“Water is life”: developing community participation for clean water in rural South Africa

Jennifer Hove, Lucia D'Ambruoso (Corresponding Author), Denny Mabetha, Maria Van Der Merwe, Peter Byass, Kathleen Kahn, Sonto Khoza, Sophie Witter, Rhian Twine, Verbal Autopsy with Participatory Action Research

Research output: Contribution to journal › Article

1 Citation (Scopus)
1 Downloads (Pure)

Abstract

Background: South Africa is a semi-arid country where five million people, mainly in rural areas, lack access to water. Despite legislative and policy commitments to the right to water, cooperative governance and public participation, many authorities lack the means to engage with and respond to community needs. The objectives were to develop local knowledge on health priorities in a rural province as part of a programme developing community evidence for policy and planning. Methods: We engaged 24 participants across three villages in the Agincourt Health and Socio-Demographic Surveillance System and codesigned the study. This paper reports on lack of clean, safe water, which was nominated in one village (n=8 participants) and in which women of reproductive age were nominated as a group whose voices are excluded from attention to the issue. On this basis, additional participants were recruited (n=8). We then held a series of consensus-building workshops to develop accounts of the problem and actions to address it using Photovoice to document lived realities. Thematic analysis of narrative and visual data was performed. Results: Repeated and prolonged periods when piped water is unavailable were reported, as was unreliable infrastructure, inadequate service delivery, empty reservoirs, and poor supply exacerbated by droughts. Interconnected social, behavioural and health impacts were documented combined with lack of understanding, cooperation and trust between communities and authorities. There was unanimity among participants for taps in houses as an overarching goal, and strategies to build an evidence base for planning and advocacy were developed. Conclusion: In this setting, there is willingness among community stakeholders to improve water security and existing community assemblies to support this. HDSSs provide important opportunities to routinely connect communities to resource management and service delivery. Developing learning platforms with Government and non-government organisations can enable more effective public participation in decentralised water governance.
Original languageEnglish
Article numbere001377
JournalBMJ Global Health
Volume4
Issue number3
Early online date11 Jun 2019
DOIs
Publication statusPublished - Jun 2019

Fingerprint

South Africa
Water
Consensus Development Conferences
Health Priorities
Droughts
Health
Community Participation
Demography
Learning
Organizations

Keywords

  • South Africa
  • participatory action research
  • photovoice
  • rural
  • water

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy

Cite this

Hove, J., D'Ambruoso, L., Mabetha, D., Van Der Merwe, M., Byass, P., Kahn, K., ... Verbal Autopsy with Participatory Action Research (2019). “Water is life”: developing community participation for clean water in rural South Africa . BMJ Global Health, 4(3), [e001377]. https://doi.org/10.1136/bmjgh-2018-001377

“Water is life” : developing community participation for clean water in rural South Africa . / Hove, Jennifer; D'Ambruoso, Lucia (Corresponding Author); Mabetha, Denny ; Van Der Merwe, Maria; Byass, Peter; Kahn, Kathleen ; Khoza, Sonto; Witter, Sophie; Twine, Rhian; Verbal Autopsy with Participatory Action Research.

In: BMJ Global Health, Vol. 4, No. 3, e001377, 06.2019.

Research output: Contribution to journal › Article

Hove, J, D'Ambruoso, L, Mabetha, D, Van Der Merwe, M, Byass, P, Kahn, K, Khoza, S, Witter, S, Twine, R & Verbal Autopsy with Participatory Action Research 2019, '“Water is life”: developing community participation for clean water in rural South Africa ', BMJ Global Health, vol. 4, no. 3, e001377. https://doi.org/10.1136/bmjgh-2018-001377
Hove J, D'Ambruoso L, Mabetha D, Van Der Merwe M, Byass P, Kahn K et al. “Water is life”: developing community participation for clean water in rural South Africa . BMJ Global Health. 2019 Jun;4(3). e001377. https://doi.org/10.1136/bmjgh-2018-001377
Hove, Jennifer ; D'Ambruoso, Lucia ; Mabetha, Denny ; Van Der Merwe, Maria ; Byass, Peter ; Kahn, Kathleen ; Khoza, Sonto ; Witter, Sophie ; Twine, Rhian ; Verbal Autopsy with Participatory Action Research. / “Water is life” : developing community participation for clean water in rural South Africa . In: BMJ Global Health. 2019 ; Vol. 4, No. 3.
@article{9c53b7ef7cac4acaada889147ddb86f4,
title = "“Water is life”: developing community participation for clean water in rural South Africa",
abstract = "Background: South Africa is a semi-arid country where five million people, mainly in rural areas, lack access to water. Despite legislative and policy commitments to the right to water, cooperative governance and public participation, many authorities lack the means to engage with and respond to community needs. The objectives were to develop local knowledge on health priorities in a rural province as part of a programme developing community evidence for policy and planning. Methods: We engaged 24 participants across three villages in the Agincourt Health and Socio-Demographic Surveillance System and codesigned the study. This paper reports on lack of clean, safe water, which was nominated in one village (n=8 participants) and in which women of reproductive age were nominated as a group whose voices are excluded from attention to the issue. On this basis, additional participants were recruited (n=8). We then held a series of consensus-building workshops to develop accounts of the problem and actions to address it using Photovoice to document lived realities. Thematic analysis of narrative and visual data was performed. Results: Repeated and prolonged periods when piped water is unavailable were reported, as was unreliable infrastructure, inadequate service delivery, empty reservoirs, and poor supply exacerbated by droughts. Interconnected social, behavioural and health impacts were documented combined with lack of understanding, cooperation and trust between communities and authorities. There was unanimity among participants for taps in houses as an overarching goal, and strategies to build an evidence base for planning and advocacy were developed. Conclusion: In this setting, there is willingness among community stakeholders to improve water security and existing community assemblies to support this. HDSSs provide important opportunities to routinely connect communities to resource management and service delivery. Developing learning platforms with Government and non-government organisations can enable more effective public participation in decentralised water governance.",
keywords = "South Africa, participatory action research, photovoice, rural, water",
author = "Jennifer Hove and Lucia D'Ambruoso and Denny Mabetha and {Van Der Merwe}, Maria and Peter Byass and Kathleen Kahn and Sonto Khoza and Sophie Witter and Rhian Twine and {Verbal Autopsy with Participatory Action Research}",
note = "Acknowledgements We thank the study participants for agreeing to be part of the process, sharing their time and perspectives, and the VAPAR staff of the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt). We also thank the three peer reviewers for the insightful comments which helped improveimproved the paper. Permissions have been secured for the reproduction of all images. Funding This study was funded by the Health Systems Research Initiative from Department for International Development (DFID)/Medical Research Council (MRC)/Welcome Trust/Economic and Social Research Council (ESRC) (MR/N005597/1 and MR/P014844/1). This work was nested within the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), supported by the University of the Witwatersrand and Medical Research Council, South Africa. The content is solely the responsibility of the authors.",
year = "2019",
month = "6",
doi = "10.1136/bmjgh-2018-001377",
language = "English",
volume = "4",
journal = "BMJ Global Health",
issn = "2059-7908",
publisher = "BMJ Publishing",
number = "3",

}

TY - JOUR

T1 - “Water is life”

T2 - developing community participation for clean water in rural South Africa

AU - Hove, Jennifer

AU - D'Ambruoso, Lucia

AU - Mabetha, Denny

AU - Van Der Merwe, Maria

AU - Byass, Peter

AU - Kahn, Kathleen

AU - Khoza, Sonto

AU - Witter, Sophie

AU - Twine, Rhian

AU - Verbal Autopsy with Participatory Action Research

N1 - Acknowledgements We thank the study participants for agreeing to be part of the process, sharing their time and perspectives, and the VAPAR staff of the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt). We also thank the three peer reviewers for the insightful comments which helped improveimproved the paper. Permissions have been secured for the reproduction of all images. Funding This study was funded by the Health Systems Research Initiative from Department for International Development (DFID)/Medical Research Council (MRC)/Welcome Trust/Economic and Social Research Council (ESRC) (MR/N005597/1 and MR/P014844/1). This work was nested within the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), supported by the University of the Witwatersrand and Medical Research Council, South Africa. The content is solely the responsibility of the authors.

PY - 2019/6

Y1 - 2019/6

N2 - Background: South Africa is a semi-arid country where five million people, mainly in rural areas, lack access to water. Despite legislative and policy commitments to the right to water, cooperative governance and public participation, many authorities lack the means to engage with and respond to community needs. The objectives were to develop local knowledge on health priorities in a rural province as part of a programme developing community evidence for policy and planning. Methods: We engaged 24 participants across three villages in the Agincourt Health and Socio-Demographic Surveillance System and codesigned the study. This paper reports on lack of clean, safe water, which was nominated in one village (n=8 participants) and in which women of reproductive age were nominated as a group whose voices are excluded from attention to the issue. On this basis, additional participants were recruited (n=8). We then held a series of consensus-building workshops to develop accounts of the problem and actions to address it using Photovoice to document lived realities. Thematic analysis of narrative and visual data was performed. Results: Repeated and prolonged periods when piped water is unavailable were reported, as was unreliable infrastructure, inadequate service delivery, empty reservoirs, and poor supply exacerbated by droughts. Interconnected social, behavioural and health impacts were documented combined with lack of understanding, cooperation and trust between communities and authorities. There was unanimity among participants for taps in houses as an overarching goal, and strategies to build an evidence base for planning and advocacy were developed. Conclusion: In this setting, there is willingness among community stakeholders to improve water security and existing community assemblies to support this. HDSSs provide important opportunities to routinely connect communities to resource management and service delivery. Developing learning platforms with Government and non-government organisations can enable more effective public participation in decentralised water governance.

AB - Background: South Africa is a semi-arid country where five million people, mainly in rural areas, lack access to water. Despite legislative and policy commitments to the right to water, cooperative governance and public participation, many authorities lack the means to engage with and respond to community needs. The objectives were to develop local knowledge on health priorities in a rural province as part of a programme developing community evidence for policy and planning. Methods: We engaged 24 participants across three villages in the Agincourt Health and Socio-Demographic Surveillance System and codesigned the study. This paper reports on lack of clean, safe water, which was nominated in one village (n=8 participants) and in which women of reproductive age were nominated as a group whose voices are excluded from attention to the issue. On this basis, additional participants were recruited (n=8). We then held a series of consensus-building workshops to develop accounts of the problem and actions to address it using Photovoice to document lived realities. Thematic analysis of narrative and visual data was performed. Results: Repeated and prolonged periods when piped water is unavailable were reported, as was unreliable infrastructure, inadequate service delivery, empty reservoirs, and poor supply exacerbated by droughts. Interconnected social, behavioural and health impacts were documented combined with lack of understanding, cooperation and trust between communities and authorities. There was unanimity among participants for taps in houses as an overarching goal, and strategies to build an evidence base for planning and advocacy were developed. Conclusion: In this setting, there is willingness among community stakeholders to improve water security and existing community assemblies to support this. HDSSs provide important opportunities to routinely connect communities to resource management and service delivery. Developing learning platforms with Government and non-government organisations can enable more effective public participation in decentralised water governance.

KW - South Africa

KW - participatory action research

KW - photovoice

KW - rural

KW - water

UR - http://www.scopus.com/inward/record.url?scp=85067238851&partnerID=8YFLogxK

UR - https://abdn.pure.elsevier.com/en/en/researchoutput/water-is-life(9c53b7ef-7cac-4aca-ada8-89147ddb86f4).html

UR - http://www.mendeley.com/research/water-life-developing-community-participation-clean-water-rural-south-africa

U2 - 10.1136/bmjgh-2018-001377

DO - 10.1136/bmjgh-2018-001377

M3 - Article

C2 - 31263583

VL - 4

JO - BMJ Global Health

JF - BMJ Global Health

SN - 2059-7908

IS - 3

M1 - e001377

ER -

Access to Document

  • Water is life

    Copyright information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

    Final published version, 2.75 MBLicence: CC BY