Building Partnership: A Descriptive Analysis of Appreciative Inquiry as a Community-Centric Approach to Public Health Challenges in Rural Limpopo Province

Monday, 22 July 2013

Anita Thompson Heisterman, MSN, RN, PMHCNS, BC, PMHNP, BC
School of Nursing, Department of Family, Community, Mental Health Systems, University of Virginia, Charlottesville, VA

Learning Objective 1: The learner will be able to discuss Appreciative Inquiry as a viable public health nursing method to build partnership and improve health outcomes

Learning Objective 2: The learner will be able to describe the outcomes of the Appreciative Inquiry project implemented in a rural village in South Africa.


An investigation was conducted to determine if an Appreciative Inquiry (AI) approach to community needs assessment would enhance participation and capacity to manage limited water and health resources in partner villages. The project was part of the Water and Health in Limpopo (WHIL) partnership, a multidisciplinary sustained effort to improve water quality and health outcomes of people of Limpopo Province, South Africa.  Each year faculty- student teams from an American and a South African University collaborate on mutually determined projects. Continuing assessment of stakeholder’s needs and priorities is an essential component of sustaining the partnership.


Appreciative Inquiry is a method of assessing community focused on the strengths of a community and based on observations that people create shared  environments, systems and beliefs together. Shared positive images result in creative and constructive outcomes.  Using the AI process, discussion questions  were developed to foster discovery of community strengths, share dreams of the   ideal village and design the envisioned community.  Nine self selected groups of villagers met with facilitators from the core AI student-faculty team. Field notes were taken during the group sessions to capture information. Each group identified 3 priority projects, then met to share outcomes, reach consensus and make plans.  Group spokespersons were asked to complete a 2 question survey regarding if they felt listened to and more confident about implementing projects. Additional comments were encouraged.


 The AI process highlighted capacity and fostered shared solutions to water and health challenges as evidenced by level of participation, number of projects identified and ability to reach consensus and formulate plans. All nine group  leaders felt listened to and seven of nine had increased confidence in capacity for implementation and all provided comments.


 Appreciative Inquiry may be a viable method in public health nursing to recognize community capacity, build partnership and implement shared solutions to health challenges