Health Committees as a Vehicle for Community Participation
Health Systems Governance: Community Participation as a key strategy for realising the Right to Health
This project aims to identify opportunities for best practice in utilising community participation as a vehicle for realising health rights. The focus on developing models for community participation in health is intended to speak to strategies that advance health equity and strengthen governance systems for health. By testing approaches and sharing experience gained using rights-based approaches to health, we anticipate generating knowledge of relevance to other developing country contexts. The focus has been on identifying training needs for health committees and advocacy and networking to strengthen health committees’ voice, both locally and internationally. Strong links have been built regionally and internationally with an emphasis on building the agency of community structures to articulate more strongly claims for health rights, with a view to proposing models for best practice.
The wider health system governance interventions, including training for health care providers, testing of models for using complaints as learning opportunities, and policy interventions aimed at raising awareness amongst key leaders also form a prominent component of the work. While the focus is on strengthening civil society agency, it will also advance conceptual understanding of how to frame health rights in ways that are complementary to strengthened health governance.
Training and capacity building for health committees has involved the development of a curriculum drawing heavily on results of the audit of Health Committees in the Cape Metro completed early in 2012. The curriculum includes four broad areas (a) understanding the health system; (b) skills to act as agents of change; (c) understanding of health rights; and (d) meeting and procedural skills to support organizational work. Building Civil Society networks has been a strong and successful feature of the project demonstrated in mutual support between LN members. Engagement with health officials has yielded mixed results. On the one hand, the LN submission on amendments to the Hospital Facilities Board Act has been well received and elements included in the Provincial Health Plan for 2020. On the other hand, there has been no movement for formal adoption of policy or regulations to empower health committees, and the establishment of District Health Councils appears to hindered rather than helped community participation. Nonetheless, there are promising links with high level officials supportive of increasing patient voice in the health services in a meaningful way.
Training for health workers is still in process. A number of collaborative links to other health systems projects are useful avenues and a Masters student is to undertake a study of facility managers which will be likely to identify a number of ‘best practice’ opportunities for interviews which we hope to capture on DVD towards the development of a training tool. Testing of local model complaints systems will also be implemented in 2013. There is extensive sharing of printed materials with adaptation of materials (in Angola, Uganda) and primary development to meet local needs.
Some important insights have emerged in the course of the work. Firstly, the concept of vulnerability needs to be more carefully constructed and analysed to be useful in a rights framework; secondly the experience of policy formation in relation to institutionalising community participation has proven to be far more ‘messy’ and non-linear than initially conceived, so will require more reflexive and adaptive strategies to achieve objectives; lastly, the tension in the two contrasting roles of health committees (governance/oversight versus supporting services) has emerged more forcefully in our research.
Health care users’ experience as a focus for unlocking opportunities to access quality health services
The objectives of this project are twofold - to strengthen the capacity of health service users to be agents for realising their rights to health; and to build skills for providers to be responsive to user demands. These broad objectives are mutually dependent and mutually reinforcing. Taken together, they will provide a basis for increasing the responsiveness of the health system to the needs and expectations of the population, and strengthen its capacity to implement the proposed re-engineering of Primary Health Care as the mainstay of the health sector. The Primary Health Care approach is dependent on active community engagement with the health services in the form of meaningful participation. The sets of results and outputs envisaged in this proposal speak directly to this aspect of PHC strengthening.
This project intends to strengthen the capacity, mandate and authority of Health Committees in the Western and Eastern Cape. The results associated with this objective are (i) the achievement of clarity on the roles and functions of Health Committees, and the translation of this understanding into policy and programmatic implementation in Districts in the W and E Cape; (ii) manifesting in empowered Health Committees able to advance access to quality health care.
Although the National Health Act stipulates the existence and composition of Health Committees linked to facilities, in the context of an intention to enhance community participation, the Health Act is, itself, silent on the role of Health Committees, leaving this to provincial regulation. In the Western Cape, a draft policy on Health Committee goes some way to providing a framework for understanding what Health Committees should do. However, the tension between acting as an extra arm for understaffed and overworked primary care services (e.g. seen as Community Health Care Workers by service providers and sometime by Health Committee members as well), and, alternatively, acting to provide oversight of service delivery and a voice for the community in terms of accountability and governance, is not addressed in the policy. These concerns have emerged clearly in research conducted to date in the Western Cape Metro. Until consensus is achieved as to what Health Committees’ roles are and should be, it is difficult to institutionalise Health committees as part of the PHC re-engineering. Accordingly, a cluster of activities is planned to achieve this consensus.
In the Eastern Cape the situation is a little different. In July 2009, a “Policy on the Establishment and Functioning of Clinic and Community Health Centre Committees” was promulgated by the Eastern Cape legislature, preceded by a long process of consultation with health committee members, staff and management of the Eastern Cape Health Department. The policy allowed for clarification on issues such as composition of health committees, the establishment process and roles of health committees. In 2010 the health services within the Nelson Mandela Bay (NMB) District contracted service providers to establish and train health committees at all 48 health facilities. By the end of the year, all health committees had been established and trained in accordance with the new policy. The policy requires 3-yearly review. A review of the policy is thus required this year. A multi-method approach of interviews and focus groups would support the process. Findings of the review would be of value to the District and would be provided to the provincial health department.
This project aims to identify opportunities for best practice in utilising community participation as a vehicle for realising health rights. The focus on developing models for community participation in health is intended to speak to strategies that advance health equity and strengthen governance systems for health. By testing approaches and sharing experience gained using rights-based approaches to health, we anticipate generating knowledge of relevance to other developing country contexts. The focus has been on identifying training needs for health committees and advocacy and networking to strengthen health committees’ voice, both locally and internationally. Strong links have been built regionally and internationally with an emphasis on building the agency of community structures to articulate more strongly claims for health rights, with a view to proposing models for best practice.
The wider health system governance interventions, including training for health care providers, testing of models for using complaints as learning opportunities, and policy interventions aimed at raising awareness amongst key leaders also form a prominent component of the work. While the focus is on strengthening civil society agency, it will also advance conceptual understanding of how to frame health rights in ways that are complementary to strengthened health governance.
Training and capacity building for health committees has involved the development of a curriculum drawing heavily on results of the audit of Health Committees in the Cape Metro completed early in 2012. The curriculum includes four broad areas (a) understanding the health system; (b) skills to act as agents of change; (c) understanding of health rights; and (d) meeting and procedural skills to support organizational work. Building Civil Society networks has been a strong and successful feature of the project demonstrated in mutual support between LN members. Engagement with health officials has yielded mixed results. On the one hand, the LN submission on amendments to the Hospital Facilities Board Act has been well received and elements included in the Provincial Health Plan for 2020. On the other hand, there has been no movement for formal adoption of policy or regulations to empower health committees, and the establishment of District Health Councils appears to hindered rather than helped community participation. Nonetheless, there are promising links with high level officials supportive of increasing patient voice in the health services in a meaningful way.
Training for health workers is still in process. A number of collaborative links to other health systems projects are useful avenues and a Masters student is to undertake a study of facility managers which will be likely to identify a number of ‘best practice’ opportunities for interviews which we hope to capture on DVD towards the development of a training tool. Testing of local model complaints systems will also be implemented in 2013. There is extensive sharing of printed materials with adaptation of materials (in Angola, Uganda) and primary development to meet local needs.
Some important insights have emerged in the course of the work. Firstly, the concept of vulnerability needs to be more carefully constructed and analysed to be useful in a rights framework; secondly the experience of policy formation in relation to institutionalising community participation has proven to be far more ‘messy’ and non-linear than initially conceived, so will require more reflexive and adaptive strategies to achieve objectives; lastly, the tension in the two contrasting roles of health committees (governance/oversight versus supporting services) has emerged more forcefully in our research.
Health care users’ experience as a focus for unlocking opportunities to access quality health services
The objectives of this project are twofold - to strengthen the capacity of health service users to be agents for realising their rights to health; and to build skills for providers to be responsive to user demands. These broad objectives are mutually dependent and mutually reinforcing. Taken together, they will provide a basis for increasing the responsiveness of the health system to the needs and expectations of the population, and strengthen its capacity to implement the proposed re-engineering of Primary Health Care as the mainstay of the health sector. The Primary Health Care approach is dependent on active community engagement with the health services in the form of meaningful participation. The sets of results and outputs envisaged in this proposal speak directly to this aspect of PHC strengthening.
This project intends to strengthen the capacity, mandate and authority of Health Committees in the Western and Eastern Cape. The results associated with this objective are (i) the achievement of clarity on the roles and functions of Health Committees, and the translation of this understanding into policy and programmatic implementation in Districts in the W and E Cape; (ii) manifesting in empowered Health Committees able to advance access to quality health care.
Although the National Health Act stipulates the existence and composition of Health Committees linked to facilities, in the context of an intention to enhance community participation, the Health Act is, itself, silent on the role of Health Committees, leaving this to provincial regulation. In the Western Cape, a draft policy on Health Committee goes some way to providing a framework for understanding what Health Committees should do. However, the tension between acting as an extra arm for understaffed and overworked primary care services (e.g. seen as Community Health Care Workers by service providers and sometime by Health Committee members as well), and, alternatively, acting to provide oversight of service delivery and a voice for the community in terms of accountability and governance, is not addressed in the policy. These concerns have emerged clearly in research conducted to date in the Western Cape Metro. Until consensus is achieved as to what Health Committees’ roles are and should be, it is difficult to institutionalise Health committees as part of the PHC re-engineering. Accordingly, a cluster of activities is planned to achieve this consensus.
In the Eastern Cape the situation is a little different. In July 2009, a “Policy on the Establishment and Functioning of Clinic and Community Health Centre Committees” was promulgated by the Eastern Cape legislature, preceded by a long process of consultation with health committee members, staff and management of the Eastern Cape Health Department. The policy allowed for clarification on issues such as composition of health committees, the establishment process and roles of health committees. In 2010 the health services within the Nelson Mandela Bay (NMB) District contracted service providers to establish and train health committees at all 48 health facilities. By the end of the year, all health committees had been established and trained in accordance with the new policy. The policy requires 3-yearly review. A review of the policy is thus required this year. A multi-method approach of interviews and focus groups would support the process. Findings of the review would be of value to the District and would be provided to the provincial health department.
The Contribution of African Philosophy in Interpreting the Right to Health
The
right to health is increasingly recognised in national and international human
rights law as one of a range of socio-economic entitlements. South Africa,
in particular, has been the site of spectacular advances in operationalising
the right to health, given the high standing afforded to socio-economic rights
in its Constitution and a very vibrant and active civil society movement
pushing rights of access to treatment for HIV.
However,
health, like many socio-economic claims, remains a right challenged on the
basis that it pits the public good and societal benefits against individualist
claims to health care. For example, the right to health has been dismissed as
“…creating an intolerable burden on the judicial system … benefiting those who
can afford judicial review …” but, by implication, draining resources from
those really in need. In other words, this logic argues that promoting a
rights-based approach to health may, ironically, disadvantage the poorest of
the poor and worsen health inequities because those who shout loudest, are
advantaged by rights mechanisms and gain preference over those with greater
need or disadvantage. Is this contradiction a matter of substance, or is it
merely the result of a poor understanding of what human rights are and what the
right to health entails? This is critically important because of the policy,
programmatic and advocacy implications of how this question is answered.
In this context, is there a body of knowledge located in non-Western scholarly traditions that can provide us with new insights into this issue and potentially resolve this seeming contradiction through creating new understanding of human rights and its relationship to health? In particular, do the philosophies and traditions of indigenous communities in African settings, rooted in communitarian models of social relationships, offer useful alternative approaches to resolving this dilemma of individual rights being pitted against the public good in the health context?
The Learning Network on Health and Human Rights is a forum of 5 Civil Society Organisations in the Western Cape engaging with Universities to explore best practices for operationalising the Right to Health at community level. As part of the Network’s efforts to expand our knowledge and understanding of how to further the right to health, the project convenesd two seminars in the course of 2010 to explore these dilemmas relating to individual and collective conceptions of rights. The seminars formed part of a broader project at the University of Cape Town set up as a Programme to Enhance Research Capacity (PERC) with a particular focus on indigenous knowledge creation.
Through reviewing the contribution of intellectuals from Africa, drawing on traditions more rooted in collective social identities, we hope to explore and develop new understandings that can help resolve the seeming contradiction between individual claims to health rights and the evident importance of measures to protect and enhance the public good.
In this context, is there a body of knowledge located in non-Western scholarly traditions that can provide us with new insights into this issue and potentially resolve this seeming contradiction through creating new understanding of human rights and its relationship to health? In particular, do the philosophies and traditions of indigenous communities in African settings, rooted in communitarian models of social relationships, offer useful alternative approaches to resolving this dilemma of individual rights being pitted against the public good in the health context?
The Learning Network on Health and Human Rights is a forum of 5 Civil Society Organisations in the Western Cape engaging with Universities to explore best practices for operationalising the Right to Health at community level. As part of the Network’s efforts to expand our knowledge and understanding of how to further the right to health, the project convenesd two seminars in the course of 2010 to explore these dilemmas relating to individual and collective conceptions of rights. The seminars formed part of a broader project at the University of Cape Town set up as a Programme to Enhance Research Capacity (PERC) with a particular focus on indigenous knowledge creation.
Through reviewing the contribution of intellectuals from Africa, drawing on traditions more rooted in collective social identities, we hope to explore and develop new understandings that can help resolve the seeming contradiction between individual claims to health rights and the evident importance of measures to protect and enhance the public good.
Social Solidarity
One of the key challenges for realising the right to health is the seeming conflict between public health utility and the entitlements that human rights afford to individuals. This conflict has been highlighted in previous research into case studies of civil society mobilisation for health rights in the Southern African region and in conceptual work conducted to explore the links between African philosophy, particularly concepts of ubuntu, and the right to health. In short, a utilitarian critique of rights to health posits the public good as incompatible with claims by individuals to resources needed for health and disputes that rights claims could ever resonate with social solidarity. Such arguments have been most evident in critiques of “AIDS exceptionalism” which coincided with denialist opposition to provision of anti-retroviral medication to persons with HIV in South Africa. However, they are also to be found in broader debates today about health systems strengthening in conditions of resource constraints.
The Learning Network has sought to explore the nature of empowerment achievable through rights mobilisation for health in civil society and how this has, or has not, strengthened processes of social solidarity. This began under a set of research funded by a grant from the Programme for Enhancement of Research Capacity (PERC) at UCT during which two public seminars were hosted to explore these issues. The Learning Network has also explored this in research within its members through self-reflection on our own experiences. We use this experience to argue that more collective approaches to realising rights offer both more sustainable opportunities to advance health equity, and better conceptual frames to enhance our understanding of rights-based approaches to advancing human well-being. The evidence confirms that the realisation of the right to health is contingent not only on sound legal application of human rights standards, but more particularly on the assertion by civil society of claims facilitated by legal entitlements in ways that recognise the collective nature of socio-economic rights. Far from being antithetical, we believe that claims to the Right to Health are essentially about strengthening the collective agency of the most vulnerable, and are best served by recognising the importance of social solidarity.
This work is ongoing. For example, a further symposium was held on the 17th April 2012 co-hosted with the National Research Foundation Chair in Customary Law to understand better the contribution of African philosophy, and particularly those elements of traditional African beliefs that emphasize social identity and solidarity, to the conceptualisation of the right to health.
The Learning Network has sought to explore the nature of empowerment achievable through rights mobilisation for health in civil society and how this has, or has not, strengthened processes of social solidarity. This began under a set of research funded by a grant from the Programme for Enhancement of Research Capacity (PERC) at UCT during which two public seminars were hosted to explore these issues. The Learning Network has also explored this in research within its members through self-reflection on our own experiences. We use this experience to argue that more collective approaches to realising rights offer both more sustainable opportunities to advance health equity, and better conceptual frames to enhance our understanding of rights-based approaches to advancing human well-being. The evidence confirms that the realisation of the right to health is contingent not only on sound legal application of human rights standards, but more particularly on the assertion by civil society of claims facilitated by legal entitlements in ways that recognise the collective nature of socio-economic rights. Far from being antithetical, we believe that claims to the Right to Health are essentially about strengthening the collective agency of the most vulnerable, and are best served by recognising the importance of social solidarity.
This work is ongoing. For example, a further symposium was held on the 17th April 2012 co-hosted with the National Research Foundation Chair in Customary Law to understand better the contribution of African philosophy, and particularly those elements of traditional African beliefs that emphasize social identity and solidarity, to the conceptualisation of the right to health.
Civil Society Agency and the Right to Health
The outline of this project is to research a model for the operationalisation of the right to health in the context of a country with high levels of inequalities in health and the conditions needed for health but with high levels of institutional and historical commitments to human rights. Evidence to date points to the importance of agency on the part of communities most vulnerable to the violation of their rights as key to redress of social inequalities. This project investigates whether a human rights approach can help to mobilise the agency needed, individually and collectively, to overcome factors driving health inequalities, and help realise the right to health, and to explore what kinds of strategies are most effective, and the role that health care providers play in either facilitating or acting as obstacle to such agency.
The network will aim to share experiences of, and develop best practices for, engagement with health facilities on the right to health. The network will be used to explore participants’ understanding and practice of human rights, the understanding and practice of human rights of health care providers with whom network members interact, and to how interaction between providers and community members can generate new models for realizing rights to health.
Activities conducted within the network will include training on human rights and its relationship to health, reflection on participants’ experiences of the health services and attempts to claim rights and the development of materials on the right to health. The training happens in a participative spiral using meetings of the network to reflect on (a) needs identified previous sessions; (b) findings from research prompted by the needs previously identified; (c) further training priorities and research questions that emerge from this reflection to inform the work of the project team and the content of the next meeting. This participative approach underlies both training and research activities, which are therefore intimately interconnected, with data collection being used to inform the development of materials and identify training needs, and to monitor the impacts of both the training and the reflection process. As information emerges from the process and is collectively reflected upon, the need for specific investigations is identified, so further objectives or methods may be added. Both qualitative and quantitative methods are be used to collect data.
Outputs thus far have included health and human rights materials for training and advocacy (best practice), policy briefs, pamphlets for community use, conference presentations and publications. The long-term outcomes sought include greater effectiveness of community participation in health and models for better interaction between communities and health care facilities in realizing the right to health.
The network will aim to share experiences of, and develop best practices for, engagement with health facilities on the right to health. The network will be used to explore participants’ understanding and practice of human rights, the understanding and practice of human rights of health care providers with whom network members interact, and to how interaction between providers and community members can generate new models for realizing rights to health.
Activities conducted within the network will include training on human rights and its relationship to health, reflection on participants’ experiences of the health services and attempts to claim rights and the development of materials on the right to health. The training happens in a participative spiral using meetings of the network to reflect on (a) needs identified previous sessions; (b) findings from research prompted by the needs previously identified; (c) further training priorities and research questions that emerge from this reflection to inform the work of the project team and the content of the next meeting. This participative approach underlies both training and research activities, which are therefore intimately interconnected, with data collection being used to inform the development of materials and identify training needs, and to monitor the impacts of both the training and the reflection process. As information emerges from the process and is collectively reflected upon, the need for specific investigations is identified, so further objectives or methods may be added. Both qualitative and quantitative methods are be used to collect data.
Outputs thus far have included health and human rights materials for training and advocacy (best practice), policy briefs, pamphlets for community use, conference presentations and publications. The long-term outcomes sought include greater effectiveness of community participation in health and models for better interaction between communities and health care facilities in realizing the right to health.
Knowledge Production for the Right to Health
In this programme of work we explore how members of civil society organisations (CSOs) and academic researchers participate in action research based on processes of co-learning and co-research about the right to health.
In particular, we are interested in knowledge that has previously been suppressed or undocumented. While charters and commissions are important, it is the collective action of civil society which will translate human rights into practice: in particular, the agency of the most vulnerable and those affected by human rights violations to monitor and hold states to account, to develop programs and policies, to take on an advocacy role and to address human rights violations.
Knowledge is instrumental to agency, yet there is a diversity of ways of knowing which reflect hierarchies of knowledge and power. To translate the right to health into practice, and to research how this is done, it is important to recognise that existing dominant knowledge may be incomplete. One of the principles underlying the work of the Learning Network (LN) is empowerment which we understand to imply knowledge, assertiveness and critical engagement for collective action. Knowledge and learning are therefore central to the four roles of the LN: a research role documenting and analyzing best practices in realizing the right to health; an informational role to ensure communities are better informed about rights to health; a capacity building role to promote access to learning opportunities for member organizations; and an action role to use the learning gained by member organizations to support services and advocacy around health.
Because knowledge in the Global North is generally dominated by individualist concepts of human rights, the LN has turned, amongst others, to African philosophers for a contribution towards an understanding of collective rights. The LN challenges the dominance of knowledge from the Global North on the right to health; without rejecting this knowledge, it has sought to expand theorisation of the right to health. Our focus is on epistemological authenticity and generation of new knowledge paradigms. The work in this programme formed part of a project at the University of Cape Town as a Programme to Enhance Research Capacity (PERC) with a particular focus on indigenous knowledge creation. Supported by PERC, we considered: How does a co-research process enable the surfacing of previously suppressed or undocumented knowledge? And how does this process of surfacing suppressed knowledge through co-research enable the dissemination of knowledge that would not otherwise be accessed?
The work under this theme has been published in different places: In the journal Gateways (Stuttaford et al 2012[M1] ) we outlined our ideas around knowledge production for health rights. We have also conducted an evaluation of pamphlets produced by the LN and found that learning and knowledge exchange was most useful when the pamphlets were used in conjunction with collective learning opportunities such as workshops and community advocacy (Strecker et al 2012[M2] ). In 2012 we presented a co-authored paper written by civil society- based and university based co-researchers, to be published in 2014 [M3] as part of a collection. This paper was the first time all co-researchers wrote together and was milestone in not only starting to establish a conceptual framework to guide the LN, but also for all co-researchers to translate research into a university-based form of dissemination through an academic monograph. The work is ongoing as the LN evolves.
In particular, we are interested in knowledge that has previously been suppressed or undocumented. While charters and commissions are important, it is the collective action of civil society which will translate human rights into practice: in particular, the agency of the most vulnerable and those affected by human rights violations to monitor and hold states to account, to develop programs and policies, to take on an advocacy role and to address human rights violations.
Knowledge is instrumental to agency, yet there is a diversity of ways of knowing which reflect hierarchies of knowledge and power. To translate the right to health into practice, and to research how this is done, it is important to recognise that existing dominant knowledge may be incomplete. One of the principles underlying the work of the Learning Network (LN) is empowerment which we understand to imply knowledge, assertiveness and critical engagement for collective action. Knowledge and learning are therefore central to the four roles of the LN: a research role documenting and analyzing best practices in realizing the right to health; an informational role to ensure communities are better informed about rights to health; a capacity building role to promote access to learning opportunities for member organizations; and an action role to use the learning gained by member organizations to support services and advocacy around health.
Because knowledge in the Global North is generally dominated by individualist concepts of human rights, the LN has turned, amongst others, to African philosophers for a contribution towards an understanding of collective rights. The LN challenges the dominance of knowledge from the Global North on the right to health; without rejecting this knowledge, it has sought to expand theorisation of the right to health. Our focus is on epistemological authenticity and generation of new knowledge paradigms. The work in this programme formed part of a project at the University of Cape Town as a Programme to Enhance Research Capacity (PERC) with a particular focus on indigenous knowledge creation. Supported by PERC, we considered: How does a co-research process enable the surfacing of previously suppressed or undocumented knowledge? And how does this process of surfacing suppressed knowledge through co-research enable the dissemination of knowledge that would not otherwise be accessed?
The work under this theme has been published in different places: In the journal Gateways (Stuttaford et al 2012[M1] ) we outlined our ideas around knowledge production for health rights. We have also conducted an evaluation of pamphlets produced by the LN and found that learning and knowledge exchange was most useful when the pamphlets were used in conjunction with collective learning opportunities such as workshops and community advocacy (Strecker et al 2012[M2] ). In 2012 we presented a co-authored paper written by civil society- based and university based co-researchers, to be published in 2014 [M3] as part of a collection. This paper was the first time all co-researchers wrote together and was milestone in not only starting to establish a conceptual framework to guide the LN, but also for all co-researchers to translate research into a university-based form of dissemination through an academic monograph. The work is ongoing as the LN evolves.
Photovoice
One method of mobilising community agency for the right to health being explored in the Learning Network involves the use of Photovoice by Learning Network members. In this project, women from the Learning Network member organisation, The Women's Circle, make use of this method to identify health rights challenges in their community, and, through reflection on the photos, opportunities for action. The Photovoice project involves women from poor townships using cameras – first, to take photos of what health means to them, and thereafter, what human rights mean. The photos were workshopped with the women to reflect on their knowledge and identify action steps. For example, in Delft, one grassroots women’s circles used the photovoice process to identify a hazardous dump site for clean-up by the municipality and to initiate an income-generating recycling project that also sought to address youth unemployment and their susceptibility to involvement with gang activity.
The method involves (a) providing participants with disposable cameras to capture images of health rights violations; (b) developing their pictures; (c) using the pictures in group discussions; and (d) jointly developing action plans to address the problems identified in the photos; (e) tracing the implementation and success or lack thereof of actions taken. Data collection throughout the process provide a rich source of materials for evaluation and for postgraduate student research across a range of disciplines, as well as opportunity to generate advocacy materials that LN member organisations can use in lobbying policy-makers for change
Following implementation of the project, an exhibition of their work and their stories was developed, thanks to a grant from the Gordon Institute of Performing and Cultural Arts (GIPCA). The Exhibition was opened on the 6th of October 2013 as part of a joint symposium with the People’s Health Movement on community participation in health.
The method involves (a) providing participants with disposable cameras to capture images of health rights violations; (b) developing their pictures; (c) using the pictures in group discussions; and (d) jointly developing action plans to address the problems identified in the photos; (e) tracing the implementation and success or lack thereof of actions taken. Data collection throughout the process provide a rich source of materials for evaluation and for postgraduate student research across a range of disciplines, as well as opportunity to generate advocacy materials that LN member organisations can use in lobbying policy-makers for change
Following implementation of the project, an exhibition of their work and their stories was developed, thanks to a grant from the Gordon Institute of Performing and Cultural Arts (GIPCA). The Exhibition was opened on the 6th of October 2013 as part of a joint symposium with the People’s Health Movement on community participation in health.