Unlocking community capabilities
The unlocking community capabilities theme systematically examines how communities can be active participants in the planning, delivery, monitoring and evaluation of their health system, by identifying and mobilising individual and collective capabilities in different social, political, and institutional environments.
Defining community capabilities
Communities are groups of people having common interests, resources, beliefs, needs, occupations or other social conditions that characterise the identity of members and affect their cohesiveness. FHS focuses on communities that live in a particular geographic area, but also examines other social characteristics of communities. The term ‘community capability’ encompasses key concepts of empowerment, mobilisation, social capital and capacity building.
- Developing reproducible ways of measuring community capabilities to understand the social relations and resources within and across communities, including the status, social relations and entitlements of disadvantaged populations.
- Developing reproducible ways of changing community capabilities as a process and outcome of health systems interventions by improving linkages, strengthening monitoring, securing resources, improving resilience, and changing social norms.
- Having robust measures of change in community capabilities and developing research methodologies to understand pathways for change in community capabilities and how they relate to changes in health systems.
Defining an appropriate model of health systems ethics relevant to long-term engagements with communities, especially in low-resource settings.
Recent FHS publications on 'unlocking community capabilities'
The objective of this brief is to introduce the Photovoice method, highlight how it helped capture the voices of mothers in the Sundarbans, and demonstrate how the method can bridge the gap between communities and local decision-makers.
In Future Health Systems, we focused on communities as active service delivery participants across a wide variety of contexts. In this brief, we reflect on the process of unlocking community capabilities, the key actors involved, and the productive tensions within community partnerships forged to build more responsive, resilient and equitable health systems.
This film captures the views and lessons from the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study, as seen in the eyes of the implementers, participants, and the evidence.
In this short video, FHS CEO, Sara Bennett highlights some of the headlines from FHS activities during its second phase.
Musoke, D; Ndejjo, R; Ekirapa-Kiracho, E and George, AS (2016) Supporting youth and community capacity through photovoice: Reflections on participatory research on maternal health in Wakiso district, Uganda, Global Public Health, DOI:10.1080/17441692.2016.1168864
This paper reflects on the experiences of using photovoice to examine maternal health in Wakiso district, Uganda. The project involved 10 youth aged 18–29 years old, who were diverse in education, occupation, and marital status and identified by community leaders with researchers. By taking photos and sharing images and experiences in monthly meetings over five months, youth reported becoming more knowledgeable. They realised that they had common experiences but also reflected on and reinterpreted their circumstances.
Musoke D., Ekirapa-Kiracho E., Ndejjo R. and George A. (2015) Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda, Reproductive Health Matters, 23(45):136-47, doi: 10.1016/j.rhm.2015.06.011
Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders.
Complex and dynamic public health problems require a different approach: an emphasis on the value of people. People who own the problem can anticipate the most likely social obstacles to its resolution, and their participation is essential to maintain an evolving strategy that can institutionalize an approach to the problem.