Use of photovoice in health systems research: methodological considerations and experiences from Uganda.

backgroundPhotovoice is an innovative community-based participatory research methodology that uses photography to capture key issues in a local setting. In Photovoice, photographs are taken to record and reflect on community strengths and challenges, facilitate critical dialogue among participants and researchers, and reach various stakeholders to make change. Although the use of Photovoice has increased in recent years, its utilisation in health policy and systems research is still limited. MAIN BODY: In this article, we give an overview of the use of Photovoice in health systems research based on literature including methodological considerations, ethical concerns, benefits, and challenges. The Photovoice methodology is based on three theoretical underpinnings: empowerment education theory; feminism and notions of voice; and documentary photography. Photovoice provides power to the participants to share their own insights hence amplifying community voices. Adequate training of Photovoice participants is crucial including on consent for taking and use of photographs. Keeping Photovoice participants engaged throughout the research process and the time commitment required are key challenges of the methodology. The article ends by providing an illustrative example of a study that used Photovoice to explore the roles of community health workers (CHWs) from their perspective in Wakiso district, Uganda. Through Photovoice, CHWs were able to reflect on their day-to-day activities, which methodology can be used among other cadres and settings to inform practice, policy and programming.

conclusionsPhotovoice is a feasible, appropriate and empowering approach in health policy and systems research.