The debate on evidence
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Although peer work is practiced all over the world,
there is an ongoing debate on the evidence that it works, especially concerning the peer-based interventions primarily aiming at behavioural change (such as peer support and peer education). Some critics say that evidence is not strong enough to support peer interventions:
Part of the debate focuses on the so-called weak evidence of peer work: whether or not it leads directly and solely to the desired results. It is true that there is no direct, 100% proof that peer work alone directly leads to better health outcomes. However, peer work is not developed to be a single tool or intervention. It is not a ‘silver bullet’ - one tool that tackles everything. That said, peer work is the best available additional tool that you’ll ever find!
“.....This appears to have been the case for much of its early development and its initial use in HIV- and drug-user education. It was a practical and intuitive response to circumstances and need, reinforced by various theories of human behaviour. Nonetheless, over the past decade concerted efforts to assess its impact have confirmed its utility, especially in the areas of HIV, hepatitis C, and sexual health education.”
“Even though there may be fundamental differences between how we and other organisations approach the subject, we must acknowledge that our practice is part of a worldwide phenomenon.”
Annie Madden in AIVL ‘A framework for peer education by drug-user organisations’
Part of the discussion may reflect ‘the collaboration gap’ between practitioners and researchers. Practitioners work on the ground, have first class information, knowledge and intuition and many operational decisions are made on ‘gut feeling’. Practitioners may not always see the benefits of evaluation processes. On the other hand, researchers coming from a traditional and different area, may have difficulties in translating their useful resources for people working at grassroots level.