Water Is Life’: Working with Communities to Develop Local Knowledge for Action to Address Water Shortage

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 8 participants representing community actors, service users and providers in a rural village from earlier work in 2013 and 2015. Lack of clean, safe water was raised as an issue that participants considered important and relevant, and a further 8 women of reproductive age 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 problems and causes, identify relevant actors, and develop action plans. Participants also used photography to document local issues around lack of water in rural villages.

The effects of lack of water are profound and multisectoral action is necessary to address the issue. Participants developed integrated community health systems action plans inclusive of multi-sectoral partnerships and monitoring mechanisms. PAR inclusive of Photovoice developed compelling evidence on the lived experience of lack of clean, safe water in rural communities. The next step is to engage stakeholders to encourage visibility and action in health systems.