Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa

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dc.contributor.authorMeier, Benjaminen_ZA
dc.contributor.authorPardue, Caitlinen_ZA
dc.contributor.authorLondon, Leslieen_ZA
dc.date.accessioned2015-11-18T04:02:46Z
dc.date.available2015-11-18T04:02:46Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: 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.en_ZA
dc.identifier.apacitationMeier, B., Pardue, C., & London, L. (2012). Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa. <i>BMC International Health and Human Rights</i>, http://hdl.handle.net/11427/15103en_ZA
dc.identifier.chicagocitationMeier, Benjamin, Caitlin Pardue, and Leslie London "Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa." <i>BMC International Health and Human Rights</i> (2012) http://hdl.handle.net/11427/15103en_ZA
dc.identifier.citationMeier, B. M., Pardue, C., & London, L. (2012). Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa. BMC International Health and Human Rights, 12(1), 15.en_ZA
dc.identifier.ris TY - Journal Article AU - Meier, Benjamin AU - Pardue, Caitlin AU - London, Leslie AB - 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. DA - 2012 DB - OpenUCT DO - 10.1186/1472-698X-12-15 DP - University of Cape Town J1 - BMC International Health and Human Rights LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa TI - Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa UR - http://hdl.handle.net/11427/15103 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15103
dc.identifier.urihttp://dx.doi.org/10.1186/1472-698X-12-15
dc.identifier.vancouvercitationMeier B, Pardue C, London L. Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa. BMC International Health and Human Rights. 2012; http://hdl.handle.net/11427/15103.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Meier et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC International Health and Human Rightsen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcinthealthhumrights/en_ZA
dc.subject.otherParticipationen_ZA
dc.subject.otherRights-based policyen_ZA
dc.subject.otherCommunity health committeesen_ZA
dc.subject.otherSouth Africaen_ZA
dc.titleImplementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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