Browsing Faculty of Community & Health Sciences by Issue Date
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September, Rose (University of Johannesburg, 2007)[more][less]
Abstract: The author reflects on the findings of a study commissioned by the Human Science Research Council (HSRC). A qualitative research methodology was used to explore the perceptions of service providers in the early childhood development (ECD) sector on job creation through government’s Expanded Public Works Programme (EPWP). The EPWP is aimed at drawing significant numbers of unemployed people into productive work by increasing their capacity to earn a sustainable income through training. In response, the national departments of Social Development, Health, and Education developed a Social Sector Plan (SSP) for EPWP in which the ECD sector was identified as one of the key areas for expansion. From a developmental social work perspective, both Early Childhood Development and productive employment are important strategies to alleviate persistent poverty. This article is intended to create dialogue, further research and action towards realizing the potential of the ECD sector to create more sustainable jobs in order to improve the quality of people’s lives. URI: http://hdl.handle.net/10566/210 Files in this item: 1
SeptemberExpandedWorks2007.pdf (220.1Kb) -
Nkonki, Lungiswa L.; Doherty, Tanya M.; Hill, Zelee; Chopra, Mickey; Schaay, Nikki; Kendall, Carl (BioMed Central, 2007)[more][less]
Abstract: Background: The objective of this study was to examine missed opportunities for participation in a prevention of mother-to-child transmission (PMTCT) programme in three sites in South Africa. A rapid anthropological assessment was used to collect in-depth data from 58 HIV-positive women who were enrolled in a larger cohort study to assess mother-to-child HIV transmission. Semistructured interviews were conducted with the women in order to gain an understanding of their experiences of antenatal care and to identify missed opportunities for participation in PMTCT. Results: 15 women actually missed their nevirapine not because of stigma and ignorance but because of health systems failures. Six were not tested for HIV during antenatal care. Two were tested but did not receive their results. Seven were tested and received their results, but did not receive nevirapine. Health Systems failure for these programme leakages ranged from nonavailability of counselors, supplies such as HIV test kits, consent forms, health staff giving the women incorrect instructions about when to take the tablet and health staff not supplying the women with the tablet to take. Conclusion: HIV testing enables access to PMTCT interventions and should therefore be strengthened. The single dose nevirapine regimen is simple to implement but the all or nothing nature of the regimen may result in many missed opportunities. A short course dual or triple drug regimen could increase the effectiveness of PMTCT programmes. URI: http://hdl.handle.net/10566/429 Files in this item: 1
NkonkiNevirapineStudy2007.pdf (184.6Kb) -
Bradley, Hazel A.; Puoane, Thandi (International Society on Hypertension in Blacks, 2007)[more][less]
Abstract: The project aimed to identify factors that contribute to hypertension and diabetes and to design and implement appropriate local interventions to prevent these non-communicable diseases and promote healthy lifestyles. This was a community-based participatory action research project in which researchers and community health workers (CHWs) were the main participants. The triple A approach to planning interventions was used, that is, the process of assessing the situation, analyzing the findings, and taking action based on this analysis. Both qualitative and quantitative methods were employed. Twenty-two CHWs working in site C, Khayelitsha, a deprived urban area of Cape Town, South Africa, participated in the study. Findings from the situational assessment indicated a lack of knowledge among CHWs and the community about hypertension and diabetes and the risk factors for these non-communicable diseases. Economic constraints and cultural beliefs and practices influenced the community’s food choices and participation in physical activity. On the basis of these findings, a training program was proposed that would provide CHWs with the skills to prevent hypertension and diabetes in their community. A program was developed and piloted by the project team. A health club that focuses on promoting healthy lifestyles is currently being piloted. This paper illustrates the unique involvement of CHWs in a successful participatory action research project on the prevention of hypertension and diabetes and promotion of health in a deprived urban setting. The project emphasizes the importance of involving local people in community-based initiatives to promote health and identifies that the primary role of health services is to develop appropriate skills in the local community, monitor activities, and facilitate a link with primary health services. URI: http://hdl.handle.net/10566/182 Files in this item: 1
BradleyPuoanePrevention2007.pdf (184.0Kb) -
Njoki, Emma; Frantz, Jose M.; Mpofu, Ratie (Informa Healthcare, 2007)[more][less]
Abstract: Purpose. To determine the health promotion needs through an exploration of health-related behaviours and the factors that influence the behaviour of physically disabled youth with spinal cord injury. Methods. A descriptive and exploratory study that utilized a qualitative approach was carried out among ten participants aged between 15 and 29 years who were purposely selected. Information was obtained from individual face-to-face interviews and a focus-group discussion. Results. The participants were involved in risky health behaviours including sedentary lifestyles, use of alcohol, tobacco, and drugs. Various factors that influenced their participation in these behaviours were identified including personal struggles with identity and adjustment issues. Conclusions. The results emphasize that participants were involved in health-risk behaviours, which are associated with development of secondary conditions such as respiratory problems, heart diseases, and stroke. Health-promotion strategies employed for these individuals should address the psychological impact of spinal cord injury (SCI) on the individual as an influence to participation in health risk behaviours. URI: http://hdl.handle.net/10566/399 Files in this item: 1
FrantzHealthPromotion2007.pdf (246.3Kb) -
Julie, Hester; Daniels, Felicity; Khanyile, Thembisile (Faculty of Community and Health Sciences, University of the Western Cape, 2007)[more][less]
Abstract: This article is informed by a retrospective study conducted by the first author, and a limited literature review on service-learning in South Africa. It attempts to give the reader a clearer understanding of service-learning by contextualizing service-learning within current debates about community engagement in higher education institutions in South Africa. A few dominant definitions of SL are described to espouse the underlying pedagogy of SL. Service –learning is then differentiated from other forms of clinical practice currently in use in nursing, based on the conceptual framework of Furco (1996). The latter discussion thus provides a backdrop for the brief description on how SL has been incorporated into the nursing curriculum at the University of the Western Cape (UWC). Lastly the challenges related to the implementation of SL are discussed. URI: http://hdl.handle.net/10566/93 Files in this item: 1
Julie_Service2007.pdf (52.26Kb) -
Joubert, Jane; Puoane, Thandi (South African Medical Association, 2007)[more][less]
Abstract: OBJECTIVE: To estimate the burden of disease attributable to excess body weight using the body mass index (BMI), by age and sex, in South Africa in 2000. DESIGN: World Health Organization comparative risk assessment (CRA) methodology was followed. Re-analysis of the 1998 South Africa Demographic and Health Survey data provided mean BMI estimates by age and sex. Population attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. SETTING: South Africa. SUBJECTS. Adults ≥ 30 years of age. OUTCOME MEASURES. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, and selected cancers. RESULTS: Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61% of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31% of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI ≥ 21 kg/m2. Excess body weight is estimated to have caused 36 504 deaths (95% uncertainty interval 31 018 - 38 637) or 7% (95% uncertainty interval 6.0 - 7.4%) of all deaths in 2000, and 462 338 DALYs (95% uncertainty interval 396 512 - 478 847) or 2.9% of all DALYs (95% uncertainty interval 2.4 - 3.0%). The burden in females was approximately double that in males. CONCLUSIONS: This study shows the importance of recognising excess body weight as a major risk to health, particularly among females, highlighting the need to develop, implement and evaluate comprehensive interventions to achieve lasting change in the determinants and impact of excess body weight. URI: http://hdl.handle.net/10566/284 Files in this item: 1
PuoaneEstimating2007.pdf (412.1Kb) -
Frantz, Jose M. (Nova Southeastern University, 2007)[more][less]
Abstract: Health care is changing and the demands put on health professionals are increasing. Physiotherapy education should reflect the health and social priorities of the nation. The World Confederation of Physical Therapy (WCPT) is committed to assisting physiotherapy associations in developing educational standards. Physiotherapy education in Africa however, seems to have a real need for assistance from the WCPT. The aim of this paper is to highlight the challenges facing physiotherapy education in Africa. The Delphi methodology was used to obtain information from key informants involved in the area of physiotherapy education from a variety of African countries. The majority of the participants were people who have experienced physiotherapy education in Africa either as graduates or current teachers. Data were analyzed into themes and sent back to respondents for confirmation. The most important challenges highlighted were: lack of undergraduate training opportunities, limited number of therapists, upgrading of physiotherapy educators, research as a major component of physiotherapy education, and recognition of physiotherapy as an essential service. It is concluded that assistance is needed for physiotherapists from Africa to take their rightful place in the health team and higher education institutions should look at improving diploma qualifications of physiotherapists in African countries. URI: http://hdl.handle.net/10566/189 Files in this item: 1
FrantzChallenges2007.pdf (221.5Kb) -
Rowe, Michael (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Information and communication technology has been shown to be increasingly important in the education and professional practice of healthcare workers. The World Health Organisation (WHO) discusses the benefits of using ICT in the Primary Healthcare setting in terms of better access to information, improved communication between colleagues, facilitating continuing professional development and providing learning tools for healthcare professionals, patients and the community as a whole. This review of the literature describes the role of information and communication technology (ICT) in the education and professional practice of healthcare workers and goes on to outline the challenges facing the widespread adoption of ICT. The conclusion is that ICT does indeed have a positive role to play in both the education and professional practice of healthcare workers, including physiotherapists, as long as it is implemented as an adjunct to established and proven practice, and not a replacement. URI: http://hdl.handle.net/10566/61 Files in this item: 1
Rowe_Information2008.pdf (398.8Kb) -
Lehmann, Uta (Health Systems Trust, 2008)[more][less]
Abstract: This chapter reviews the progress made in recent years to strengthen human resources to deliver health care within a Primary Health Care approach. It focuses specifically on the availability and preparedness of old and new cadres of health workers, their distribution within the South African health system, as well as their training and development. Findings suggest that overall the health workforce is substantially weaker today than it was in the mid-1990s. There are fewer doctors and nurses available for the vast majority of public sector dependent population, as production has not kept up with population growth, increasing care needs and attrition. Disparities between provinces remain, and disparities between the private and public sectors have grown. The nursing sector faces a serious crisis brought on by an aging professional population. Progress with the development of mid-level cadres has been slow, with pharmacy being the exception. Furthermore, the implementation of community health worker programmes remains fragmented and uneven. Importantly, while there has been curriculum reform in many medical schools, there has been no fundamental shift in the orientation and resourcing of health professions. Health workers entering primary or community care services, thus, often remain illprepared and find themselves poorly supported and resourced. It is suggested that the following areas must be a priority in the human resource agenda in coming years: an accelerated production of professionals and mid-level cadres; comprehensive curriculum audits; the regulation and integration of community health workers; and an integrated and comprehensive reconfiguration of Primary Health Care teams. URI: http://hdl.handle.net/10566/437 Files in this item: 1
LehmannPrimaryHealthCare2009.pdf (692.3Kb) -
Assuman, Nuhu; Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Introduction Although stretching increases soft tissue flexibility and joint range of motion, numerous studies demonstrated contradictory findings as to its effect in injury prevention. Aim The purpose of this systematic review is to assess the effectiveness of stretching on the prevention of injuries. Methods An electronic search using MEDLINE, SCIENCE DIRECT, COCHRANE, EBSCOHOST, SPORTDiscus and CINAHL databases, checking the references. Randomised control trials (RCTs) and cohort studies investigating stretching as an injury prevention measure published in the last decade were selected in this review. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results Two RCTs and two prospective cohort studies all of high quality were included in this analysis. One cohort study found that stretching reduced the incidence of exercise related injuries. Two RCTs and one cohort study found that stretching did not produce practical reduction on the occurrence of injuries. Conclusion Stretching exercises does not give a practical useful reduction in the risk of injuries. Not enough recent research has been done to draw definitive conclusion on the effect of stretching in injury prevention. Well designed studies are needed to shed light as to the effect of stretching in exercise-related injury risk reduction. URI: http://hdl.handle.net/10566/117 Files in this item: 1
NuhuStretching2008.pdf (374.7Kb) -
Phillips, Julie (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Background: According to the World Health Organization global alcohol consumption has increased in recent decades, with most of this increase occurring in developing countries. Added to this is the concern of the increased social acceptability of alcohol use and the widespread experimentation with alcohol during adolescence. Objectives: The purpose of this study was to better understand health risk behaviours, specifically alcohol use, among black female high school learners in a designated research locale of a local community in the Western Cape, South Africa. Study design: The method of inquiry in this study was a mixed methods sequential explanatory strategy. Results: A lifetime prevalence of alcohol use was reported by 57.8% of the study sample. All the participants agreed that drinking has a negative influence on adolescent health. Conclusion: Alcohol use in South Africa is an ever-increasing health problem and the current study provides evidence that the prevalence of this behaviour remains a public health concern. URI: http://hdl.handle.net/10566/113 Files in this item: 1
PhillipsAlcohol2008.pdf (68.01Kb) -
Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Objective: The author aimed to develop a valid and reliable questionnaire that would measure the knowledge of learners relating to risk factors for chronic disease of lifestyle such as stroke, diabetes and hypertension. The questionnaire was intended to be used as part of a health education programme aimed at improving the knowledge of learners as it relates to risk factors for chronic diseases of lifestyle. Method: The development of the questionnaire was guided by Williams 9 steps of questionnaire design and was influenced by the national curriculum of education’s life orientation programme and literature. A 31 item questionnaire was designed and presented to an expert panel. Content validity was done by the expert panel and face validity was tested through informal discussions with high school learners. Reliability testing was done using the test-retest method and Kappa co-efficient was used to test stability of the items. The questionnaire was administered to 40 high school learners but only 30 did the test the second time. Results: The questionnaire yielded a reliability analysis that revealed internal consistency with a Cronbach’s alpha of 0.897. The average score obtained by learners using this questionnaire was 14. The questionnaire can be used for learners with a grade 10 education. The questionnaire also highlighted that learners had a moderate knowledge relating to risk factors for chronic diseases of lifestyle and the need for appropriate information interventions was emphasized URI: http://hdl.handle.net/10566/115 Files in this item: 1
FrantzQuestionnaire2008.pdf (372.6Kb) -
Labonte, Ron; Sanders, David; Baum, Fran; Schaay, Nikki; Packer, Corinne (CSIRO, 2008)[more][less]
Abstract: Primary health care (PHC) is again high on the international agenda. It was the theme of The World Health Report in 2008, thirty years after the Alma-Ata Declaration, and has been the topic of a series of significant conferences around the world throughout 2008. What have we learnt about its impact in improving population health and health equity? What more do we still need to know? These two questions framed a four-year international research/capacity-building project, “Revitalizing Health for All” (RHFA), funded by the Canadian Global Health Research Initiative, which began in 2007. The findings of a global literature review conducted by this Initiative, and focusing on comprehensive primary health care - and how it has been implemented since Alma Ata are presented. The way in which the political context has affected the comprehensiveness of PHC is considered - along with a series of proposed future PHC research areas. URI: http://hdl.handle.net/10566/476 Files in this item: 1
LabontePrimaryHealthCare2008.pdf (235.2Kb) -
Puoane, Thandi; Tsolekile, Lungiswa; Sanders, David; Parker, Whadiah (Health Systems Trust, 2008)[more][less]
Abstract: This chapter will examine the current actions, including lifestyle measures, for the prevention and management of non-communicable diseases within a South African context. It will also focus on the biological, behavioural and social determinants of health. Interventions and initiatives directed at primary, secondary and tertiary prevention of chronic non-communicable diseases are also discussed. This chapter ends with recommended lifestyle changes, which can be taken to influence the adoption of healthy lifestyles, and therefore reduce the risks for chronic non-communicable diseases. URI: http://hdl.handle.net/10566/255 Files in this item: 1
PuoaneChronic2008.pdf (621.8Kb) -
Puoane, Thandi; Katie, Cuming; Sanders, David; Ashworth, Ann (Oxford University Press, 2008)[more][less]
Abstract: Staff at 11 rural hospitals in an under-resourced region of Eastern Cape Province, South Africa, participated in an intervention to improve the quality of care of severely malnourished children through training and support aimed at implementing the WHO case-management guidelines. Despite similar intervention inputs, some hospitals reduced their case-fatality rates by at least half, whereas others did not. The aim of this study was to investigate reasons for this disparity. Two successful and two poorly performing hospitals were purposively selected based on their case-fatality rates, which were <10% in the successful hospitals and >30% in those performing poorly. Comparative data were collected during June to October 2004 through structured observations of ward procedures, compilation of hospital data on case-loads and resources, and staff interviews and discussions related to attitudes, teamwork, training, supervision, managerial support and leadership. The four study hospitals had broadly similar resources, infrastructure and child:nurse ratios, and all had made changes to their clinical and dietary management following training. Case-management was broadly in line with WHO guidelines but the study revealed clear differences in institutional culture which influenced quality of care. Staff in the successful hospitals were more attentive and assiduous than staff in the poorly performing hospitals, especially in relation to rehydration procedures, feeding and the recording of vital signs. There was a strong emphasis on in-service training and induction of incoming staff in the successful hospitals and better supervision of junior staff and carers. Nurses had more positive attitudes towards malnourished children and their carers, and were less judgmental. Underlying factors were differences in leadership, teamwork, and managerial supervision and support. We conclude that unless there are supportive structures at managerial level, the potential benefits of efficacious interventions and related training programmes to improve health worker performance can be thwarted. URI: http://hdl.handle.net/10566/295 Files in this item: 1
PuoaneHospitals2008.pdf (102.3Kb) -
Puoane, Thandi; Tsolekile, Lungiswa (Kamla-Raj Enterprises, 2008)[more][less]
Abstract: This paper was conducted to describe some of the circumstances that increases the risk factors for non-communicable diseases amongst the previously disadvantaged South African population. The work presented here is based on an action research in an urban black township of Cape Town. The goal was to develop a Non- Communicable Disease model, which can be used to benefit an urban township community. Using a participatory process data was collected during each stage of the development and implenting interventions. Interviews, observations and situational assessment of resources available for promoting healthy lifestyle in the township were used to collect data. Although urbanisation seems to be a driving force in nutrition transition, there are underlying factors that influence lifestyle changes. These includes the environment in which people find themselves. The city provides variety of cheap unhealthy food at a lower price. Due to poverty and lack of knowledge, healthy foods become of less important. People tend to indulge in food rich in fat and sugars due to the belief that they have missed opportunities of enjoying these foods due to deprivation. This has lead to the increase in the prevalence of NCDs among poor South Africans. In conclusion, this work provided important information regarding the challenges faced by the urbanised poor population in South Africa. Although Khayelitsha was used to illustrate these challenges, the situation is similar to other urban townships of in South Africa. URI: http://hdl.handle.net/10566/242 Files in this item: 1
PuoaneChallenges2008.pdf (28.29Kb) -
Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: A number of initiatives were launched in various countries worldwide to provide quality physical education in schools. However, the promotion of participation in sport and specifically elite sport is still regarded to be economically more feasible, than the introduction of physical education in schools and “sport for all” programmes at community level. In order to improve the current situation, the conventional ideas of the school physical education programme needs to be reconsidered and more serious consideration should be given to the preferences and needs of the key stakeholders. The aim of the study was to determine the views of teachers and learners with regards to physical education and the promotion of physical activity in a local community school. Participants included learners and teachers involved in life orientation and coaching of sport in a high school in a local community in the Western Cape, South Africa. The school was purposively selected as it caters for the previously disadvantaged learners in the area. Data was collected by means of focus group discussions. The results indicated that both the learners and teachers appreciated the benefits associated with participation in physical education but also highlighted significant barriers that prevented the effective implementation of physical education programmes in the school. South Africa needs a structured, cost effective approach to physical and health education in schools that stipulates national objectives and detailed strategies to realize the objectives. URI: http://hdl.handle.net/10566/118 Files in this item: 1
FrantzPhysicalEducation2008.pdf (46.38Kb) -
Puoane, Thandi (MedPharm Publications, 2008)[more][less]
Abstract: OBJECTIVE: To estimate the prevalence of overweight and obesity, and identify factors associated with Body Mass Index (BMI) and waist circumference (WC) among adults residing in an urban township in South Africa. DESIGN: Cross-sectional study. SETTING: Khayelitsha, a large black township located in Cape Town. SUBJECTS: 107 males and 530 females, aged ≥ 18 years. METHODS: The prevalence of overweight/obesity (BMI ³ 25 kg/m2) and abdominal obesity (WC ≥ 94 cm for men and ≥ 80 cm for women), and their relationship with factors previously found to increase the risk of obesity, such as age, gender, marital status, educational level, employment status, immigrant status from rural to urban, and physical activity level, were assessed using logistic regression analyses. RESULTS: The prevalence of obesity (BMI ³ 30 kg/m2) was 53.4% and 18.7%, and that of abdominal obesity was 71.5% and 23.4%, among women and men respectively. However, more women (21.3%) than men (11.2%) reported walking more than 45 minutes per day. Female gender and being married were associated with a high BMI and large WC. Recent migration was associated with a smaller WC. The level of physical activity was not associated with BMI or WC. CONCLUSIONS: These findings suggest that physical activity may play less of a role in obesity control, or that more than 45 minutes of physical activity per day is required to reduce the risk of obesity, especially in women. At least among South African women, obesity control focused on nutritional interventions may be more beneficial than increasing the intensity or duration of physical activity. URI: http://hdl.handle.net/10566/233 Files in this item: 1
MalhotraPuoaneSAJCN2008.pdf (303.1Kb) -
Phillips, Julie; Frantz, Jose M.; Mpofu, Ratie (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Introduction: There is mounting evidence of the health risk behaviours that adolescents are involved in on a daily basis. Local and national governments have advocated for intervention programmes to prevent an increase in the health risk behaviours among young people. In order to introduce effective prevention strategies, evaluation of the current situation is needed. The University of the Western Cape, identified Youth Wellness as one of the niche areas for research. Aim: This paper aims to synthesize the studies on youth wellness conducted at the University of the Western Cape. Findings: The studies conducted included epidemiological studies and intervention studies. Studies used both qualitative and quantitative designs. Most of the studies highlighted the need for intervention programmes at various levels such as personal (individual), community and policy. Conclusion: The findings of the research clearly highlights the need for researchers at UWC to identify appropriate criteria by which to measure the desired intervention outcomes. URI: http://hdl.handle.net/10566/112 Files in this item: 1
FrantzYouthHealth2008.pdf (909.0Kb) -
Scott, Vera; Stern, Ruth; Sanders, David; Reagon, Gavin; Mathews, Verona (BioMed Central, 2008)[more][less]
Abstract: BACKGROUND: While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets. METHODS: A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision. RESULTS: The studies both demonstrate the value of adopting the GEGA approach of research to action, adopting three pillars of assessment and monitoring; advocacy; and community empowerment. In the Equity Tools for Managers Project study, the participation of managers meant that their support for implementation was increased, although the failure to include nurses and communities in the study was noted as a limitation. The development of a community Water and Sanitation Forum to support the Project had some notable successes, but also experienced some difficulties due to lack of capacity in both the community and the municipality. CONCLUSION: The two very different, but connected projects, demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice. URI: http://hdl.handle.net/10566/171 Files in this item: 1
ScottResearchToAction2008.pdf (299.6Kb)