Reflections on Developing and Implementing a Participatory Learning and Action Intervention Addressing Diabetes in Ghana

Abstract Ghana is a country facing a rapid increase in type 2 diabetes (T2D), yet resources are stretched and addressing the causes and consequences of T2D on individuals and communities is challenging. Participatory Learning and Action (PLA) is a community intervention that can improve health following a cycle of identifying problems with communities, planning and implementing solutions to address the problems, and reflecting on them. This approach has proved effective in addressing T2D and other health outcomes in low resource settings. This paper reflects and reports on the development and pilot implementation of PLA to address T2D in a poor urban area of Accra (Ga Mashie), from the perspective of the research team. Drawing on discussions, research notes and team meetings, we report on the process of the intervention development and implementation, challenges, lessons learned and the extent of participation. PLA proved feasible and popular. We (the research group) worked closely with community members through a community advisory group and workshops. Problems identified included low knowledge of risk behaviours and structural factors. Solutions implemented were a series of community events focusing on knowledge and raising awareness. Challenges included: time constraints, logistical difficulties, ensuring decisions were not over-influenced by researchers and sustainability. Our findings indicate that the successful implementation of interventions requires careful organisation, reflection throughout and needs to be built on genuine trusting relationships. The insights gained from this study offer valuable lessons on how PLA may be implemented and considerations needed for similar settings.