Social Determinants of COVID-19 Pandemic Control: Participatory Learnings From Everyday Experiences in Cape Town, South Africa

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Expectations Pub Date : 2024-09-16 DOI:10.1111/hex.70030

Frederick Marais, Erna Louisa Prinsloo, Christi Niesing, Petra Bester

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Abstract

Introduction

As countries adapted their disaster responses to the COVID-19 pandemic, South Africa responded with an alert-level risk approach based on epidemiological principles that impacted all societal levels. We explored the everyday experiences of people in Cape Town whose basic needs were met and who could report on the realities of the COVID-19 pandemic control. Gaining insight into their perspectives contributes to knowledge that can inform policies and practices for managing future public health crises.

Methods

Community-Based Participatory Research principles guided the design and a series of facilitated dialogues with 18 research participants. The thematic analysis was deepened through two colloquiums with members of an overarching research consortium and a participant reflection workshop.

Findings

The pandemic impacted individuals, their interpersonal relationships, workplaces and communities, leading to societal processes such as stigma, virtue signalling and the subversion of mandates. The public health response had mixed reactions, with useful information about preventive measures being diluted by COVID-19 denialism and fake news. Health and other authorities were frequently perceived as out of touch with, and unresponsive to, the everyday realities of local communities.

Conclusions

Our study demonstrates the connectedness of people and the need to maintain and re-establish severed connections. A holistic approach to health care and promotion from social determinants of health and a community-engaged perspective may significantly increase the outcomes of public health responses.

Participant and Public Contribution

People with everyday experience of the COVID-19 pandemic—including community members, healthcare workers, case managers, carers and researchers—collaborated on the study design, interview schedule, data interpretation, analysis and refinement of this article.

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COVID-19 大流行控制的社会决定因素：从南非开普敦的日常经验中参与式学习

导言：在各国对 COVID-19 大流行病的灾难应对措施进行调整时，南非根据流行病学原则采取了影响社会各个层面的警戒级风险应对方法。我们调查了开普敦人的日常经历，他们的基本需求得到了满足，并能报告 COVID-19 大流行病控制的实际情况。深入了解他们的观点有助于了解未来公共卫生危机管理的政策和实践。方法以社区为基础的参与式研究原则为指导，设计并与 18 名研究参与者进行了一系列促进性对话。通过与总体研究联盟成员的两次座谈会和一次参与者反思研讨会，深化了主题分析。研究结果大流行病对个人、其人际关系、工作场所和社区产生了影响，导致了社会进程，如污名化、美德信号和对任务的颠覆。公共卫生应对措施的反应不一，有关预防措施的有用信息被 COVID-19 的否认主义和假新闻所冲淡。卫生部门和其他部门经常被认为与当地社区的日常现实脱节，对其反应迟钝。结论我们的研究表明了人与人之间的联系，以及保持和重建被切断的联系的必要性。从健康的社会决定因素和社区参与的角度出发，采取整体性的保健和促进方法，可能会显著提高公共卫生应对措施的效果。参与者和公众贡献日常经历过 COVID-19 大流行的人员--包括社区成员、医护人员、病例管理人员、护理人员和研究人员--共同参与了本文的研究设计、访谈计划、数据解读、分析和完善。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.