Community Leadership and Health Promotion: Lessons From Rural South Africa

Saturday, 23 July 2016

Wilson Majee, PhD, MPH, MBA
Department of Health Sciences and Oublic Health, University of Missouri, Columbia, MO, USA
Karien Jooste, DLittetPhil, MCur, BCur, RN
Nursing, University of the Western Cape, Bellville cape Town, South Africa
Lydia Aziato, PhD, RN
Department of Adult Health, School of Nursing, University of Ghana, Legon, Accra, Ghana

Purpose:

Rural communities have continued to face a complex set of challenges: geographic isolation, high levels of poverty, sparse and declining human population, as well as loss of jobs and economic opportunities. These factors create two big challenges for rural communities – continued rural urban migration of predominantly young people and a pool of disengaged youth among those that stay. Because of this, rural communities have a greater human capital need – for more leaders. Though actively engaging community leaders in building programs and policies that consider equity and liveability of environments is important, little research has been done to examine the issue at a local level, particularly in rural settings. While the goal of all leadership development initiatives is to develop and equip leaders with necessary skills to create change at different levels, from individual to societal – significant impact is achieved when programming targets local community members (UNDP, 2006). The objective of this study was to explore the experiences of community leaders on their role in health promotion in a rural community.  Community leadership development is one intervention commonly used to unlock community assets and release people’s potential to participate in activities that affect their health and socioeconomic well-being (Blanchard, 2012; Majee, Maltsberger, Johnson, & Adams, 2014). It recognizes the need for community members to acquire and apply skills, through involvement, in shaping the decisions and policies that affect their lives (Langone & Rohs, 1995; National Extension Task Force, 1986). The study aimed at a) identifying current barriers and opportunities for the inclusion and advancement of youth and women in resource limited communities in health promoting activities, and b) identifying potential interventions for empowering local communities to engage in and lead health promoting initiatives.

Methods:

A qualitative, exploratory design was followed. Burns and Grove (2003:313) define exploratory research as research conducted to gain new insights, discover new ideas and/or increase knowledge of a phenomenon. Creswell (2013:37) states that to study a problem, qualitative researchers use an emerging qualitative approach to inquiry and the collection of data in a natural setting sensitive to the people and places under study. Eighteen semi-structured individual interviews were conducted over a period of one month with purposively sampled community leaders such as school principals, church leaders, nurses, directors of non-governmental organizations, local government officials. The participants were males and females over the age of 35. Open coding was used to organize data collected in the unstructured individual interviews (Creswell 2012:244). An independent coder assisted the researchers and a consensus discussion was held to finalise the themes and categories that emerged. Five themes emerged which focused on the actions that needed to be taken to empower community leaders to play a more active role in health promotion.

Results: Community leaders need to implement activities that promote the health of community members through support services, promoting collaboration between different stakeholders to establish a multidisciplinary team approach while having a personal vision in addressing the needs of the community. Participation of different generations in the community is essential to promote health within economical and financial constraints.

Conclusion: Facilitation of improved interpersonal relationships and coordination of community activities are needed in order to use the available resources in a more effective way.