Capacity development through reflective practice and collaborative research among clinic supervisors in rural South Africa--a case study.
This article provides an example of one form of action research, collaborative enquiry, in the health sector. It argues that collaborative inquiry is a powerful tool to develop reflective capacity among health workers and can facilitate the ownership of learning and the production of usable knowledge. It reports the results of a research project investigating the roles and functions of clinic supervisors in three districts in the Eastern Cape Province, South Africa.


BACKGROUND
Clinics are the cornerstone of the new district-based health system. They are staffed primarily by nurses and are often the only contact point for large parts of the rural population. In conditions of remoteness and isolation, clinic staff depend upon personal interaction with clinic supervisors to enable them to function productively. Yet experience has shown that supervisors do not always fulfil this role. This project aimed at gaining insight into the status of clinic supervision, understanding the factors that hinder effective supervision and making recommendations for improvements.


METHODS
Using a participative approach of Collaborative Inquiry, a team of 10 clinic supervisors and the research co-ordinator collected data reflecting on their own practice over a period of 5 months. These data were then jointly analysed and written up.


CONCLUSIONS
The participating clinic supervisors went through several periods of uncertainty, when many of them asked themselves why they agreed to this project. However, the engagement with stakeholders and colleagues and the joint analysis of research data soon proved to be a valuable source of insight. There was unanimity in the end that the research process had been very valuable and enabling.
Lehmann
U
U
School of Public Health University of the Western Cape, Cape Town, South Africa. ulehmann@uwc.ac.za
Blom
W
W
Dlanjwa
M
M
Fikeni
L
L
Hewana
N
N
Madlavu
N
N
Makaula
V
V
Pennacchini
M
M
Seal
S
S
Sivuku
T
T
Snyman
K
K
D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D006285:Health Planning; D006801:Humans; D012106:Research; D013019:South Africa