Living the Methodology: Applying a Participatory Action Research and Case Study Method in Neonatal Nursing Research in Malawi

Participatory action research (PAR) is increasingly being used in healthcare research, especially in nursing. PAR offers the opportunity to disrupt power hierarchies and produce transformative knowledge that meets the needs of the participants. Engaging in this process of democratization of knowledge production is appealing and yet, the experience is often complex and messy. Often the backstage political processes of PAR are not shared, despite the opportunity to learn from each other. In this paper, we explore the use of Freirean PAR as an epistemological and theoretical framework alongside Merriam’s case study methodology. We consider the philosophical and epistemological congruencies and departures between PAR and case study and examine its application in a research project on neonatal nursing-led research in Malawi, Africa. In this, we expose the messiness of utilizing PAR and case study methods in complex health systems and in majority world settings. The data we present in this paper is drawn from the reflexive journals of myself, the principal investigator. We suggest that PAR and case study can be used collaboratively but require critical reflexivity at each stage of the research project and the relinquishing of control in ways you do not expect. We hope the vulnerable sharing in this paper and discussion of the messiness offer methodological learning in the advancement of PAR.