Original Articles

Jobs, food, taxis and journals: Complexities of implementing Stepping Stones and Creating Futures in urban informal settlements in South Africa

DOI: 10.2989/16085906.2014.927777
Author(s): Andrew GibbsHealth Economics and HIV/AIDS Research Division (HEARD), South Africa, Rachel JewkesGender and Health Unit, South African Medical Research Council, South Africa, Nompumelelo MbathaProject Empower, Room E304 Diakonia Conference Centre, South Africa, Laura WashingtonProject Empower, Room E304 Diakonia Conference Centre, South Africa, Samantha WillanHealth Economics and HIV/AIDS Research Division (HEARD), South Africa

Abstract

This paper seeks to refocus debates on structural interventions away from ‘assessing’ their effectiveness towards understanding processes around how such interventions are implemented. Implementation Science is focused on understanding potential challenges of translating interventions from highly controlled conditions into ‘real life’ settings. Using the case study of Stepping Stones and Creating Futures a structural and behavioural intervention to reduce intimate partner violence and HIV risk behaviours amongst young women and men in urban informal settlements, we explore the challenges of implementing such an approach. We move beyond simply describing challenges of implementing, to understand how these challenges had an impact on the safe social space the intervention seeks to create as its underlying theory of change. We identify four major challenges of implementation: taxi fares, food provided during the intervention, young people’s ongoing need to work and journals provided during the intervention. We suggest that, in different ways, these factors all impinged on the emergence of a safe social space. Understanding the challenges of implementing the intervention is critical for reflecting on scaling up interventions. Central to this is the need to work with participants to help them negotiate the challenges of participating in interventions.

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