What values drive communities' nutrition priorities in a resource constrained urban area in South Africa?
What values drive communities' nutrition priorities in a resource constrained urban area in South Africa?
Background: voices of under-resourced communities are recognised as important yet are often unheard in decisions about healthcare resource allocation. Deliberative public engagement can serve as an effective mechanism for involving communities in establishing nutrition priorities. This study sought to identify the priorities of community members of a South African township, Soweto, and describe the underlying values driving their prioritisation process, to improve nutrition in the first 1000 days of life.
Methods: we engaged 54 community members (28 men and 26 women aged > 18 years) from Soweto. We conducted seven group discussions to determine how to allocate limited resources for prioritising nutrition interventions. We used a modified public engagement tool: CHAT (Choosing All Together) which presented 14 nutrition intervention options and their respective costs. Participants deliberated and collectively determined their nutritional priorities. Choices were captured quantitatively, while group discussions were audio-recorded. A thematic analysis was undertaken to identify the reasons and values associated with the selected priorities.
Results: all groups demonstrated a preference to allocate scarce resources towards three priority interventions-school breakfast provisioning, six-months paid maternity leave, and improved food safety. All but one group selected community gardens and clubs, and five groups prioritised decreasing the price of healthy food and receiving job search assistance. Participants' allocative decisions were guided by several values implicit in their choices, such as fairness and equity, efficiency, social justice, financial resilience, relational solidarity, and human development, with a strong focus on children. Priority interventions were deemed critical to supporting children's optimal development and well-being, interrupting the intergenerational cycle of poverty and poor human development in the community.
Conclusion: our study demonstrates how public engagement can facilitate the incorporation of community values and programmatic preferences into nutrition priority setting, enabling a responsive approach to local community needs, especially in resource constrained contexts. Findings could guide policy makers to facilitate more appropriate decisions and to improve nutrition in the first 1000 days of life.
Administrative Personnel, Child, Female, Health Priorities, Humans, Male, Nutritional Status, Pregnancy, Resource Allocation, South Africa, Decision-making, Resource allocation, Maternal-child health services, Community involvement, Social values, Malnutrition
Erzse, Agnes
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Rwafa-Ponela, Teurai
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Goldstein, Susan
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Motlhatlhedi, Molebogeng
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Watson, Daniella
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Hofman, Karen J
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Danis, Marion
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Norris, Shane A
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Ward, Kate A
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Tugendhaft, Aviva
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12 May 2023
Erzse, Agnes
817251b4-544e-4535-8ceb-4d1126fe0102
Rwafa-Ponela, Teurai
d14560f8-f620-44f6-9424-eee503a119ed
Goldstein, Susan
436a0ca6-4d5f-458e-8851-427a9541a399
Motlhatlhedi, Molebogeng
b882c6ed-b0ac-42be-8e69-6897d7fa3c9c
Watson, Daniella
26005c9f-779f-407b-b7e4-b7c9b812b6be
Hofman, Karen J
c4f9b7ec-6446-4eae-9af1-36af699f7d47
Danis, Marion
69a7de70-dc20-44c6-9f37-80ba4f10b185
Norris, Shane A
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Ward, Kate A
39bd4db1-c948-4e32-930e-7bec8deb54c7
Tugendhaft, Aviva
df979acf-c507-4dd6-b077-a98c568f72ba
Erzse, Agnes, Rwafa-Ponela, Teurai, Goldstein, Susan, Motlhatlhedi, Molebogeng, Watson, Daniella, Hofman, Karen J, Danis, Marion, Norris, Shane A, Ward, Kate A and Tugendhaft, Aviva
,
INPreP study group
(2023)
What values drive communities' nutrition priorities in a resource constrained urban area in South Africa?
BMC Public Health, 23 (1), [873].
(doi:10.1186/s12889-023-15761-1).
Abstract
Background: voices of under-resourced communities are recognised as important yet are often unheard in decisions about healthcare resource allocation. Deliberative public engagement can serve as an effective mechanism for involving communities in establishing nutrition priorities. This study sought to identify the priorities of community members of a South African township, Soweto, and describe the underlying values driving their prioritisation process, to improve nutrition in the first 1000 days of life.
Methods: we engaged 54 community members (28 men and 26 women aged > 18 years) from Soweto. We conducted seven group discussions to determine how to allocate limited resources for prioritising nutrition interventions. We used a modified public engagement tool: CHAT (Choosing All Together) which presented 14 nutrition intervention options and their respective costs. Participants deliberated and collectively determined their nutritional priorities. Choices were captured quantitatively, while group discussions were audio-recorded. A thematic analysis was undertaken to identify the reasons and values associated with the selected priorities.
Results: all groups demonstrated a preference to allocate scarce resources towards three priority interventions-school breakfast provisioning, six-months paid maternity leave, and improved food safety. All but one group selected community gardens and clubs, and five groups prioritised decreasing the price of healthy food and receiving job search assistance. Participants' allocative decisions were guided by several values implicit in their choices, such as fairness and equity, efficiency, social justice, financial resilience, relational solidarity, and human development, with a strong focus on children. Priority interventions were deemed critical to supporting children's optimal development and well-being, interrupting the intergenerational cycle of poverty and poor human development in the community.
Conclusion: our study demonstrates how public engagement can facilitate the incorporation of community values and programmatic preferences into nutrition priority setting, enabling a responsive approach to local community needs, especially in resource constrained contexts. Findings could guide policy makers to facilitate more appropriate decisions and to improve nutrition in the first 1000 days of life.
Text
s12889-023-15761-1
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Accepted/In Press date: 26 April 2023
e-pub ahead of print date: 12 May 2023
Published date: 12 May 2023
Additional Information:
© 2023. The Author(s).
Keywords:
Administrative Personnel, Child, Female, Health Priorities, Humans, Male, Nutritional Status, Pregnancy, Resource Allocation, South Africa, Decision-making, Resource allocation, Maternal-child health services, Community involvement, Social values, Malnutrition
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Local EPrints ID: 477432
URI: http://eprints.soton.ac.uk/id/eprint/477432
ISSN: 1471-2458
PURE UUID: a206417a-ddb3-4cd7-936e-f948c8877773
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Date deposited: 06 Jun 2023 16:56
Last modified: 17 Mar 2024 03:57
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Contributors
Author:
Agnes Erzse
Author:
Teurai Rwafa-Ponela
Author:
Susan Goldstein
Author:
Molebogeng Motlhatlhedi
Author:
Karen J Hofman
Author:
Marion Danis
Author:
Aviva Tugendhaft
Corporate Author: INPreP study group
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