‘It Destroys Families and Communities’: Alcohol and Drug Abuse in Rural South Africa

We present participatory action research (PAR) inclusive of Photovoice from rural South Africa as part of a broader programme of health policy and systems research entitled ‘Verbal Autopsy with Participatory Action Research (VAPAR).

We re-engaged 16 participants representing community actors, service users and providers across two villages from earlier work in 2013 and 2015. Alcohol and other drug abuse was an issue that participants considered important and relevant, and a further 16 young people were recruited by the original participants to explore the topic as a collective. We then held a series of village-based workshops employing deliberative techniques to understand the problem and its causes, identify relevant actors, and develop action plans. Participants also used photography to document local issues around AOD abuse.

The combined effects of AOD abuse on families, communities, society and the economy were evident. Participants developed integrated community health action plans inclusive of multi-sectoral partnerships and monitoring mechanisms. PAR inclusive of Photovoice developed compelling evidence on the lived experience of AOD abuse in rural communities. The next step is to engage stakeholders to encourage visibility and action in health systems.