We had the privilege of participating in the MARCE Society for Perinatal Mental Health Conference, representing different country contexts while sharing a common commitment to improving perinatal mental health through community-centred and participatory approaches.
As three PhD researchers from South Africa, Lesotho and The Gambia, working within the CHIME programme, it was particularly meaningful to share space across an exhibition, symposium and reflexive panel discussion. Our PhD journeys are distinct, shaped by our different contexts and research questions, but connected by a shared interest in how communities can be meaningfully involved in shaping research and responses to perinatal mental health.
Our Symposium: Through a collaborative Lens
Chaired by Doctor Stefani Du Toit (PhD) was a 3-part session starting off with an exhibition, panel discussion and reflexive question & answer session set out a clear overview of what we have been working on as part of the CHIME study team and plans for our individual PhDs.
The exhibition provided an opportunity to showcase how community-centred research can look across different settings, while highlighting the importance of local knowledge, participation, partnership and context.
Noluthando Mpisane – South Africa
Detailing a multi-stage co-adaptation process where Photovoice activities and stakeholder engagement informed the intervention’s cultural relevance, acceptability, and community ownership in Khayelitsha
Moroesi Makhetha – Lesotho
CHIME Lesotho showcased how art-based methods, including the River of Life, photography and music were used to amplify the voices of young mothers regarding their motherhood journey and explore the meaning they attach to their experiences.
Sainabou Drammeh- The Gambia
In partnering to co-create research, moments and items were captured from The Gambia depicting CHIME’s commitment to building research partnerships grounded in community knowledge, collective practice, cultural context, meaningful representation and shared ownership of the research process.
A reflexive conversation across three contexts
During our panel discussion, Dr. Stefani Du Toit one of our PhD supervisors invited us to reflect on 2 straight forward but deeply nuanced questions:
Q1. What did each presenter learn from women’s and communities lived experiences that they would not have understood through conventional research methods alone?
Q2. We often use terms such as “co-creation”, “participation” and “community engagement”. What did genuine participation actually look like in your projects, and where is there still room for improvement?
Our responses drew on our experiences from South Africa, Lesotho and The Gambia, exploring what genuine participation looks like in practice, what we have learned from communities, and the challenges and possibilities of conducting research that is genuinely responsive to local contexts.
One of the things that stood out from our discussion was that although our contexts differ, there are important common threads: trust, reciprocity, community knowledge, power, accountability and the willingness to listen and adapt.
Our reflections are grounded in the collective work of the CHIME team, which began in The Gambia and has since been adapted and contextualised across South Africa and Lesotho. Seeing how these principles translate across different settings reinforced the importance of creating research processes that are not simply delivered to communities but shaped through partnership with them.
We are grateful for the many conversations and connections that made MARCE such a valuable learning experience. The conference brought together researchers and practitioners from psychiatry, psychology, public health, nursing, midwifery, counselling and many other disciplines, reminding us of the value of learning across professional and geographical boundaries. We left MARCE with new questions, new ideas, new connections and an even stronger appreciation for the possibilities of community-centred perinatal mental health research across the Global Majority.
We hope the questions below provide interest and reflection for others as much as they did for us, and that our responses will start conversations across community-based health research, particularly for perinatal mental health across the globe.
Our Reflexive Responses:
Noluthando Mpisane – South Africa
Response Q1: Music gave the perinatal women a space to voice the challenges and situations they were living through. One Intervention Development Group member had been shunned by her church because she was pregnant out of wedlock. She found comfort in music, and she composed music for her baby while she was still pregnant. This showed how music can hold women through isolation and rejection, and how a group (creating music together) can offer the support that was withdrawn elsewhere.
Music and symbolism also helped with language. In isiXhosa, emotional vocabulary can be limited, and it is not always easy to say directly how you feel. Symbolism gives women a way to express their emotions in greater depth. In the object storytelling activity, one woman chose a carrot because it brought her joy and helped her cope. When she held the carrot, she would smile and feel at peace. A simple object became a way to communicate something that words alone could not.
Response Q2: Working with the IDG and composing the music taught me what genuine engagement takes. I had to advocate for multiple sessions, stay flexible, and invest real time, effort, and resources to accommodate the members. Genuine engagement is not a one-off exercise. It means putting people at the centre of the process and adapting to their needs.
True co-development means people are involved throughout, but in practice they are often left out once the intervention is delivered. We need to ask how we bring them back in, for example to review the outcomes, help interpret the findings, and shape what happens next.
Makhetha Moroesi- Lesotho
Response Q1: While conventional research method is effective in gathering data, it may limit how participants express themselves due to its direct questioning. Using art-based method, I observed that it allowed young mothers to deeply reflect on the experiences that may have not been easily captured through conventional research. It allowed them to interpret their own experiences from their own perspective, highlighting turning points in their motherhood journey, including moments of sadness and joy, experiences of loss or disappointment, and moments of support. This form of expression helped me to not only capture the meaning of their journey, but to understand it alongside the context.
Response Q2: For me, genuine participation meant enabling participants to actively contribute to the body of knowledge by giving them the decision-making power to shape the narrative of their journey and interpret their own experiences. To achieve this, we allowed them to engage in collective reflection of their journey through participant-led analysis process. This experience also highlighted the need for methodical flexibility by allowing participants to choose the method that works for them to tell their stories. This was highlighted during the reflection session when we asked participants about the art-based tool that worked best for them.
Sainabou Drammeh – The Gambia
Response Q1: Conventional research gives us valuable data and helps us identify patterns, but working directly with women and communities creates a different kind of understanding. Through CHIME, I learned that women already hold significant knowledge about care and supporting one another, and that engaging with lived experience can challenge our assumptions and fundamentally change how we understand the questions we are asking.
Response Q2: For me, genuine participation has been about trust, honesty and creating real opportunities for communities to influence the process, from adapting the CHIME intervention with Kanyeleng women to shaping how our CABs function and co-developing guidance for collaboration.
There is still room for improvement, particularly in ensuring that we allocate adequate time for meaningful engagement alongside research activities, while continually asking whose voices are missing, what power communities have, and what we are willing to change in response.
A special thank you to our supervisors Professor Sarah Skeen and Doctor Stefani Du Toit (Institute for Life Course Health Research-Stellenbosch University), CHIME’s co-lead Professor Lauren Stewart (University of Roehampton), colleagues across the globe including the Medical Research Council Unit The Gambia at LSHTM and the National Center for Arts and Culture (NCAC) in The Gambia, communities we work with, and everyone who took the time to engage with our work and share their own.
And, of course, thank you to the whole CHIME team for creating the spaces that made these exchanges possible.
Three PhD journeys. Three contexts. One shared commitment to learning with communities. 🌍