Building Back Better from Below
Lead Research Organisation:
Institute of Development Studies
Department Name: Research Department
Abstract
The COVID-19 pandemic has deepened existing social, health and nutritional inequities and highlighted common challenges facing marginalised and racialised communities in cities across the Global North and South. It has also driven new social innovations and cross-sector collaborations, some of which may have the potential to transform the longstanding inequities that undermine global health, food systems and governance processes.
This Trans-Atlantic collaboration will combine insights from social science research and the lived experiences of activists, social entrepreneurs, front-line workers and local public officials to identify strategies for future action to disrupt entrenched patterns of inequity and secure health rights and food justice after the pandemic. Recognising the intersecting nature of the health, food equity and democratic representation challenges the pandemic has brought, we will take an action research approach to analysing the trajectories, outcomes and sustainability of grassroots innovations and collaborations that have emerged since March 2020 among activists and front-line service providers working with marginalised and racialised communities in three socially diverse and economically dynamic but unequal cities: São Paulo (Brazil), Toronto (Canada) and Brighton (UK).
Thematic workstreams will examine innovative local initiatives to ensure access to primary health care, emergency food provision and political representation of the needs and priorities of marginalised communities disproportionately burdened by COVID-19, analysing the social, political, institutional and policy factors that have enabled or hindered effective collaboration and co-production of programmes and services between citizens and public authorities, between different levels of government and between state, community and business actors. Synthesis work will examine the outcomes and sustainability of the experiences of cross-sector policy coordination and multi-stakeholder collaboration that have emerged in the three cities during the pandemic, assessing their potential to underpin strategic and scaled-up action to tackle intersecting inequities affecting marginalised and racialised communities in Brazil, Canada, the UK and beyond.
This Trans-Atlantic collaboration will combine insights from social science research and the lived experiences of activists, social entrepreneurs, front-line workers and local public officials to identify strategies for future action to disrupt entrenched patterns of inequity and secure health rights and food justice after the pandemic. Recognising the intersecting nature of the health, food equity and democratic representation challenges the pandemic has brought, we will take an action research approach to analysing the trajectories, outcomes and sustainability of grassroots innovations and collaborations that have emerged since March 2020 among activists and front-line service providers working with marginalised and racialised communities in three socially diverse and economically dynamic but unequal cities: São Paulo (Brazil), Toronto (Canada) and Brighton (UK).
Thematic workstreams will examine innovative local initiatives to ensure access to primary health care, emergency food provision and political representation of the needs and priorities of marginalised communities disproportionately burdened by COVID-19, analysing the social, political, institutional and policy factors that have enabled or hindered effective collaboration and co-production of programmes and services between citizens and public authorities, between different levels of government and between state, community and business actors. Synthesis work will examine the outcomes and sustainability of the experiences of cross-sector policy coordination and multi-stakeholder collaboration that have emerged in the three cities during the pandemic, assessing their potential to underpin strategic and scaled-up action to tackle intersecting inequities affecting marginalised and racialised communities in Brazil, Canada, the UK and beyond.
Publications
Coelho V
(2023)
Governança e coordenação no SUS: aprendendo com a pandemia de Covid-19
in Novos Estudos - CEBRAP
| Description | The project has systematically documented a series of innovations in food provision, primary health care delivery and political voice and representation that emerged during the COVID-19 pandemic and have shaped subsequent policy and practice for tackling the longstanding racial inequities that were heightened and made more visible by the pandemic. These innovations have received very little attention in the post-pandemic period despite their proven effectiveness, and their relevance to current debates on food, health, poverty, democracy and devolution in England. |
| Exploitation Route | The project's documentation and analysis of the evidence both on the innovations themselves and on the enabling conditions that are necessary to sustain them in a 'post-emergency' context has been welcomed by policymakers and practitioners from the local to the national level, many of whom feel that the country has failed to learn some of the most important lessons from the pandemic, particularly with respect to the ability of grassroots community groups and front-line service providers to respond rapidly, innovatively and effectively to societal challenges. These lessons are currently being fed into a series of engagements with local and national policy processes, including the development of the new NHS Ten Year Plan. |
| Sectors | Agriculture Food and Drink Communities and Social Services/Policy Healthcare Government Democracy and Justice |
| URL | https://www.ids.ac.uk/projects/building-back-better-from-belowb4-harnessing-innovations-in-community-response-and-intersectoral-collaboration-for-health-and-food-justice-beyond-the-covid-19-pandemic/ |
| Description | The project's findings on local health system innovations for tackling health inequities have had a significant influence on key aspects of the ongoing reform process within the National Health Service (NHS) in England. At the local and regional levels, they have been used to inform the development of the Neighbourhood Health strategy of the Sussex Integrated Care Board, following the International Symposium and subsequent Learning Conclave co-hosted with NHS Sussex with the research team and partners from Brazil and Canada in Brighton & Hove in June 2024. At the national level, following a dialogue on international mutual learning on strategies to reduce racial health inequities involving representatives from the Brazilian Ministry of Health and the project research team at the Department of Health and Social Care (DHSC) in June 2024, the team were invited to work with King's College London to deliver a major international learning event for the Secretary of State for Health and Social Care and other ministers and senior civil servants from DHSC on the 'shift from hospital to community'. This shift is part of the strategy announced by the Secretary of State for the new NHS Ten Year Plan, and the IDS-KCL collaboration has involved mobilising senior policymakers and practitioners from the partner countries (Brazil and Canada) and seven other countries (Chile, Costa Rica, Japan, New Zealand, South Africa, Thailand and Zimbabwe) to participate in a symposium at IDS and a round-table at KCL as well as field visits and presentations to MPs and NHS leaders in London and Brighton in March 2025. The project's findings on local innovations for equity in the food system have also been fed into a series of dialogues with local authorities and voluntary sector groups from the West Midlands (Birmingham and Solihull) and London (Barnet and Brent) as well as Brighton & Hove as part of the collaboration with another ESRC-funded T-AP RRR project, Panex-Youth (led by UCL). These dialogues are in turn informing a Call to Action on Health and Food Justice which will be launched in mid-2025, the impacts of which will be assessed and reported on in the next submission. |
| First Year Of Impact | 2024 |
| Sector | Agriculture, Food and Drink,Healthcare,Government, Democracy and Justice |
| Impact Types | Societal Policy & public services |
| Description | An attendee at the NHS Sussex Health Delivery Board |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | Based on the participation of Bridging Change on the board meeting they are shaping attitudes, efficiency and access to public services, and education levels. |
| Description | An attendee at the NHS Sussex Race transformation Board |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | Based on the participation of Bridging Change on the committee they are shaping attitudes, efficiency and access to public services, and education levels. |
| Description | Attendee as an Assembly member on the NHS Sussex ICP (Integrated Care Partnership Board) |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | Through the participation of Bridging Change (BC) as an assembly member at the NHS Suusex ICP, BC is able to shape attitudes, efficiency and access to public services, and education levels. |
| Description | Brighton and Hove City Council Health and Scrutiny Committee |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | Based on the participation of Bridging Change on the committee they are shaping attitudes, efficiency and access to public services, and education levels. |
| Description | Sitting on the Strategy, Finance and City Regeneration Committee |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | Based on the participation of Bridging Change on the committee they are shaping attitudes, efficiency and access to public services, and education levels. |
| Description | Action learning set on affordable food projects in Brighton and Hove |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Third sector organisations |
| Results and Impact | In the spring of 2023, IDS and the Brighton and Hove Food Partnership co-facilitated an Action Learning Set (ALS) with participants involved in delivering Affordable Food Projects in the city of Brighton and Hove, including the following organisations: Woodingdean food hub, BMECP, Pankhurst Pantry, Phoenix Food Shop, Chomp and Cornerstone. Three sessions took place, and in the spirit of ALS, the aim of the exercise was to explore learning-in-action possibilities for the people and organisations involved in affordable food projects and related initiatives focused on dignified food access. Through a participatory prioritisation exercise food sourcing was chosen as the 'problem' or 'challenge' to focus on through the ALS process. Challenges of food sourcing were discussed based on participants' experiences . Ways forward were proposed considering participants' immediate sphere of influence and the challenges imposed by the external context. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.ids.ac.uk/projects/building-back-better-from-belowb4-harnessing-innovations-in-community... |
| Description | BME Infrastructure working with Brighton and Hove City Council and others |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Bridging Change directors have been working with Brighton and Hove City Council to create a stronger infrastructure for BME organisations, to help them thrive - working with: Brighton and Hove City Council Euromermet Racial Harassment Forum, Black Minority Ethnic Community Project (BMECP) Black Minority Ethnic Young People's Project (BMEYPP) |
| Year(s) Of Engagement Activity | 2023 |
| Description | Bridging Change & NHS world café and information sharing session |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Public/other audiences |
| Results and Impact | This included over 50 people (predominantly individuals and BME organisations, with ally organisations attending) - this was in the form of a workshop in the first half, followed by a world café style engagement group with commissioners from mental health (both adults and children's); primary health care, maternity and all other. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Bridging Change ChangeMaker sessions (Action Learning Sessions) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Third sector organisations |
| Results and Impact | These were a series of sessions run by Bridging Change with three organisations - Racial Harassment Forum, Jollof Café and Black Minority Ethnic Community Project (BMECP) which was action learning sets over 6 month period to help support individuals in organisations to build on specific issues to build stronger infrastructure within their organisations. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Brighton and Sussex Medical School anti-racism workshop |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | This is a jointly let workshop between Bridging Change and IDS - looking at social participation within healthcare for NHS professionals across Brighton and Hove and also Sussex-wide - it will involve engaging with commissioners, clinical practitioners and medical students. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Engagement with Brighton & Hove Health & Care Partnership Executive Board |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | Following a series of dialogues led by the PI with NHS Sussex and Brighton & Hove City Council (BHCC), both agreed to sign MoUs with IDS for partnership on delivering the project, and invited Co-I Dr Gerald Bloom to attend a meeting of the Brighton & Hove Health & Care Partnership Executive Board and present the research strategy. The response from the Board was enthusiastic, and NHS Sussex and BHCC subsequently confirmed that the primary research component had successfully passed through their ethical review process and was cleared to begin after the end of the scoping / desk-based research phase in 2023. We anticipate that these partnership agreements will deliver substantial regional policy impact in 2023 and beyond, as the primary research component develops. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.ids.ac.uk/news/trans-atlantic-study-looks-to-brighton-and-hove-for-lessons-from-pandemic... |
| Description | Participation in reflection session for WellBN on pilot antiracism work on health |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | Erica Nelson facilitated a reflection session for a team of professionals who were organising a health sector initiative to address race-based inequalities |
| Year(s) Of Engagement Activity | 2024 |
| Description | Participation in workshop on innovations in food provisioning in high and middle income countries |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | In September 2023, B4 researchers Lidia Cabral, Santiago Ripoll and Jennifer Constantine participated in an international research workshop, hosted by Kingston University, on different approaches to food provisioning across high and middle-income countries, in the context of the Covid-19 pandemic. Experiences from Brazil, Canada, France and the United Kingdom were presented and common and distinctive elements across the various cases were discussed. Plans to continue the collaboration were outlined, including bringing other countries into the dialogue (South Africa), producing a working paper, and searching for opportunities to fund further research. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.ids.ac.uk/projects/building-back-better-from-belowb4-harnessing-innovations-in-community... |
| Description | Participation in workshop on the new Brighton & Hove Food Strategy |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Professional Practitioners |
| Results and Impact | We were invited to participate in a workshop to discuss the new Brighton and Hove Food Strategy. Workshop participants (approximately 50 people) included members from various departments of the BHCC, researchers and practitioners. The workshop comprised two main sessions: (1) sharing of ongoing research related to food systems and food poverty in Brighton and the Sussex county; (2) group discussions on ways forward for the new Brighton and Hove Food Strategy, including what the stop, continue and add in relation to the previous (2018-2023) strategy. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.ids.ac.uk/projects/building-back-better-from-belowb4-harnessing-innovations-in-community... |
| Description | Participation in workshop organised by Brighton and Hove Food Partnership and University of Sussex to discuss research engagement with the new Brighton and Hove Food Strategy (March 2024) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Third sector organisations |
| Results and Impact | About 50 researchers, charity staff, practitioners and local government officials participated in a workshop to discuss the Brighton & Hove Food Strategy and contribute to its new 2025-2030 edition. This took place on the 7th of March at the University of Sussex. The workshop included presentations on relevant ongoing food projects across the city and discussions about relevant areas for action-research to support the new strategy. |
| Year(s) Of Engagement Activity | 2024 |
| URL | https://www.sussex.ac.uk/broadcast/read/64792 |
| Description | Participation in workshop organised by the Brighton and Hove Food Partnership on alternatives to food banks in addressing food poverty (April 2024) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Third sector organisations |
| Results and Impact | A city-wide meeting of stakeholders and experts to come up with alternative, preventative strategy to reduce food poverty, particularly considering the recurring budget pressures. This workshop fed into BHFP's overall Food Strategy Refresh. The structure of the workshop was as follows: 1. Setting the scene Eg 6,500 people reliant on emergency food each week; food banks under increasing pressure; surplus food supplies dwindling; unhealthy diets; lack of choice and dignity; knock on effects on health, hospital admissions, public services etc. 2. Outline some of the good initiatives already happening city-wide The attached document outlines some of the good initiatives happening city-wide and more widely in the UK. 3. Blue sky vision Imagine a Brighton and Hove without food insecurity. What would that look like? 4. Gap Analysis and Ideas What do we already have in the city that works well? How could we utilise or scale that up? What's missing? What could we do differently or better? 5. Way forward (stepping stones) What might work best in Brighton? 6. Next steps What would need to happen to take this forward. Who can help us? Who can lead? |
| Year(s) Of Engagement Activity | 2024 |
| Description | Presenting B4 Findings at the Royal Geographical Society Annual International Conference 2023 |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Other audiences |
| Results and Impact | We presented the findings on the nature of political representation and governance of racialised minorities in Brighton, Sao Paulo, and Toronto during Covid-19 and how it's changed since the end of the lockdown. Around 15 academics and postgraduate students listened to the presentation and 4 of them asked questions about the project and were curious to learn more about B4 findings. |
| Year(s) Of Engagement Activity | 2023 |
| Description | VCSE Alliance meeting with Adam Doyle, Jane Lodge, et al to discuss future working within NHS Sussex's relationship with the voluntary sector across all three areas (Brighton and Hove, East Sussex and West Sussex) |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Policymakers/politicians |
| Results and Impact | One of the directors of Bridging Change worked in partnership within the Voluntary Sector Alliance as a group to look to developing shared understandings around how integrated care can work with the voluntary sector - building on previous work, looking at best practice around commissioning and procurement, engagement and partnerships. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Videocast on health system transformation |
| Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Gerald Bloom was interviewed for a videocast produced and made available online by the Einstein Digital Academy at the Einstein School of Medicine in Sao Paulo. |
| Year(s) Of Engagement Activity | 2024 |
| Description | Workshop on digital health |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | A workshop was organised to facilitate mutual learning between the Sao Paulo State Government and the Sussex NHS on opportunities and challenges associated with the rapid diffusion of digital health services. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Workshop on the future of the Food Insecurity Network, Brighton and Hove |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Other audiences |
| Results and Impact | In July 2023, IDS and the Brighton and Hove Food Partnership co-facilitated a workshop on the future of the Food Insecurity Network in Brighton. Participants comprised members of the network, including different Brighton and Hove City Council departments and local charities. Participants reflected on the contributions made by the network since its creation and its particular role during the Covid-19 Pandemic. They also discussed challenges posed by the current context and issues to be tackled. The need for the continuation of the network was highlighted and options for its format moving forward were discussed. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.ids.ac.uk/projects/building-back-better-from-belowb4-harnessing-innovations-in-community... |
| Description | faciliation of a strategy review |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Professional Practitioners |
| Results and Impact | The IDS provided facilitation support for a internal strategy review by Bridging Change. |
| Year(s) Of Engagement Activity | 2024 |