Developing stakeholder participation to address lack of safe water as a community health concern in a rural province in South Africa
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Date
2021-09-20Author
Hove, Jennifer
D’Ambruoso, Lucia
Twine, Rhian
Mabetha, Denny
van der Merwe, Maria
Mtungwa, Ishmael
Khoza, Sonto
Kahn, Kathleen
Witter, Sophie
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Hove, J., D’Ambruoso, L., Twine, R., Mabetha, D., van der Merwe, M., Mtungwa, I., Khoza, S., Kahn, K. and Witter, S. (2021) ‘Developing stakeholder participation to address lack of safe water as a community health concern in a rural province in South Africa’, Global Health Action, 14(1), article no. 1973715.
Abstract
Background
Despite legislative and policy commitments to participatory water governance in South Africa, and some remarkable achievements, there has been limited progress to improve the water infrastructure servicing in marginalized rural communities. Around five million South Africans still do not have access to safe water. Objective
This paper seeks to understand and advance processes to engage multisectoral stakeholders to respond to lack of safe water as a community-nominated health priority in rural South Africa. Method
We engaged representatives from Mpumalanga Department of Health (MDoH), rural communities, other government departments and non-governmental organisations (NGOs) to cooperatively generate, interpret and act on evidence addressing community-nominated priorities. A series of participatory workshops were conducted where stakeholders worked together as co-researchers to develop shared accounts of the problem, and recommendations to address it. Consensus on the problem, mapping existing planning and policy landscapes, and initiating constructive dialogue was facilitated through group discussions in a collective learning process. Results
Community stakeholders nominated lack of safe water as a local priority public health issue and generated evidence on causes and contributors, and health and social impacts. Together with government and NGO stakeholders, this evidence was corroborated. Stakeholders developed a local action plan through consensus and feasibility appraisal. Actions committed to behavioural change and reorganization of existing services, were relevant to the needs of the local community and were developed with consideration of current policies and strategies. A positive, collective reflection was made on the process. The greatest gain reported was the development of dialogue in ‘safe spaces’ through which mutual understanding, insights into the functioning of other sectors and learning by doing were achieved. Conclusion
Our process reflected willingness and commitment among stakeholders to work together collectively addressing local water challenges. Location in an established public health observatory helped to create neutral, mediated spaces for participation.