Résumé de section

    • A Case Study Page

    • 🧩 Worked Example: Gibbs’ Reflective Framework - 6 Stages

      1) Description
      A one-day mobile clinic was well resourced (cold chain, staff, supplies). Many mothers stayed back, concerned about side effects and an “outsider” team. There was no prior briefing with leaders, and materials were not in the local language.

      2) Feelings
      We began confident, then felt frustrated and worried. It was surprising to see a gap between strong logistics and low turnout. We were concerned about missing chances to protect children.

      3) Evaluation
      What went well (+): Smooth logistics; safe clinical flow; some families liked the convenience.
      What didn’t (−): Low trust; language/cultural mismatch; little pre-engagement; no visible community champions on site.

      4) Analysis
      Uptake depended more on trust and relevance than on access. No co-designed messages; no leaders present; unfamiliar staff → low social proof. Local beliefs/rumours were likely unaddressed.

      5) Conclusion
      For outreach to work, relationship-building and cultural alignment must sit alongside technical delivery — not after it.

      6) Action plan (SMART)

      • T+14 days: Hold a joint briefing with religious, women’s, and youth leaders to co-design clinic flow and FAQs.
      • Before clinic: Produce local-language audio/posters with trusted figures; send radio/WhatsApp reminders.
      • On the day: Recruit two local volunteers for translation and introductions; run a 3-minute group Q&A on arrival.
      • Monitoring: Track uptake, questions asked, and satisfaction; debrief within 48 hours to adjust quickly.

      Tip: Keep a one-page Gibbs template in your PDP.

    • 🧩 Worked Example: Schön’s Reflective Framework

      1) Knowing-in-action (our default approach)
      We planned a one-day clinic with strong logistics: cold chain, staff, supplies, clear flow. Assumption was: “If access is easy, families will attend.”

      2) Surprise (the situation “talks back”)
      Mothers hung back. Concerns about side effects and “outsiders.” Posters in English weren’t landing. No prior word from leaders. Turnout stayed low.

      3) Reflection-in-action (thinking on our feet) — during
      On the day, we paused and asked: What’s going on right now and what can we try immediately?

      • Switched to simple language and short verbal FAQs.
      • Pulled a known CHW into the welcome area to greet families.
      • Offered brief private chats for worried caregivers.
      • Moved shade and seating closer to the gate to feel more inviting.

      4) On-the-spot experimentation (small tests)

      • 3-minute talks every 30 minutes addressing the top two fears.
      • A CHW translated key points for small groups.
      • Invited one mother who’d just vaccinated to share her experience (peer signal).

      Result during clinic
      Conversations improved; a few fence-sitters converted. Coverage rose slightly, but overall remained below target.

      5) Reflection-on-action (afterwards)
      The core issue wasn’t access; it was trust and recognition. Without prior leader endorsement or local-language messaging, the clinic felt like a stranger’s tent.

      6) Reframing the problem
      From “bring vaccines closer” → to “earn permission to deliver” (build social licence through trusted voices, language, timing).

      7) Next time (design for learning, not just delivery)

      • Before (T−2 weeks): Sit with village head, women’s leader, youth rep, and faith leaders. Co-design date, flow, FAQs. Record a 90-second voice note by the local nurse/leader in the local language (radio/WhatsApp).
      • Materials: Picture poster + audio FAQ in local language; test with two mothers for clarity.
      • On the day: Local nurse at the welcome table; scheduled short talks and a private consult corner.
      • Timing & access: Avoid market hours; shade, water, queue tickets.

      8) Evidence to collect (so the situation can “talk back” again)

      • Coverage (overall and by household/compound).
      • Conversion (number hesitant on arrival → vaccinated after dialogue).
      • Language reach (materials distributed/played; radio/WhatsApp plays).
      • Experience (1-question exit poll: “Was the information clear and respectful?” Yes/No).
      • Safety (follow-up within 48 hours).

      Prompt: “What am I noticing right now, and what small change can I test in the next 10 minutes?”

    • 🧩 Worked Example: Rolfe’s Reflective Framework

      What?

      • One-day mobile clinic set up at the school courtyard.
      • Logistics strong: vaccines, cold-chain, staff, clear flow.
      • Many mothers hesitated: fears about side effects; team seen as “outsiders”.
      • No prior briefing with leaders; posters and explanations mostly in English.
      • Uptake below target.

      So what?

      • The main barrier wasn’t access — it was trust, language, and recognition.
      • Without leader endorsement and local-language messaging, the clinic felt unfamiliar.
      • Health beliefs/rumours were unaddressed; families wanted a trusted local voice (e.g., nurse, imam/pastor).
      • Technical readiness alone does not drive demand; social licence matters.

      Now what?

      • Before clinic (within 2 weeks):
        • Convene village head, women’s leader, youth rep, and faith leaders. Co-design the date, venue, flow, and FAQs.
        • Produce local-language audio and pictogram posters; test with two mothers.
        • Share 90-second voice notes from a local nurse/leader via radio/WhatsApp.
      • On the day:
        • Welcome desk staffed by a known local; name badges with language.
        • 3-minute micro-huddles every 30 minutes to address top concerns.
        • Private consult corner for worried caregivers; translator on hand.
        • Avoid market hours; provide shade, water, and simple queue tickets.
      • After:
        • Track coverage, hesitant→vaccinated conversions, language reach (poster/audio), 1-question exit poll (“Was the information clear and respectful?”).
        • Debrief within 48 hours; adjust for the mop-up day.

      One-liner: “If the community didn’t help shape it, they may not show up for it.”

    • 🧩 Worked Example: Triple-Loop Learning Framework

      1) Single-loop: Are we doing things right?

      Adjust actions to fix immediate gaps.

      • Observation: Low turnout despite strong logistics.
      • Immediate tweaks (on the day):
        • Move shade/seating to the gate; add a welcome greeter.
        • Give simple verbal FAQs in plain language.
        • Offer private chats for worried caregivers; brief talks every 30 minutes.
      • Aim: Improve flow and answer fears quickly.

      Quick checks: fence-sitters converted, questions answered, shorter waiting, slight coverage lift.

      2) Double-loop: Are we doing the right things?

      Re-examine assumptions, redesign the approach.

      • Challenged assumption: “If access is easy, families will come.”
      • New design: Trust first, then delivery.
        • Pre-clinic (T−2 weeks): Meet village head, women’s leader, youth rep, faith leaders to co-design date, venue, flow, FAQs.
        • Language: Posters + audio voice notes in local language; test with two mothers.
        • Messengers: Local nurse/CHW and faith leader co-host the clinic.
        • Timing: Avoid market hours; provide childcare corner/shade; queue tickets.

      Success signals: Higher first-dose uptake, more families from distant compounds, fewer walk-aways at the gate.

      3) Triple-loop: How do we decide what is “right”?

      Examine values, governance, and power; change how we learn and decide.

      • Guiding values: Respect, co-creation, equity.
      • Governance shift:
        • Create a community advisory huddle (leaders + CHWs + women’s rep) that signs off dates, messages, and messengers.
        • Set a rule: “No clinic without community briefing.”
        • Budget time for listening sessions and translation as core inputs, not add-ons.
      • Learning culture:
        • After each clinic, run a 15-minute debrief with a local representative; share back what changed because of community input.
        • Track trust metrics alongside coverage; publish a one-page feedback note to the community.

      End-state: Decisions are made with the community, not just for the community.

      📏 Simple measures at each loop

      • Single-loop (process): wait time, number of questions answered, number of private consults, fence-sitters converted.
      • Double-loop (design fit): percentage of materials in local language distributed/played; attendance by hamlet; turnout outside market hours.
      • Triple-loop (trust/governance): leader co-sign-off recorded; number of advisory huddle meetings; exit poll “Information clear & respectful?” (Yes/No); repeat attendance next round.

      Governance prompt: “Who helps define success, and who has authority to change the plan?”