The potential of creative research methods for health systems research in fragile and conflict-affected settings

What if play, curiosity, mess, mayhem and art led the process of academic enquiry? How can we mitigate the extractive nature of our work and create an environment where we moved from research subjects to subject knowers? How can we work in concert with our colleagues in the creative sector to harness their unique and aesthetically punchy way of capturing the world in all its complexity?

These were some of the questions that led Kate Hawkins, Rouham Yamout, Shahreen Chowdhury, Shrutika Murthy, Thazin La, Katy Davis to engage with the International Conference on Creative Methods, which took place in Manchester last week.

Why were we there?

We are all members of the Thematic Working Group on Fragile and Conflict-Affected States, with many years of experience of research in multiple countries on a multitude of projects. What brings us together is the desire to explore new ways of generating evidence which excites, includes and incites.

Our session at the conference covered our work on:

• Animation and colouring books to support disability-inclusion in Myanmar’s health system
  • Link to YouTube presentation on the inclusion of disabled people into the health system in Myanmar (and an animation and colouring book)
• Photo essays with waste workers in India
  • Link to YouTube presentation, Walking with Suvartha by Shrutika Murthy
• Photovoice and artistic methods to work with co-researchers with disabilities in Bangladesh and Liberia
• Documentary film making with Syrian refugee health workers in Lebanon

What did we learn?

The conference is a treat for the brain and the body, with many lively sessions which encouraged us to practice the methods under discussion. Some of the highlights were:

• A session by Sarah Campbell, Robyn Dowlen, Rebecka Fleetwood-Smith and Helen Manchester that prompted reflection on CAREful creative methods, where we created our own collage on the experiences and challenges of doing careful research as an ethical practice. Our collage reflected on the constraints of time, editing and knowing when to stop but also the importance of connections and feminist solidarity.
• The opening plenary, If Global Health Is Broken, Anti-Colonial Creative Justice Might Be the Only Cure, began with acknowledging the devasting floods in Nepal and opened with a beautiful and moving sound healing prayer led by Abhishek Chitrakar.  Ranjita Dhital’s work in Nepal challenged Eurocentric and North American funding and knowledge structures and invited us to ask: what knowledge, perspectives and possibilities have we been missing? It was exciting to see the myriad of methods and mediums used, demonstrating the possibilities of bringing together music, food, clay, photography, film and festival.
• What can fish tell us about co-production? Helen Berry’s session on researching with artist illustrations began with a playful activity where we explored what illustrations of fish could reveal about co-production, examining the types, size and placements of fish and their meanings. It offered food for thought about slower knowledge production, participant agency and multimodal approaches to data analysis. Both this session and Julie Kane’s zine-making workshop invited us to play and create. We loved hearing how zine-making had fostered a sense of belonging among young people and reflecting on the punk and political roots of zines.
• One presentation that particularly stayed with us was Alistair Roy’s reframing of knowledge production in health research. He used the metaphor of ‘crossing a river’ to challenge the idea that those who have experienced mental ill-health and sought support for it have somehow crossed over to the other side, arriving at a definitive understanding of the ‘solution’ to good mental health is. Instead, Roy argued that we are all on the side of the river, navigating changing circumstances and experiences, “we do not swim in the same river twice”. For us, this became a powerful reminder that lived experience does not necessarily confer a fixed or universal form of expertise. We were also left to reflect about the extractive potential of research, where subjects of research are often made into objects of research, when experiences are documented within academic frameworks. The question, then, is not simply about the methods we used to investigate a research enquiry, but how do we conduct the process of knowing and knowledge production. This is why we found Roy’s call for understanding creative methods as an energy, and not merely tools, so compelling. Creative methods bring a different energy to the research process. It is not something that is just added to research to make it more engaging and interactive, but it can fundamentally alter the relationships between researchers, interlocuters, and meaning making itself.
• Remaining authentic and taking inclusivity to another level. Through poetry and storytelling, Jo Strang shared her journey through her PhD and challenged us to move beyond black and white academic text while remaining authentic in our work.  Rebecca Ellis’s session on offering and incorporating creative methods within a study on autistic reproductive health was inspiring through its emphasis on offering creative methods; there was so much to learn from the study’s inclusive, neuro-affirming approach and the reflections on bringing a study to a meaningful close.

Why this matters for health systems research in fragile and conflict-affected settings

As we argued in the European HSG Pre-Conference presentation we believe that creative methods deepen understanding, encourage participation and co-creation, and even shift the conceptual frameworks of researchers themselves. Collage, in particular, can offer opportunities to present testimonies of those living through crisis in non-verbal ways that challenge dominant narratives, and to facilitate the layering of perspectives, practically and metaphorically.  The conference pushed this thinking further, challenging what evidence and knowledge can look like and showing how creative approaches can make space for joy, play and belonging, but also the need for this to be trauma informed.

Creative methods should be integrated and legitimised within existing research systems - in an endeavour to foster plurality in how evidence and impact are defined and measured. We are delighted that the Thematic Working Group has supported us in this work. We hope we can connect with you to continue to build this work across settings and issues.

Building on the ideas explored in this blog, the Collage Collective Exhibition at #HSR2026 will showcase how collage can be used to surface diverse perspectives, challenge dominant narratives and foster dialogue around pressing health systems challenges.

Want to explore these ideas further? Browse our interactive zine on the Collage Collective Exhibition, which uses collage to reflect on the impacts of aid cuts on health systems research and brings together diverse perspectives through a creative and collaborative process. Or read more about the exhibition on the HSR2026 website.