What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa?
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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-15761-1 |
| _version_ | 1797827294467719168 |
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| author | Agnes Erzse Teurai Rwafa-Ponela Susan Goldstein Molebogeng Motlhatlhedi Daniella Watson Karen J. Hofman Marion Danis Shane A. Norris Kate A. Ward Aviva Tugendhaft on behalf of the INPreP study group |
| author_facet | Agnes Erzse Teurai Rwafa-Ponela Susan Goldstein Molebogeng Motlhatlhedi Daniella Watson Karen J. Hofman Marion Danis Shane A. Norris Kate A. Ward Aviva Tugendhaft on behalf of the INPreP study group |
| author_sort | Agnes Erzse |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T12:46:14Z |
| format | Article |
| id | doaj.art-6b7444f76060422aa4d74569b3d5f6aa |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-09T12:46:14Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-6b7444f76060422aa4d74569b3d5f6aa2023-05-14T11:30:41ZengBMCBMC Public Health1471-24582023-05-0123111510.1186/s12889-023-15761-1What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa?Agnes Erzse0Teurai Rwafa-Ponela1Susan Goldstein2Molebogeng Motlhatlhedi3Daniella Watson4Karen J. Hofman5Marion Danis6Shane A. Norris7Kate A. Ward8Aviva Tugendhaft9on behalf of the INPreP study groupSAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of WitwatersrandSAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of WitwatersrandSAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of WitwatersrandSAMRC/ Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, School of Clinical Medicine, University of the WitwatersrandGlobal Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of SouthamptonSAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of WitwatersrandDepartment of Bioethics, National Institutes of HealthSAMRC/ Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, School of Clinical Medicine, University of the WitwatersrandSAMRC/ Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, School of Clinical Medicine, University of the WitwatersrandSAMRC/ Wits Centre for Health Economics and Decision Science, PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of WitwatersrandAbstract 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.https://doi.org/10.1186/s12889-023-15761-1Decision-makingMalnutritionMaternal-child health servicesResource allocationCommunity involvementSocial values |
| spellingShingle | Agnes Erzse Teurai Rwafa-Ponela Susan Goldstein Molebogeng Motlhatlhedi Daniella Watson Karen J. Hofman Marion Danis Shane A. Norris Kate A. Ward Aviva Tugendhaft on behalf of the INPreP study group What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? BMC Public Health Decision-making Malnutrition Maternal-child health services Resource allocation Community involvement Social values |
| title | What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? |
| title_full | What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? |
| title_fullStr | What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? |
| title_full_unstemmed | What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? |
| title_short | What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa? |
| title_sort | what values drive communities nutrition priorities in a resource constrained urban area in south africa |
| topic | Decision-making Malnutrition Maternal-child health services Resource allocation Community involvement Social values |
| url | https://doi.org/10.1186/s12889-023-15761-1 |
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