Citizen: Community healthcare
Context:
Access to quality healthcare is a constant struggle. A new project invites residents to identify health concerns, gather evidence, and work with health workers on solutions—building trust and a more equitable system.
Dilemma:
A) Join and gain a direct voice in shaping healthcare and strengthen alliances with health workers. But expect slow progress and heavy time demands.
B) Instead of joining the project, advocate for the community's needs through existing local councils.
Story behind the dilemma:
This South African study examined how participatory action research (PAR) could build community power in rural primary healthcare. Researchers collaborated with residents, health workers, and officials through iterative cycles of evidence-gathering, dialogue, and action-planning. The process created safe spaces for cooperative learning, strengthened community-health system alliances, and enhanced recognition of community health workers' roles. When COVID-19 hit, the model was adapted to train workers in rapid PAR methods. Results showed that this relational, non-linear approach developed collective decision-making capabilities while maintaining local relevance. The successful model was scaled district-wide, demonstrating how power-sharing transforms healthcare systems through community-led solutions.