C-SHARP
Summary of the Project
Current services
Masincedane community health workers in Nomzamo visit people in their homes to provide home- and community-based health services. Masincedane works in partnership with the Western Cape Department of Health and Wellness and the local clinics to provide the best possible services for their clients. Working together includes sharing patient information with the Department of Health and Wellness to improve patient care.
What is C-SHARP?
C-SHARP is a research project that will study and monitor the living conditions and health of people living in Nomzamo. There is a second research site in Bishop Lavis. There are many researchers working together on this project, and this research is also part of a bigger research network in South Africa.
The study will help us to understand:
· How many people live in Nomzamo (the number of births and deaths, how many people move in and out of Nomzamo)
· The living conditions of people in Nomzamo (access to water, toilets and electricity)
· The main health problems in Nomzamo
· The challenges people face with education and employment
Community health workers will be helping to collect information for the research, by asking additional questions during their home visits. The services that they provide will remain the same and will always be more important than the research.
What will it mean to take part in the study?
· All households in Nomzamo will be invited to be part of the study.
· You are free to decide to be part of or to not be part of the study at any time.
· Your community health worker will continue to visit and provide health care whether you choose to join the study or not.
· If you agree to participate, one member of the household will sign permission for the questions to be asked.
· Normally the community health worker asks questions and checks on everyone in the home, and this takes about 20 minutes. The study questions will take an extra 10 minutes to answer.
· Community health workers will do interviews in the home at least once a year. In 2024 two short telephone interviews will also be done. You will be asked every time whether you want to participate and are free to decide whether you want to or not.
· There are no direct benefits to being part of the study. It is hoped that the information collected will help to improve service delivery.
Who will see the information that is collected?
All information will be kept private and confidential. The information will also be shared with the researchers, but your identity will be protected, by removing information like names and ID numbers.
Current services
The Western Cape Department of Health and Wellness, together with Masincedane in Nomzamo, provides community oriented primary health care (COPC). This includes community health workers employed by Masincedane visiting people in their homes to provide basic health services. Part of this work includes asking questions about health issues (e.g. pregnancy, childhood immunizations, tuberculosis screening, etc). If the community health worker finds that someone needs to be referred for care or sent on to other services, they will give a referral letter and help you access those services.
Participating in the C-SHARP Research project
Study introduction
C-SHARP is a health and demographic surveillance system, similar to the National Census, being set up in Bishop Lavis and Nomzamo by the Western Cape Department of Health and Wellness and researchers (from the University of Cape Town, Stellenbosch University, University of the Western Cape, Human Sciences Research Council, the Medical Research Council and the City of Cape Town). A health and demographic surveillance system allows us to understand exactly how many people live in a community, how many births and deaths there are, how people move in and out of the community, as well what the main health problems are. C-SHARP is part of the South African Population Research Infrastructure Network (SAPRIN). SAPRIN aims to support health, economic and social policies in South Africa, by understanding the reality of people’s lives, especially those in poorer communities.
C-SHARP will be added into primary health care services, and we will now be increasing the number of questions that community health workers ask to look at living conditions in more detail. We will not disrupt routine services, and providing health care services will always be more important than research.
Ethics approval for this study was given by the University of Cape Town (HREC 517/2023).
What will it mean to take part in the study?
All households living within the Nomzamo area, will be invited to join this study. Your involvement in this study is completely voluntary, and you are free to decide not to be part of the study at any time. Normal primary health care services, including visits from community health workers, will be provided whatever your decision about the study is.
When the community health workers visit households to provide normal services, they will then offer the household the chance to be part of this study. A member of the household, usually an older person who knows about all the people living in the house, will be asked if the household would like to be part of the research. If the person agrees, they will be asked to give signed permission, known as informed consent, for the whole household. This household member will then provide answers to the additional questions that the community health workers will ask. The normal primary health care questions from the Department of Health take around 20 minutes. The extra research questions about the household should take around 10 minutes. You are free to refuse to answer some, or all, questions.
The community health worker will record the answers on a mobile phone or on a paper form. For C-SHARP households, we will also link the information that the community health worker collects to information from health facilities to get more detail about births or deaths.
What information is included in C-SHARP?
When the community health worker visits, they collect basic information on the household for normal primary health care services (e.g., how many people live there, what their water supply and toilet facilities are etc.).
When a household agrees to be part of C-SHARP, that information will be included, along with the extra research questions, like what the house is built out of, what cooking fuel they use, what internet access they have etc.).
As part of normal services, community health workers also ask detailed questions around individual people’s health, such as about pregnancy, HIV or TB. But that personal information is only for health services, and will not be part of the C-SHARP household research project.
Who will see the C-SHARP information that is collected?
All information recorded will be kept private and confidential, and stored safely. C-SHARP will share information with SAPRIN and other researchers but will do so in a way that does not allow people and households to be recognised or identified again. This is done by removing information such as your name and your ID number from the data that we share. All data sharing will be done according to the privacy policies of the Western Cape Department of Health and Wellness and with the national Protection of Personal Information Act (Act No. 4 of 2013).
Will I be interviewed again?
C-SHARP plans to visit each household in person at least once a year. When we visit the household in the next year, we will ask for consent again, and you are free to decide to be part of this research project or not.
From 2024 onwards we will also visit or phone the household respondent two extra times a year for short updates, to check if any births or deaths have taken place, or if people moved into or out of the household. These telephone interviews or short visits should take around 5 minutes to do. At the start of the phone call or visit, you will also be asked if you would like to be part of the study and you are free to decide to be part of the interviews or not.
What are the benefits and risks of being part of this study?
There are no direct benefits to being part of the study. C-SHARP aims to strengthen community oriented primary health care services in Bishop Lavis and Nomzamo. And the information collected in the study will hopefully be used to improve service delivery in communities throughout South Africa.
Being part of the study will take up some of your time. And while there is a very small risk that in sharing your data, you could be identified again, we are taking all reasonable steps to ensure that this will not happen.
Who can I contact for more information?
If you have any other questions, please speak to your community health worker or your local health committee, or you can contact:sharp@westerncape.gov.za
· Masincedane (Nomzamo): 021 854 6303; Market Square, corner of Wesley & Kort Street, Strand, 7140; kobus@masi.org.za
