QHR Conference: Banff, Canada: 2004 The quality of sustainable development:. Evaluation at the edge of chaos Oliver Slevin University of Ulster, UK. Evaluation of a PPP healthcare project. Addresses:
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Evaluation at the edge of chaos
University of Ulster, UK
Evaluation of a PPP healthcare project
Between heart and mind … knowledge, one is warp and the other woof. It is no more important to count the sands than it is to name the stars. Therefore let both kingdoms live in peace.
We approach the problems of human psychology as humans, and it seems a pity to waste that advantage.
Midgley, M. (1981).
Heart and mind: the varieties of moral experience.
Narratives not only help to humanize aliens, strangers and scapegoats … but also to make each one of us into an ‘agent of love’ sensitive to the particular details of others’ pain and humiliation.
Rorty, R. (1991). On ethnocentrism: A reply to Clifford Geertz.
In R. Rorty, Objecivity, relativism and truth: philosophical papers, Vol. I.
New York: Cambridge University Press
TOWARDS DEVELOPMENT AID EFFICIENCY: The PPP project scapegoats … but also to make each one of us into an ‘agent of love’ sensitive to the particular details of others’ pain and humiliation.
Population characteristics are enjoined by an unfriendly environment with high levels of pollution and risks of disaster particularly from flooding.
Most of the pernicious tropical diseases (including Malaria) are endemic; AIDS is a threat and old diseases such as TB and Leprosy are on the increase.
Delivered on principles of Efficiency, Safety, Equity and Resilience (sustainability)
PPP AT START: (ESP)
A PILOT SCHEME TO DEVELOP PARTNERSHIP BETWEEN:
THE PUBLIC (HEALTH) SERVICES
PRIVATE FOR-PROFIT PROVIDERS
The PPP Project therefore developed instead as a community empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
The community would, with technical support from Nicare (the facilitating Development agency), set up its own local healthcare services best suited to its needs.
LIMITED EVALUATIVE RESEARCH empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
Evaluation overview empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
(Annexes are contained only in the full PPP Policy Review report)
SUSTAINABILITY empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
EVALUATION OUTCOMES empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
Global and national Influences empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
EXCLUDING STAKEHOLDER VOICES FROM DESIGN empowerment initiative - described within the project as a Public-Community Partnership or also as Grassroots PPP.
EXCLUDING STAKEHOLDER VOICES FROM IMPLEMENTATION
EXCLUDING STAKEHOLDER VOICES FROM EVALUATION
AN EXTENSION OF EVALUATION, IN TERMS OFTHEORYANDACTION, WAS THEREFORE REQUIRED
RELEVANT THEORETICAL UNDERPINNINGS CAN BE SEEN TO EMERGE AS DRIVING FORCES
I DRIVING FORCES
The idea of critical consciousness and community empowerment as a process of conscientization, that liberates the voice of the previously ‘unheard’.
Freire, P. (1993). Pedagogy of the oppressed. London: Penguin
II DRIVING FORCES
The idea that within each situation there are interpretive communities, each attributing meaning and with different values and goals
Yanow, D. (2000) Conducting interpretive policy analysis. Thousand Oaks, CA: Sage Publications.
III DRIVING FORCES
The idea that through dialogue , and as co-equals, differences can be acknowledged and consensuses reached
Habermas, J. (1987). The theory of communicative action. Boston: Beacon.
Adapted from Yanow (2000) DRIVING FORCES
SEEKING THE UNHEARD VOICES DRIVING FORCES
… a movement from the homophonic voice (in this case, we might term this a ‘Western’ lens) to a polyphonic voice that “orientates itself responsibly toward the words and voices of others … the extent, in short, to which it adopts otherness as a value.”
Tarulli, D. (2000). Identity and otherness.
Narrative Inquiry, 10, 1, 111-126.
Richard Kearney on stories: DRIVING FORCES
THE LISTENING GUIDE DRIVING FORCES
Plot: What is taking place in the story.
Self: How the individual as a feeling, thinking, acting ‘I’ is enclosed within the story.
Supportive others: The positive sustaining relationships with sympathetic others.
Devaluing others: The relationships that would and oppress.
Brown, L. Mikel and Gilligan, C. (1992).
Meeting at the crossroads: women’s psychology and girls’ development. New York: Ballentine Books.
MARRIED AND AT HOME IN RURAL BANGLADESH DRIVING FORCES
She is one of the ladies in one of our community schemes – she is unwell, she would call for help but cannot (Mythos)
Her husband has been purchasing douches from the male village quack. She now attends the health clinic. The health assistant diagnoses thrush and prescribes one suppository and sends her home. Her actual ‘malady’ is severe uterine prolapse (Mimesis)
We experience, from our contact with her, the magnitude of her plight (Catharsis)
It becomes clear to us that the system put in place does not address the social and cultural influences that construct such circumstances (Phronesis)
By becoming aware, there is an immediate ethical demand to respond appropriately to explore the situation, to address the quality deficit (Ethos)
Life is pregnant with stories. It is a nascent plot in search of a midwife. For inside every human being there are lots of little narratives trying to get out.
Kearney op cit. (p. 130)
Nature is not just like a book; nature itself is a book, and the manmade book its analogue. Reading the man-made book is an act of midwifery … it is an act of incarnation. Reading is a somatic, bodily act of birth attendance witnessing the sense brought forth by all things encountered by the pilgrim through the pages.
Illich, I. (1993). In the vineyard of the text. Chicago: University of Chicago Press.