The role of community engagement and involvement for community empowerment in health settings: the case of Ingwavuma community, KwaZulu-Natal, South Africa.

Abstract

Community Engagement (CE) in health research can improve a community's ability to address its own health needs and health inequalities, while ensuring that researchers understand community priorities. However, if effective CE processes are not used, communities will not be empowered to make effective decisions about their own health and wellbeing. This study is based on community-based health research projects; the Malaria and Bilharzia in South Africa (MABISA) and Tackling Infections Disease Burden in Africa-South Africa (TIBA-SA) implemented by the KwaZulu-Natal Ecohealth Program (KEP). I evaluated CE processes and outcomes, with a focus on schistosomiasis and malaria in a rural community of Ingwavuma, uMkhanyakude district in KwaZulu-Natal. The research approach was both qualitative and quantitative (mixed methods) with data collected through 34 in-depth interviews, 4 focus group discussions and 338 household questionnaires. Data was collected from heads of households, community advisory board members, community research assistants, primary school principal and KEP research team (including the project principal investigator and administrators). Data was collected in line with the five-stages of Community Engagement Vancouver Coastal Health framework. Data was analysed using QSR International Pty Ltd, NVivo 12 Pro and Chi-square tests were performed to assess associations between demographic variables and respondents’ knowledge and information of projects. The Principal Investigators informed the community about the project through community leaders (headmen) before the project commencement. As community members were involved at every stage of the process, from conceptualisation to dissemination, the study provided empirical evidence that collaborative partnerships lead to win-win outcomes. Involving headmen (indunas), CAB members, and CRAs in the project ensured shared goals, reciprocity, and mutual benefit, demonstrating the project's intention to help the community. Nearly half (48%) of the surveyed community members had never heard of MABISA. Ninety-four percent (94%) and ninety-seven percent (97%) of respondents had heard of bilharzia and malaria. Nearly the same proportions knew how both diseases are transmitted, thus demonstrating empowerment of community members on schistosomiasis and malaria issues. This study contributed to the understanding of best practices for community empowerment. The study provided information on how communities can positively influence their lives and manage their health problems. Such information can be extracted from the thesis and presented in vernacular language from the area. Furthermore, the thesis provided information of empowering researchers on how they can empower communities through effective engagement. Policy briefs that can be generated from the thesis provided useful information on community empowerment to policymakers and other stakeholders.