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How a rural South African learning platform transformed primary healthcare

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How a rural South African learning platform transformed primary healthcare

Verbal Autopsy with Participatory Action Research (VAPAR)

Ten years of research in rural South Africa.

A new long read from the 51cg follows the Verbal Autopsy with Participatory Action Research (VAPAR) programme, led by Dr Lucia D'Ambruoso of the School of Medicine, Medical Sciences and Nutrition with the MRC/Wits Agincourt Unit and the Mpumalanga Department of Health.

In settings where many deaths pass without medical certification, verbal autopsy uses interviews with families to establish probable cause of death. VAPAR extended this methodology, systematically recording critical limiting circumstances at and around time of death such as transport, delays, barriers to care, and bringing communities, health workers and district managers together in cooperative dialogue to interpret and act on the data.

Over a decade, the process became a learning platform embedded in provincial programmes supporting shared problem-solving, routine evidence use, and from Community Health Workers leading analysis and advocacy in their own districts.

Read the story: /stories/VAPAR/index.html

Full 10-year evaluation (Witter, D'Ambruoso et al., 2026):

Please get in touch if you would like more information about our work: bhds@abdn.ac.uk

#GlobalHealth #HealthSystems #CommunityHealthWorkers #SouthAfrica

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