Many deaths in low- and middle-income countries occur because of exclusion from health systems, due to financial, bureaucratic or geographical issues, as well as wider factors which affect health. The research in this project aims to understand why these barriers may exist and provide the evidence to groups at all levels of the health and other public administrative systems in order to make positive change.
Work completed through IGHD at Queen Margaret University will contribute to all areas of the project, including analysis of existing evidence from verbal autopsy and engagement with communities in Mpumalanga; feeding that evidence into an action research cycle, involving communities and multi-sectoral actors; and assessing and fine-tuning the programme approach over a repeated cycle.
The aspiration is to contribute to more participatory approaches in the health and other sectors longer term in South Africa and beyond, contributing to better governance and public engagement.
Find out more at the main VAPAR webpage
VAPAR is a multi-partner research project, with collaboration between Queen Margaret University, University of Aberdeen, Mpumalanga Department of Health, University of Witwatersrand, Johannesburg and Umeå University, Sweden.
To find out more about specific people working on this project as well as other project partners, see the People & Partners page on the VAPAR website
The research is supported by the Health Systems Research Initiative from Department for International Development (DFID)/ Medical Research Council (MRC)/ Wellcome Trust/ Economic and Social Research Council (ESRC) (MR/N005597/1, MR/P014844/1)
The VAPAR project objectives are sequential and build on one another as follows:
1. Develop inclusive knowledge partnerships to strengthen health systems for health equity: Apply VAPAR in a cycle of collective reflection and action cycles to generate information on disease burdens, their social and health systems determinants (using VA), and priorities for action from the perspectives of disadvantaged groups (using PAR). Analyse in a multi-level process of health systems engagement, develop recommendations, plan and document implementation, and re-evaluate;
2. Evaluate changes in health, health services and health equity: Over three reflection and action cycles, analyse trends in health outcomes, behaviours and service provision. Identify mechanisms through which changes do (or do not) occur in implementation and empowerment. Understand impacts and whether and how these address health equity, and whether and how these relate to the use of evidence, and the influence of social and political contexts;
3. Build sustainability and transferability: Explore and promote integration of VAPAR into routine health systems functions at different levels to translate co-produced evidence into action. Contribute to communities of practice for collaborative research through teaching and training. Disseminate to the public, health systems stakeholders, governmental, technical and research groups.
For full project publications, see the Papers & Reports page on the VAPAR website