Re-imagining community participation at the district level: Lessons from the DIALHS collaboration.
Cleary, S;
Schaay, N;
Botes, E;
Figlan, N;
Lehmann, U;
Gilson, L;
(2015)
Re-imagining community participation at the district level: Lessons from the DIALHS collaboration.
In: Padarath, A; King, J; English, R, (eds.)
South African Health Review 2014/15.
Health Systems Trust, Durban, pp. 151-162.
ISBN 1025-1715
https://researchonline.lshtm.ac.uk/id/eprint/2814536
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In South Africa, the value of community participation as one of the central
components of a primary health care approach is highlighted in legislation, policy
documents and strategic plans. There is widespread acceptance that community
participation strengthens community empowerment, disease prevention and access
to services.
Since 2010, the District Innovation and Action Learning for Health System Development
collaboration has co-produced knowledge about how to strengthen district
health systems. Nested within this collaboration is a series of engagements seeking
to understand and strengthen community participation including a multi-stakeholder
health risks and assets mapping activity; ‘Local Action Group’ initiatives; reflective
meetings with service colleagues about community participation experiences; and a
capacity-development initiative (community participation-related short courses and
mentoring).
These engagements hold a number of lessons for those interested in enhancing the
population orientation of primary health care and the district health system, the first
of which is the clear benefit to those interested in community roles and engagement of
convening spaces for dialogue. However, it is not easy to generate and sustain these
spaces. Through the application of a framework of collective capacity, this chapter
aims to shed light on why this is the case, and in so doing, to highlight a second
lesson, which is the perhaps unrecognised capacities of certain cadres, particularly
environmental health practitioners, in the implementation of community participation.
Ultimately, the chapter seeks to stimulate thinking and engagement about the ways in
which dialogue and participation can enrich the South African health system.