Using photovoice and action research to assess the ecological factors which impede and promote the health of children in Sierra Leone: A case study

Purpose: Sierra Leone currently has the highest child mortality rate in the world. Among those children who have the greatest chance of survival are those who have access to life's basic needs. Non-governmental organizations (NGOs) are often lifelines for millions of children because they are working to provide access to these basic needs. Few studies have worked with NGOs to identify barriers to care. The purpose of this action research study was to assess the ecological factors affecting the health of children in Sierra Leone through the lens of NGO workers.

Methods: A group of NGO child relief workers (n=10), all natives of Sierra Leone, used Photovoice to capture the ecological factors affecting health through photography. The participants then discussed their photographs in an in-depth interview with the researcher. Data analysis included an evaluation of interview transcripts using the constant-comparative method as well as over 1200 photographs to identify the significant themes that emerged.

Results: All participants identified a number of environmental threats to healthy child development, such as the country's destroyed infrastructure, overcrowding, and poor sanitation. However, the most recurrent and pressing theme was limited access to clean drinking water. An action plan to combat these challenges was discussed by the participants.

Conclusion/Recommendations: This research study serves as a case study for NGOs, health professionals, and governmental leaders. Photovoice can be used as an effective tool to mobilize communities and governments to find ways to link people in countries like Sierra Leone to the building block of life: water.