Lessons from community engagement approaches in the Western Cape’s COVID 19 health response: A document review

Abstract

Introduction: The COVID-19 pandemic strained health systems globally, including South Africa. The Western Cape provincial health department responded by mobilizing resources, expanding infrastructure, and implementing control measures like community screening and public health campaigns. Additionally, the department established a COVID-19 Steering Committee to facilitate equitable access and increase vaccine uptake through community engagement with civil society. This paper describes the lessons learned from this process to guide future community and stakeholder engagement. Methods: A qualitative review of documents from April 2021 to October 2022 was conducted. Data consisting of 21 sets of meeting minutes, which were subjected to reflexive thematic analysis using ATLAS.ti. Ethics clearance was obtained from Stellenbosch University Health Research ethics committee and permission for the study from the Western Cape Government Department of Health. Results: Themes revealed how strategic intentions translated into actions to boost vaccine uptake and foster community trust. Efforts involved culturally sensitive communication, capacity building for health workers, and high adaptability. Key actions included multisectoral coordination, countering misinformation, logistical problem-solving, managing power imbalances between government and civil society leaders, and addressing socio-economic barriers. Conclusions: Community engagement is vital for effective emergency responses. Building trust and community ownership by involving diverse stakeholders and addressing resource inequities are central to the success of health interventions. This study highlights the importance of multisectoral collaborations and tackling social power differentials to foster inclusive responses.