Building Community-Led Health Futures in Cape Town

Pillars

Health Ecosystems

Health Ecosytems

Learn about how the University of Cape Town is partnering with communities in South Africa to co-create health solutions for better health outcomes

In Cape Town’s Klipfontein region, young people and their families continue to face complex and interlinked health challenges, including mental health concerns, substance abuse, and teenage pregnancies. Determined to be part of the solution, community members are stepping forward to shape programmes and policies that reflect their lived realities. As part of the Africa Health Collaborative (AHC), the University of Cape Town (UCT) is supporting this movement by creating inclusive spaces where local knowledge and evidence come together to drive practical change and inform health policies.

Over the past months, two initiatives have demonstrated the power of that commitment in action.

In Bridgetown/Silvertown, Klipfontein, over 100 youth, parents, educators, healthcare workers, and NGOs braved stormy weather to participate in UCT’s community-driven health dialogue. Together, they spoke honestly about mental health and sexual and reproductive health challenges, co-designed solutions, forged new partnerships between health facilities, local schools, NGOs, and local youth groups. This dialogue reinforced a collective commitment to provide youth-centred support on these issues — showing that meaningful change happens when those closest to the challenges lead the way.

At the same time, a Youth Wellbeing Survey — conducted by UCT across 15 schools in Klipfontein and Langa in partnership with Planet Youth, the Western Cape Department of Health & Wellness and the Western Cape Education Department — captured the voices of 85% of Grade 8-9 learners in the selected schools. These youth shared insight into their experiences of substance use, family dynamics, leisure time, peer influence, community safety, violence, and general well-being. The data revealed both urgent risk factors and protective factors. For instance, learners whose parents clearly disapproved of substance use were up to three times less likely to drink, vape, or use dagga — highlighting the importance of strong parental engagement. At the same time, the widespread and early uptake of vaping, now affecting more than a third of adolescents, emerged as a critical public health concern.

Their perspectives are now being used to guide community-driven interventions and inform policy discussions with decision-makers to create safer, more supportive environments for young people.

Together, these initiatives offer a compelling model for building responsive primary health care systems and local policy solutions — one that starts by listening deeply, involving communities from day one, elevating youth voices, and grounding actions in lived experience and data. Led by UCT as part of the Africa Health Collaborative’s mission to champion locally led solutions, this approach shows the commitment of communities and young people to be co-creators of health solutions and dialogues. It demonstrates that working with communities — not for them — can be a catalyst for healthier, more resilient futures for young people.