Browsing by Subject "Participation"

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    Factors influencing adolescent girls and young women’s participation in a combination HIV prevention intervention in South Africa
    (2021-02-27) McClinton Appollis, Tracy; Duby, Zoe; Jonas, Kim; Dietrich, Janan; Maruping, Kealeboga; Abdullah, Fareed; Slingers, Nevilene; Mathews, Catherine
    Background For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15–24-years-old, as well as the perspectives of AGYW, intervention implementers, and facilitators who participated in this intervention. Methods This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15–24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included a total of 100 semi-structured in-depth interviews and 21 focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators. Thematic analysis was used to explore the perspectives of participating and implementing the intervention. Results Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15–19-year-olds and 20–24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20–24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW. Conclusion Designers of combination HIV prevention interventions need to address the barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
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    Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa
    (BioMed Central Ltd, 2012) Meier, Benjamin; Pardue, Caitlin; London, Leslie
    BACKGROUND: Amidst an evolving post-apartheid policy framework for health, policymakers have sought to institutionalize community participation in Primary Health Care, recognizing participation as integral to realizing South Africa's constitutional commitment to the right to health. With evolving South African legislation supporting community involvement in the health system, early policy developments focused on Community Health Committees (HCs) as the principal institutions of community participation. Formally recognized in the National Health Act of 2003, the National Health Act deferred to provincial governments in establishing the specific roles and functions of HCs. As a result, stakeholders developed a Draft Policy Framework for Community Participation in Health (Draft Policy) to formalize participatory institutions in the Western Cape province. METHODS: With the Draft Policy as a frame of analysis, the researchers conducted documentary policy analysis and semi-structured interviews on the evolution of South African community participation policy. Moving beyond the specific and unique circumstances of the Western Cape, this study analyzes generalizable themes for rights-based community participation in the health system. RESULTS: Framing institutions for the establishment, appointment, and functioning of community participation, the Draft Policy proposed a formal network of communication - from local HCs to the health system. However, this participation structure has struggled to establish itself and function effectively as a result of limitations in community representation, administrative support, capacity building, and policy commitment. Without legislative support for community participation, the enactment of superseding legislation is likely to bring an end to HC structures in the Western Cape. CONCLUSIONS: Attempts to realize community participation have not adequately addressed the underlying factors crucial to promoting effective participation, with policy reforms necessary: to codify clearly defined roles and functions of community representation; to outline how communities engage with government through effective and accountable channels for participation; and to ensure extensive training and capacity building of community representatives. Given the public health importance of structured and effective policies for community participation, and the normative importance of participation in realizing a rights-based approach to health, this analysis informs researchers on the challenges to institutionalizing participation in health systems policy and provides practitioners with a research base to frame future policy reforms.
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    Women doctors in medical professional organisations in South Africa – a report by the Women in Medicine Workgroup
    (2003) Kane-Berman, Jocelyne; Hickman, Rosemary
    OBJECTIVES: To determine the level of representation of women doctors in medical professional organisations in South Africa historically and currently, and if not adequate, to ascertain the reasons for women's limited participation in medico-political activities. DESIGN: A descriptive study of the membership of South African medical professional organisations and their executive structures. OUTCOME MEASURES: The number and percentages of women doctors as members and at executive level in medical professional organisations compared with the number of registered women practitioners. RESULTS AND CONCLUSIONS: Women are inadequately represented at all levels in the great majority of organisations for which information was provided. In view of the rapidly increasing number of women doctors the profession and its professional bodies need to take active steps to promote the participation of women in these organisations.