Applying a community change process to achieve sustainable community health change
1
Health and Wellness, Western Cape Government, Vredenburg, South Africa
2
Family, Community and Emergency care, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1497
ABSTRACT
BACKGROUND:
Healthy Futures South Africa (HFSA) is a University of Cape Town (UCT) programme within the Mastercard Foundation’s higher education Africa Health Collaborative. HFSA is guided by the Community-oriented primary care (COPC) framework to effect change and uplift communities, focusing on youth, health and employment. The Saldanha Bay HFSA site is using established Community Change Processes (CCP) to create sustainable change and move the health system from reactive to proactive stance. CCP is a COPC and development tool that is represented as a cycle with the elements of Relationship Building, Concern Identification, Concern Exploration, Decision making, Action, and Reflection and Review.
METHODS:
The study uses a qualitative process evaluation to show progress. We invited key stakeholders to a local community hall, where people collaborated around tables to actively identify community assets and concerns using a consensus-building methodology. Subsequently, concerns were explored and the decision-making process facilitated. Community engagements were approached with an asset-based mindset as a meeting of equals.
RESULTS:
Analysis focuses on the first steps of the cycle: from Relationship building to decision-making. Community engagement with stakeholders, non-government organisations (NGO), community members, and the local government enabled the facilitation and development of the community change process. Relationships were built with local government, NGOs, key community leaders, representatives of vulnerable groups, and youth. Identified concerns included substance abuse, family crises, unemployment, mental health, safety and crime. A small-group exercise explored and prioritized themes, mapping for decision making.
CONCLUSIONS:
The findings demonstrate that the community change process cycle remains relevant for creating sustained change. Meaningful stakeholder engagement enabled community members to take ownership of identifying their concerns; as a result, we aim to work with the community in a joint decision-making process for sustainable, accountable implementation.
Healthy Futures South Africa (HFSA) is a University of Cape Town (UCT) programme within the Mastercard Foundation’s higher education Africa Health Collaborative. HFSA is guided by the Community-oriented primary care (COPC) framework to effect change and uplift communities, focusing on youth, health and employment. The Saldanha Bay HFSA site is using established Community Change Processes (CCP) to create sustainable change and move the health system from reactive to proactive stance. CCP is a COPC and development tool that is represented as a cycle with the elements of Relationship Building, Concern Identification, Concern Exploration, Decision making, Action, and Reflection and Review.
METHODS:
The study uses a qualitative process evaluation to show progress. We invited key stakeholders to a local community hall, where people collaborated around tables to actively identify community assets and concerns using a consensus-building methodology. Subsequently, concerns were explored and the decision-making process facilitated. Community engagements were approached with an asset-based mindset as a meeting of equals.
RESULTS:
Analysis focuses on the first steps of the cycle: from Relationship building to decision-making. Community engagement with stakeholders, non-government organisations (NGO), community members, and the local government enabled the facilitation and development of the community change process. Relationships were built with local government, NGOs, key community leaders, representatives of vulnerable groups, and youth. Identified concerns included substance abuse, family crises, unemployment, mental health, safety and crime. A small-group exercise explored and prioritized themes, mapping for decision making.
CONCLUSIONS:
The findings demonstrate that the community change process cycle remains relevant for creating sustained change. Meaningful stakeholder engagement enabled community members to take ownership of identifying their concerns; as a result, we aim to work with the community in a joint decision-making process for sustainable, accountable implementation.
| eISSN: | 2654-1459 |
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