An Alliance in Action: Building stronger partnerships for rural health
Rural health challenges are complex and cannot be solved by one organisation working alone. This was the focus of RHAP’s panel discussion, An Alliance in Action, at the Rural Health and Family Physicians Joint Congress 2026, where speakers explored what it takes to build meaningful partnerships and work together towards better health outcomes for rural communities.
The panel brought together three speakers with different experiences of collaboration in health and social justice. Tracey Malawana, a social justice activist and movement builder, brought the perspective of advocacy and community power. Mildred Thabeng, a qualitative social science researcher, shared her experience in public health research, community engagement and youth participation. Dr George Mahembe, a family physician and senior lecturer based at Zithulele Hospital in rural Eastern Cape, spoke about collaboration within rural health systems and the importance of connecting healthcare workers.
The discussion was facilitated by RHAP’s Research and Policy Officer Celene Coleman, who opened the discussion with a simple but important question: When did you realise you could not do the work alone?
For Malawana, the answer came through her advocacy work. She reflected on her experience with the Health Living Alliance, where she worked on advocacy that contributed to the adoption of the Health Promotion Levy, commonly known as the Sugar Tax.
She explained that achieving policy change required more than one organisation pushing for the same goal. It meant identifying the people who held power, organisations already working on the issue, researchers who could contribute evidence and civil society groups connected to communities.
For Malawana, however, communities remain at the centre of this work.
“We do the work for our people,” she explained, emphasising that the people affected by an issue must have a role in shaping the decisions and policies that affect them.
Thabeng brought a research perspective to the conversation, highlighting a challenge that is often overlooked. People may want to collaborate, but they do not always know how.
She explained that there are few clear structures that guide organisations and stakeholders through the process of building, assessing and sustaining meaningful collaboration. Having a shared goal is important, but collaboration also requires a process that allows people to understand their different roles and contributions.
Her experience in public health research and community engagement has also reinforced the importance of allowing communities to influence the work being done with them.
For Thabeng, listening to communities is not enough. Their voices should be able to change the research questions, plans and approaches being developed.
Dr Mahembe brought the discussion into the realities of providing healthcare in rural areas.
As a family physician and senior lecturer based at Zithulele Hospital in the rural Eastern Cape, his work focuses on strengthening rural health systems through collaborative networks and digital health innovations.
He explained that hospitals cannot work in isolation. A district hospital depends on clinics, nurses, community health workers and other healthcare providers to deliver care to communities.
This becomes even more important in rural areas, where distance, poor roads, connectivity challenges and limited resources can make communication and referrals difficult.
Dr Mahembe shared how a simple WhatsApp group connecting healthcare workers at referral clinics has helped address some of these challenges. The group provides an accessible way for doctors and nurses to communicate about patients and seek advice when immediate communication is needed.
For him, however, technology is only one part of building stronger relationships. Trust is equally important.
He explained that trust develops when healthcare workers know that they can depend on each other. This can mean answering a call, making a visit to a clinic or simply being present when support is needed.
Trust was a common theme throughout the discussion.
The speakers emphasised that collaboration cannot be built simply by putting organisations in the same room. It requires relationships, honesty, respect and consistency.
The panel also considered what happens when communities do not want the solution that an organisation is offering.
Malawana shared an experience where a community made it clear that the issue researchers wanted to study was not the issue they considered most important. Rather than forcing the project forward, the organisations involved chose to listen and recognise that there was no shared purpose at that point.
For Malawana, this was an important lesson: not every potential partnership needs to become a collaboration.
The discussion highlighted the importance of understanding communities before introducing new programmes or research. Rural communities already have networks, relationships and ways of working together. External stakeholders should not arrive assuming they have all the answers.
Instead, they need to understand what is already working, build on existing strengths and create space for communities to shape the work.
The panel offered an important message for those working towards rural health equity. Collaboration is not simply about working alongside other organisations. It is about building relationships around a shared purpose and recognising that different people bring different forms of knowledge and experience.
From community activists and researchers to healthcare workers and health systems, each has a role to play.