Research for stronger health systems during and after crisis

Using participatory visual methods to understand and support health systems with a focus on marginalized populations


Date: October 9th 2018

Session team: Kim Ozano (Liverpool School of Tropical Medicine); Sapana Bista (Liverpool John Moores University); David Musoke (Makerere University, Uganda); Kim Rosse-Houle (Liverpool John Moores University); Ayesha Idriss (College of Medicine and Allied Health Sciences, Sierra Leone); Joanna Raven (Liverpool School of Tropical Medicine)


About the session

Visual research methods are an effective way to elicit and organise local knowledge, identify priorities for action and evaluate performance of health systems, adding valuable insights, especially with marginalised populations, into health systems functioning. This session aims to build skills and create discussion on using photo elicitation and photovoice. 


Participatory visual methods:

Visual methods have the potential to provide insights into health systems functioning using a people-centred perceptive. Health systems are social institutions, whose structure and functions reflect and reinforce community values and norms of how people interact with and navigate the system. By supporting an empowerment process through participatory visual research, people can better connect with the health system to effectively communicate needs and suggest sustainable solutions to health problems. Visual methods have been shown to advance knowledge around marginalisation through documentation of people’s own worlds, discussion of key issues with policy makers and by becoming active agents for social change. Whilst there are many visual methods, this session will focus on the use of photovoice and photo elicitation.

  • Photovoice entails the use of photographic images taken by the community to capture cultural practices and social conditions. This method entrusts cameras to people who can then act as recorders, and potential catalysts for change, in their own communities, and uses the immediacy of the visual image to furnish evidence and to promote an effective, participatory means of sharing expertise and knowledge.

  • Photo elicitation can be used in conjunction with interviews, focus groups or participatory workshops to elicit comments. It involves using images such as photographs, paintings, cartoons etc. to spark discussion. Images can evoke deeper elements of human consciousness than words alone and have the potential to enhance discussion.

However, there are many challenges to using visual methods including conceptualising the study, data collection and management, required technical knowledge and quality control using equipment, legal and ethical issues, analysing and disseminating visual data.


In this session, we will draw upon the learning community of researchers who have used visual methods. They will share their experience of using visual methods in health systems research in the UK and in fragile and conflict affected contexts. Examples which will be shared include:

  • Cambodia with health workers

  • Nepal with people living with disability

  • Uganda with young people

  • Sierra Leone with health workers

  • Liverpool with homeless people

The session will start with an overview of participatory visual methods and their use in health systems, particularly with marginalised populations, and include theory and conceptualisation, participant selection and training, technical aspects, data collection and management, ethics and legal considerations, analysis and dissemination.  

The example cases will be presented, highlighting challenges and unexpected benefits that emerged from using visual methods as opposed to other research methods. Participants will then attend a series of stations to learn more on the approach and discuss further, with feedback from the groups afterwards.

Stations will cover:

  1. Technical Aspects and quality control

  2. Ethics and legal considerations

  3. Visual data collection and management

  4. Analysis and dissemination

The session will end with a discussion on how visual methods can be used to inform health policy and health systems development, including considering opportunities for an ongoing learning community.

Who is the session aimed at?

This session will be of relevance for researchers, academics, communication and research uptake specialists, students and policy makers interested in visual approaches.