seminars, on the basis that they lacked education credentials. On this point we realized that there was a gap in communication. We were aware that for one to qualify for training, she needed to have a certain level of education, but this had not been well communicated. So there was a need for developing communication skills among the young people. The committee nonetheless also had other issues to communicate to participants which were related to discipline. That some group members were using the telephone without permission, some were refusing to pay after using the phone going against what had been agreed upon in the established rules. Some trainees were not complying with the orders of the trainer. That also some members were engaged in petty gossip and competition which marginalized their peers and led to a loss of interest. Other participants were telling people in the community that ‘to be a committee member, one had to be HIV positive’ (one of the dialogue meetings). It was also reported some youth wanted to be paid to attend to the training centre activities, when at no time was this considered in the project arrangement. All of these issues were addressed through open discussions. The issue of stigma, its implications and the need to respect the rights of HIV/AIDS positive persons was addressed. Members re-committed themselves to showing respect to each other and decided to take an active stance against petty in-fighting. Rules were to be followed in using the telephone. Non-complying members would be warned and if they refused to cooperate, they were to be excluded from further participation. The months that followed indicated an improvement in the salon. Although some participants did not continue, a good number of new members joined and have been successfully trained. The saloon is acting as a training centre and members continue to offer HIV/AIDS information. As for the women group, the participation of members appeared to have fewer problems, except that the issue of power relations related to the involvement of women representatives in the salon project, had become problematic.


As already pointed out, women’s involvement in the youth project was aimed at helping the women generate knowledge and skills from youth activities which they would pass on to other women in the women’s group. Women in turn were to help girls develop an attitude that values work and sexual health and encourage them to adopt safer sexual behaviour. While the girls had the powers over the daily running of the salon, they found it difficult to compel women representatives who were older than them, to do the required work in the saloon. (The women carried the image of parents, but not necessarily that of elders.) One youth made this observation about some of the women: This is what they say [old women – when you talk to them] ‘How can you tell me to mop, I am a mature person you cannot give me orders, young girls are not supposed to order me around. How can young girls order us to mop? If I want I can mop and if I don’t want I will not’ . . . managing such people is not easy . . . they . . . tarnish your name. (youth participants)

In the meetings, participants viewed it as culturally inappropriate for a young girl to order a mature woman to do a certain kind of activity. They agreed that the youth leader needed to talk to the chairperson of the women’s group in case there were difficulties. The chairperson would in turn talk to the women. The women’s group members also decided to distribute the chickens which numbered about 290 amongst the active participants, earlier than the date planned. They complained that some work was not shared equally among members. After sharing, some members (10) continued raising stock and have started bigger projects. Others sold off the chickens. The group is still active and is involved with the activities of Health Child, a local service organization.

Discussion Fostering participation of the girl youths and adult women One of the lessons drawn with respect to fostering participation of girls and women in micro-activities relates to the need for continuous clarification of expectations, interests and priorities between facilitators and participants prior to and during implementation of activities. These evolve throughout the life of the project and if not clarified, may negatively affect participation. More importantly, tensions should be acknowledged (explicit or implicit) between formally agreed upon intervention goals which facilitators are bound to stick to (in this case the controversial aspect of ‘behaviour change’), and the hopes that guide community participation (‘income generation’). Community groups increasingly demon strated an interest in income generation much more than behaviour change. In fact, behaviour change as implied in this presentation cannot be easily determined but can be more implied. The complementary nature of the two goals was dis-


cussed during project inception. Economic activities would enable income generation, but not immediately as it required them to first acquire knowledge and skills in certain activities which would also change aspects of their behaviour in relation to work. Afterwards, they would focus on securing employment or start up their own activities. They would in the process become economically more independent assuming that their projects succeeded. The projects were to help some start up their own activities upon achieving sustainability and gaining profitability. Those who were to benefit in the first round would in turn help others to create a multiplier effect. Hence, building economic capacity was a goal that needed a change of attitude and behaviour and sustained commitment to realize. As some youth dropped out midway during the implementation on issues more related to immediate income generation, there are some lessons to learn. One is that there is a limit on the part of facilitators and community leaders over the control of many aspects of project management through the use of community dialogue techniques, like member attrition. To counter drop-off in attendance, a mechanism must be created and should function as a fundamental part of the actual project design that sustains commitment, perseverance and patience for some youth to continue pursuing the generally agreed goals. Alternatively, perhaps, the project was not flexible enough to explore alternatives for such youth who could not wait for a longer period to realize the goal of income generation. Our assumption that women would act as role models and help youth get more committed to collectively agreed upon goals also did not in this particular case help this category of youth. We underestimated the generation gap between these youth and women who were acting with the authority of adults with cul tural power. This challenges us to make more visible both to ourselves and participants, the many entrenched cultural assumptions underpinning concepts such as ‘gerontocratic order’ which we may take for granted in many African societies. The continued participation of youth and women in groups gives more encouragement that there is more scope and hope for participation to be successful particularly if issues of power and authority in the groups and positions of responsibility or roles of actors are clarified. Other requirements relate to building discussion points or questions within the participatory process, around concepts such as ‘leadership’, ‘structure’ and ‘rules’ (renegotiation of rules if deemed necessary) so that issues of power and hierarchies among others, can be addressed. Other issues that need careful attention relate to good communication, encouraging participatory decision-making and consensus building. For researchers, there is need for a careful examination of our agendas, our positions of power and authority as these may act as stumbling blocks to successful implementation of participatory activities. Similarly, the roles and responsibilities of different community actors need continuous evaluation. Furthermore, it is imperative to have both financial and technical resources in place, to support community activities. With continuous monitoring and participation by facilitators, it helps to identify


emerging challenges to team work in the groups and addressing them directly through open dialogue and continuous dialogue.

Continuity of HIV/AIDS education, dialogue and addressing vulnerability to HIV infection To ensure continuous HIV/AIDS education and other activities that help with youth behaviour change requires a sustained involvement of both youth group participants and HIV/AIDS service organizations. HIV/AIDS organizations are particularly important because they usually have more resources and stay longer in the communities. Addressing vulnerability (here it is limited to factors that predispose young people to HIV infection and over which they had limited control) to HIV infection requires the involvement of many stakeholders to address power relations between men and women not only within the home, but also in workplaces such as bars, where working girls face the risk of sexual assault and increased exposure to HIV infection. Encouraging community groups to continue dialoguing, collectively generating solutions concerning their problems, and linking groups to organizations that provide financial resources, and those that advocate for women rights, are all crucial. Acquisition of knowledge and skills concerning HIV prevention was suggested by women to have assisted them in sharing information with their partners about issues of safer sex and HIV testing. Some felt that they had more power to negotiate for safe sex while others felt they were no more dependent on men for economic survival.

Conclusion This article has reflected on the processes and activities involved in the implementation of micro-projects aimed at reducing the vulnerability of women to HIV infection. While the participation of girl youth and women in community activities has great scope to succeed, it is not devoid of challenges, which if not addressed through constructive and ongoing dialogue, can negatively impact on the implementation of project activities. These relate to clarification of roles, positions of authority, rules and their enforcement, paying attention to cultural and positional power, having in place a well streamlined structure and encouraging participatory decision-making and effective communication. Ongoing clarification of expectations and reconciling the agenda of facilitators and the community participants is also critical to project success. Addressing wider issues of the status of women, access to productive resources and so forth, requires continuous dialogue and sustained involvement of wide array of stakeholders and service providers.


Acknowledgements I would like to extend my profound gratitude to several people whose editorial input made it possible to have this article in the form it is. These include the two anony mous reviewers for this journal, Julie Guyot (M.S.W. Africanist Doctoral Fellow Woodrow Wilson International Center for Scholars, a friend and former participant at the Institute of Social Studies, The Netherlands), Faith Maina, OSWEGO State University of New York, Beth Maina, Skaraborg Institute Sweden. Further appreciation is extended to Prof. James Sengendo and Dr Paul Wako, Bukuluki Makerere University, for their good team work in implementing the project and their invaluable ideas. We thank Dr Meghna Guhathakurta for leading the review process for the author of this paper. Should you have comments/reactions you wish to share, please bring them to the interactive portion of our website: http://arj.sagepub.com.

References Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall. Bandura, A. (1991). Self regulation motivation through anticipatory and selfregulatory mechanisms. In R.A. Dienstbier (Ed.), Perspectives on motivation: Nebraska symposium on motivation (Vol. 38, pp. 69–164). Lincoln: University of Nebraska Press. Bandura, A. (1994). Social cognitive theory and exercise of control over HIV infection. In R.J. DiClemente & J. L. Peterson (Eds.), Preventing AIDS theories and methods of behavioural interventions (pp. 25–59). New York and London: Plenum Press. Becker, M. H., & Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78(4), 394–410. Bernett, T., & Whiteside, A. (2003). AIDS in the twenty first century. Disease and globalization. New York: Palgrave Macmillan. Bryman, A. (1988). Quantity and quality in social research. London: Unwin Hyman. Canadian Rural Partnerships (2002). Community Dialogue toolkit. Retrieved 15 March 2003 from: http://www.rural.gc.ca/dialogue/tool/toolcontent_e.phtml#1 (last modified 2002), Government of Canada. Casale, M., & Whiteside, A. (2006). The Impact of HIV/AIDS on poverty, inequality and economic growth. IDRC working papers on globalization, poverty and inequality, paper no. 3, International Development Research Center, Ottawa, Canada. Cooperrider, D. L., & Whitney, D. (1999). Appreciative inquiry. San Francisco, CA: Barrett-Koehler Communications. Denzin, N. K., & Lincoln, Y. S. (Eds.) (1994). Handbook of qualitative research. Thousand Oaks, CA: SAGE. Fishbein, M., & Azjen, I. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall. Gergen, K. J. (1985). The social construction movement in modern psychology. American Psychologist, 40, 266–75. Gergen, K. J., & Gergen, M. M. (1991). Toward reflexive methodologies. In F. Steier (Ed.), Research and reflexivity (pp. 76–95). Newbury Park, CA: SAGE.

Walakira Reflective learning in action research • 69 Holden, S. (2003). AIDS on the agenda: Adapting development and humanitarian programmes to meet the challenge of HIV/AIDS. Oxford: Oxfam, Action Aid and Save the Children UK. Klein, C., Eastern, D., & Parker, R. (2002). Structural barriers and facilitators in HIV prevention: A review of international research. In A. O’Leary (Ed.), Beyond condoms. Alternative approaches to HIV prevention (pp. 17–46). New York: Kluwer Academic/Plenum. Ministry of Health (MoH) (1997). HIV/ AIDS surveillance report 1997, STD/AIDS control programme. Kampala: Ministry of Health, Republic of Uganda. Ministry of Health & ORC Macro (2006). Uganda HIV/AIDS sero-behavioral survey 2004–2005. Calverton, MD: Ministry of Health (Uganda) and ORC Macro. Neema, S., & Bataringaya, D. (2000). Research on adolescents’ sexual and reproductive health in Uganda. Kampala: Africa Alive. New Vision (2006, 11 October). Museveni warns against new infections, by Alfred Wasike. New Vision, 21(243), 11. Parker, W. (2004). Rethinking conceptual approaches to behaviour change: The importance of context. Communicating AIDS Needs Project (CAN), Center for AIDS Development, Research and Evaluation, South Africa. Sengendo, J., Bukuluki, P., & Walakira, E. J. (2001). A cultural approach to HIV/AIDS prevention and care. UNESCO/UNAIDS Research Project, Studies and Reports, Special Series, Issue No. 15. Division of Cultural Policies. Paris: UNESCO. Sengendo, J., Walakira, E. J., & Bukuluki, P. (2006). Participatory action methodologies and community dialogue as tools for HIV and AIDS prevention. In A. M. Pertet (Ed.), Rethinking research and intervention approaches that aim at preventing HIV infection among youth (pp. 17–21). Nairobi: The Regal Press Kenya Ltd and Social Science and Medicine Africa Network (SOMA-net). Uganda Bureau of Statistics (UBOS) (2005). The 2002 Uganda Population and Housing Census main report. Entebbe: Uganda Bureau of Statistics, Republic of Uganda. United Nations Joint AIDS Programme (UNAIDS) (2005). Uganda. Retrieved 29 April 2005 from: http://www.unaids.org/EN/Geographical+Area/by region/subsaharan+Africa.asp. United Nations Development Programme (UNDP) (2002). Uganda human development report: The challenge of HIV/AIDS: Maintaining the momentum of success. Kampala: United Nations Development Programme. United Nations Children Fund (UNICEF) (2004). Community Dialogue field manual. Kampala: United Nations Children Fund. Walakira, E. J. (2002a). Worst forms of child labour: An investigation into commercial and sex exploitation of children in Uganda. MAWAZO, pp. 46–55. Walakira, E. J. (2002b). Baseline survey for young people’s sexual and reproductive health needs in Kayunga District. The World Population Foundation (WPFThe Netherlands) and The Teenage Health and Education Center (THECUganda). Walakira, E. J., Bukuluki, P., & Sengendo, J. (2006). The untapped knowledge in condom promotion: A case of young people in Uganda. In A. M. Pertet (Ed.), Rethinking research and intervention approaches that aim at preventing HIV infection among youth (pp. 73–80). Nairobi: The Regal Press Kenya Ltd and Social Science and Medicine Africa Network (SOMA-net). Wright, S., & Nelson, N. (1995) Participatory research and participant observation: Two incompatible approaches. In N. Nelson & S. Wright (Eds.), Power and

70 • Action Research 8(1) participatory development (pp. 43–59). London: Intermediate Technology Publications.

Eddy Joshua Walakira lectures in the Faculty of Social Sciences, Makerere University. He holds a PhD in Social and Cultural Anthropology from the University of Vienna, a Masters of Arts in Development Studies and a Post Graduate Diploma in Children, Youth and Development from Erasmus Institute of Social Studies (ISS), Netherlands. His research interests are in the area of children and youth. He has offered advisory services on issues of children in countries including Uganda, Rwanda, Kenya and Ethiopia. Address: Makerere University, Faculty of Social Sciences (SWSA Department) P.O. Box 7062, Kampala, Uganda. [Email: [email protected]. ac.ug, [email protected]]