RESEARCH WITH SOCIAL MISSION
Raising Rural Voices: Creating a Lasting Impact in People’s Lives
VAPAR Mpumalanga Health Policy and Systems Research Learning Platform inspires action, serves donors and supports communities. We’re driven by a firm belief in the power of evidence and partnerships. Supported by the Medical Research Council in the UK, we provide long-term solutions and benefits for those otherwise excluded from equietable evidence-informed public services.
"There have been a lot of service delivery protests in communities, but they did not accomplish much; everyone realized that it is time to shift our ways of thinking and initiate dialogue, unite and collaborate and create sustainable partnerships to solve community problems" [Community stakeholder]
Our Learning Platform addresses exclusion from access to health systems by connecting service users and providers to generate and act on research evidence of practical, local relevance.
The platform has been developed through the research programme VAPAR (Verbal Autopsy with Participatory Action Research) progressed by the MRC/Wits Agincourt Rural Health and Health Transitions Research Unit. MRC Wits/Agincourt hosts the Health and Socio-demographic Surveillance System (HDSS) within which we develop health statistics, using verbal autopsy, and work with local communities to expand local knowledge on health priorities. Our Platform connects two issues:
lack of research evidence on the health needs of those excluded from access to health and information systems, and
lack of uptake of evidence by the authorities: health service planners, managers, policy makers and providers at different levels.
Our platform creates a space through research that we employ to connect people and services in a mutually supportive learning-and-action engagement. The process combines longitudinal data with narratives and visual images, generating analysis and interpretations of practical relevance in communities and health systems.
The work is based on the premise that health policy is enacted at many levels and among many actors, and that harnessing implementation at multiple levels can effect change (Gilson, 2003). The work is intended to have impacts on services through an inclusive and adaptive knowledge partnerships process strengthening health systems to achieve health equity gains. Our objectives are as follows:
- Develop inclusive knowledge partnerships to strengthen health systems: conduct a series of collective reflection and action cycles to generate information on disease burdens, their social and health systems determinants, and on norms, practices and priorities for action from the perspectives of disadvantaged groups; analyse in a multi-level process of health systems engagement, develop recommendations, plan and document implementation, and reevaluate;
- Evaluate change in health, health equity and empowerment: Over three reflection and action cycles, analyse health outcomes, behaviours and service provision. Identify mechanisms through which changes do (or do not) occur in implementation. Understand impacts and whether and how these address health equity and empowerment, whether and how these relate to the use of evidence, and the influence of social and political contexts;
- Build sustainability and transferability: Promote and support the use of VAPAR in routine health systems functions to translate co-produced evidence into action. Contribute to communities of practice for collaborative research through teaching and training. Disseminate to the public, health systems stakeholders, governmental, technical and research groups. The research will engage communities and health systems actors at different levels to develop and act on co-produced evidence for health systems change.
The project will contribute to the stock of knowledge for groups excluded from the health system using people-centred methods that combine core international standards with techniques adaptable to local contexts. The process will develop systems and partnerships to generate evidence that is locally owned and embedded in the health system at different levels.