Presentation at the Global Maternal Newborn Health Conference, October 21, 2015
The use of narrative approaches has emerged in organization studies and social sciences as a powerful source of data about profound values and beliefs, serving as a source for rapid feedback for decision-makers. We adopted a narrative-as-data approach, allowing program implementers and policy-makers in the Salud Mesoamerica 2015 (SM2015) initiative to ‘make sense’ of tacit knowledge found in their stories about how they help achieve performance targets.
Methodology: During a six-month period, we collected over 2200 stories from front-line workers, local health care administrators, and policy-makers in Belize, El Salvador, Nicaragua, Costa Rica, Honduras, Panama, Chiapas, and Guatemala. Data was collected using SenseMaker, a narrative data collection tool. Based on those stories, we generated visual data at single- and multi-country-level to identify patterns from experiences and provided rapid feedback to decision-makers in charge of managing the multi-country portfolio and national programs. Reports were created and jointly analyzed in participatory workshops, involving various levels of program implementers.
Results: Seeing patterns in the story narratives helped participants learn about successes, failures, and perceived barriers to performance at organizational and community levels. The stories collected provided insights to adjust program design and interventions through joint-analysis of anonymous perceptions, concerns and experiences, allowing for meaningful discussion between program implementers about how things were working and what could be improved.
Conclusion: The insights gained by analyzing patterns in stories is relevant to the implementation of large-scale maternal and neonatal health programs because of its potential to i) Complement existing M&E designs by providing highly contextualized information about the local production of results; ii) Enhance the quality of policy-dialogue activities by reducing the distance between policy makers in central agencies and local implementers; and, iii) Improve the quality of decision-making by providing rapid, actionable feedback about front-line workers values, attitudes and opinions about implementation.