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Changing Policy & Practice Award

Building bridges – institutionalising practical solutions for community participation in rural South Africa through primary health care policy and practice engagement

Community participation is recognised as a key, enabling mechanism to achieve ‘health for all’. Knowledge of how to operationalise the concept is limited, however. Based in rural South Africa, the Verbal Autopsy with Participatory Action Research (VAPAR www.vapar.org) project has developed an intervention supporting Community Health Workers (CHWs) to build competencies in community mobilisation. We have trained over 100 CHWs in a rural sub-district (population 500,000), improving functionality and capacity for local decision-making. We now plan to respond to demand from the provincial health authority to adapt the intervention for implementation across the province (population 4.4 million). In South Africa, the health system faces many challenges: entrenched health inequalities, resource shortages, and multiple health crises. CHW roles are crucial but hindered by inadequate training and support. Our intervention has been rigorously developed and tested responding to local needs and priorities, and is endorsed by health officials. We now seek to expand its application, building on its success in improving CHW capabilities and connecting them with communities to better understand and address health disparities. We plan to embed practical solutions for community participation across practice settings, and share learning at provincial and national levels to facilitate policy and strategy commitments to participation in health.

Supported by the Medical Research Foundation (MRF) 2024-25

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EHLANZENI

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NKANGALA

GERT SIBANDE

Coming soon

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COMMUNITY HEALTH WORKER TRAINING IN COMMUNITY MOBILIZATION

November 2022

“The training taught me ways of identifying challenges and addressing them, I understand challenges better than I used to. I'm confident that now I know even how to identify people who can assist us in dealing with various issues” (CHW, Bushbickridge sub district)

This manual contains a set of tools that can be used by Community Health Workers (CHWs) who are working in their designated area as part of Ward Based Primary Healthcare Outreach Teams (WBPHCBOTs). The manual aims to assist CHWs to convene community stakeholder groups, to raise and/or respond to priority health concerns, to understand the nature of the concerns from different perspectives in the community and to start a discussion on and facilitate and monitor action that can be taken in communities and in the health systems and public services more widely. 

Manual in siTsonga                     Manual in English

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MPUMALANGA PROVINCIAL HEALTH ETHICS RESEARCH COMMMITTEE

August 2022 and August 2024

This 2-day training programme was develoepd with VAPAR and the Committee with 4 main intended learning outcomes, to: (1) Describe basic research methodology and design; (2) Understand ethical principles, standards and criteria for ethical review and evaluation of research; (3) Critically reflect on research governance (structures and processes) and monitoring research conduct; and (4) Appreciate the decolonisation imperative in global health research

Module 1: Health research and Ethical Principles

Module 2: Norms, standards and criteria

Module 3: Research governance, RECs

Module 4: Contemporary issues

Module 5: Monitoring Research Conduct

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POSTGRADUATE TEACHING AND RESEARCH

Exceptional Achievements

We work extensively in postgraduate teaching and research. Since 2013/14 we have hosted students from India, Nigeria, Ghana, Zimbabwe, UK, Germany, Norway and Palestine. We also continue to work with many of our graduates as they extend their professional roles, often in connected research and practice settings. We also deliver a postgraduate taught course in health policy and systems research (HPSR), participatory methods and verbal autopsy at Universities of the Witwatersrand and Aberdeen

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VOICE NEEDS TEETH TO HAVE BITE! Strengthening social accountability in health systems through participatory learning and action

OVERVIEW: Drawing on political scientist Johnathan Fox’s work on citizen voice, these introductory videos seek to build understanding of and skills in approaches to strategically advance social accountability in health systems. We explore embedding participatory and cooperative learning and action in health systems to improve care and outcomes, and progress broader shifts towards ‘state-society synergies’. 

VIDEOS 

Part 1: Overview of theory and method, participatory approaches to strategically advance collective agency and accountability in health systems. | Denny Mabetha

Part 2: Key processes for participatory learning and action, building social accountability in health systems​ | Nombuyiselo Nkalanga

Part 3: PAR data: analysing and reporting the evidence for further action | Maria van der Merwe

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