DECIPHer goes to Cape Town

Emily Lowthian is a PhD Student and Research Associate at DECIPHer. Her research interests are parental behaviours and child wellbeing outcomes. She attended and facilitated the short course ‘Developing and Evaluating Complex Public Health Interventions’ in October 2019 at Stellenbosch University, Cape Town, South Africa, and reported back to us.

As a former DECIPHer placement student, I never would have imagined that five years later I would be writing a blog about my trip to Cape Town to help deliver their renowned short course! A lot has changed in these five years, as I have gone from an undergraduate placement student, to a master’s student, and now a joint Research Associate and PhD Student at DECIPHer.

The offer to visit Cape Town to help facilitate the short course came about when Prof. G.J. Melendez-Torres and Dr. Graham Moore set up a collaboration with Stellenbosch University. The short course was part of this collaboration between DECIPHer and the Institute for Life Course Health Research (ILCHR) at Stellenbosch University. This course was even shorter than usual because it was a three-day long (or short!) course, rather than the usual five. It was delivered in the same way, though, with students and staff sitting in groups and course material delivered and applied in activities. It even involved some brief yoga sessions by Prof. Melendez- Torres!

What was unique about this course delivery was the social context added by the staff and students taking the course.

Throughout the course, the usual content was delivered, including: intervention theory; logic models; co-production; process evaluation; feasibility; review methods and adaptation. However, what was unique about this course delivery was the social context added by the staff and students taking the course. As a facilitator for each session, I had first-hand experience of listening to, and understanding, the way interventions are conducted in South African contexts. This is particularly important as poverty is not the only context they have to consider, as South Africa has many challenges, including high crime rates, deep poverty and the movement away from apartheid.

These contexts proved challenging when we came to the adaptation activity. Dr. Evans gave the group an example of an intervention and the attendees had to apply this to a South African context. For instance, the way mental health is conceptualised in South Africa is much different to the UK – attendees mentioned that it is difficult to get help with mental health; that the waiting lists are long and much of the mental health issues South Africans deal with are often in conjunction with poverty, neighbourhood crime and tension and ill physical health. The group also discussed how home visits can often be dangerous for the intervention researchers, but how they often take place despite this, as many South Africans are not able to attend a centre to receive an intervention. They also discussed the problems with retention in their interventions, and that often people participate in the interventions for extra income, and the difficulties surrounding this.

It was very moving to meet some of the participants who had really benefitted from the intervention; they were full of good energy and hope. It was a morning I will remember for a long time.

The hour-long discussion included how different provinces would then need to adapt this intervention, and, due to the complex nature of each province, we decided that we would focus on and adapt one province. However, even focusing on one was difficult, illuminating the complexity of South Africa’s public health challenges, and how different it is to the UK.

After the course had finished, we visited Khayelitsha, an informal township in South Africa that had recently received a football (or soccer to them!) intervention to help coach young men with life problems and issues. It was very moving to meet some of the participants who had really benefitted from the intervention; they were full of good energy and hope. It was a morning I will remember for a long time.

It was great to be reminded of the excellent work we do at DECIPHer, and how important public health interventions are worldwide. The course showed that G.J., Graham, Jemma and Rhiannon each have their own specialist knowledge that makes the course one of a kind. I think when we do our day-to-day jobs, we sometimes forget to appreciate the wonderful work we all do here, and how important it is for the future.

In April 2020, thanks to ESRC funding, I will return to Cape Town to work on some of the ILCHR’s very interesting projects and continue the collaboration. I’ll report back – watch this space!

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