‘Water is life’: developing community participation for clean water in rural South Africa
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Date
2019-06-11Author
Hove, Jennifer
D'Ambruoso, Lucia
Mabetha, Denny
van der Merwe, Maria
Byass, Peter
Kahn, Kathleen
Khosa, Sonto
Witter, Sophie
Twine, Rhian
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Hove, J., D’Ambruoso, L., Mabetha, D., Van Der Merwe, M., Byass, P., Kahn, K., Khosa, S., Witter, S. and Twine, R. (2019) ‘“Water is life”: developing community participation for clean water in rural South Africa’, BMJ Global Health, 4(3), p. e001377. Available at: https://doi.org/10.1136/bmjgh-2018-001377.
Abstract
Background South Africa is a semiarid country where 5
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
there are existing community assemblies to support this.
Health and Socio-Demographic Surveillance Systems provide
important opportunities to routinely connect communities
to resource management and service delivery. Developing
learning platforms with government and non-government
organisations may offer a means to enable more effective
public participation in decentralised water governance.