There are many routes through which community engagement is conducted in the context of higher education, not only via one process. Community engagement can be conducted via service learning, community-based research and participatory action research (Esau 2015:69; Ross & Stoecker 2017:7). In addition, other methods of community engagement include distance education, outreach and professional community services, service internships as well as community-based projects in the form of directed study or extra-credit modules (Bandy 2018). Despite the many methods of community engagement available at higher education institutions, faculty members are not keen to participate in community engagement, as it is not aligned with the standards for promotion and tenure at an institutional level, and there are no rewards given in recognition of participation (Gorski & Mehta 2016:110). The first author works as a lecturer at an institution of higher education and observed that academic staff in the Faculty of Health Science are not certain of what counts as community engagement when completing their appraisal forms at the end of an academic year. The same observation was also made at the business review of the institution, where some activities from the faculty were cancelled from the review reports, as they were not recognised as community engagement, which posed a problem. There appears to be confusion, ambiguity and a lack of clarity about the meaning of the concept ‘community engagement’; therefore, the research question is, what is the meaning of the concept ‘community engagement’?

The purpose of this research is to clarify the meaning of the concept ‘community engagement’.

The research objectives are to:

The concept ‘community engagement’ was selected because it is complex, ambiguous and still needs more clarity.

The purpose of the analysis was to clarify the meaning of the concept of community engagement and develop a theoretical definition. This will be used to develop strategies to facilitate community engagement in the Faculty of Health Science.

Dictionaries, thesauri, encyclopaedias, conference papers, research reports, journal articles and books were consulted to search for uses of ‘community engagement’. This was done via library databases and Internet searches. The online library databases that were most instrumental are Medical Literature Analysis and Retrieval System Online (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resource Information Centre (ERIC), dissertations and theses. Google, Google Scholar and citations were used to complement the search. From the literature reviewed, the concept of community engagement featured as part of the cognitive processes in learning, decision-making and collaborative activities. Moreover, some literature indicates ontological use of the concept of community engagement. There were differences observed in terms of the contextual use of the concept ‘community engagement’; for example, it is expressed as a practice, a networking activity, a process and a continuum of activities in some contexts. The theoretical sample contained 225 (N = 225) definitions and uses of community engagement.

The researcher tabulated a list of definitions, the uses of the concept of community engagement and its defining attributes, and their citations in three columns (Schiller 2018:250). The first column is titled ‘Analysis’, and it consists of the identified definitions and uses of ‘community engagement’ from relevant literature. The second column is titled ‘Synthesis’, and it contains a further reduction of the key words from the first column. Thirty-five (n = 35) statements were recorded in the second column. The third column is titled ‘Derivation’, and it consists of a final reduction into categories and connotations from the second column. Derivation was done by reading the statements in the second column several times, whereafter they were further reduced and rearranged to obtain categories of defining attributes.

Antecedents are defined as occasions or instances that must happen or be in place before the existence of the concept under study (Walker & Avant 2014:173). Consequences are defined as occasions or instances that happen as a result of the existence of the concept under study. In other words, it refers to the outcomes of the concept (Walker & Avant 2014:173); therefore in this study, the consequences of community engagement are referred to as the outcomes of community engagement. The antecedents and consequences are described in the ‘Findings and discussion’ section.

Empirical referents indicate the presence or existence of actual phenomena that demonstrate the occurrences of the concept itself. In the majority of concept analysis findings, the defining attributes identified are identical to the empirical referents (Walker & Avant 2014:174). The empirical referents of community engagement are social responsiveness, service learning, capacity building, partnership and participatory action research.

Ethical clearance and permission were obtained from the Faculty of Health Science – Higher Degrees Committee (HDC-01-31-2017) and Academic Ethics Committee (REC-01- 40-2017) of the University of Johannesburg on 02 June 2017 and from the Research Ethics Committee (SC/358/2017) of the University of Namibia (project research number REC-241112- 035) on 20 November 2017.

Community engagement does not take place in a vacuum; there must be a situation such as community challenges, health inequalities, societal needs or a need for a socially responsive approach in education, research and services. The community challenges include any difficult situation that affects the wider population, the community as a whole or a group of individuals in the community. It is noted that there are several layers of communities, but each has its own challenges, structure and interest (Cherrington et al. 2018:7). Community challenges may be identified by the community members themselves, faculty members and students. The second antecedent is health inequalities, which is defined as variances in the health status or in the spread of health determinants amongst different population groups (WHO 2018:Online). Depending on the situation, the extent of inequality may be noted to give information on unique situations and set priorities within a given population (Hosseinpoor, Bergen & Grove 2018:655). Some health disparities are related to biological differences, and others may be related to the external environment and conditions mainly outside the control of the affected individuals (WHO 2018:Online).

Societal needs were also identified as an antecedent; these refer to the needs of society as a whole. According to De Haan et al. (2014:126), societal needs are divided into three categories, and they all need to be fulfilled to facilitate liveability in society. The first one comprises existence needs, which include the need for shelter, health, security and material for sustenance such as drinks and food (De Haan et al. 2014:127). This incorporates the first and second levels from Maslow’s hierarchy of needs, which are physiological needs and safety and security needs (Berman, Snyder & Frandsen 2016:476). The second societal need is the relatedness need. This entails the need for interaction, social cohesion, ecological health, knowledge and beliefs, beauty and pleasure, and comfort and convenience (De Haan et al. 2014:127). In Maslow’s hierarchy of needs, it incorporates the needs for love and belonging, which are the level 3 needs (Berman et al. 2016:476). The last societal need is the growth need, which encompasses needs relating to identity, social justice, intergenerational equity, culture and identity, purpose and expression, influence and respect, and freedom and autonomy (De Haan et al. 2014:127). Understanding the societal needs entails extensive exploration of different sources to obtain insight into the pressing needs and expectations of community members (Cassi et al. 2017:1098). When students and academic staff engage with the community, societal needs are identified via community assessments, and then services, information and material supports are provided to attend to the needs. The fulfilment of societal needs is achieved in partnership with community members.

Social responsiveness is a concept used as an umbrella term that denotes all types of engagement with external non-academic populations (UCT 2018:Online). This is also an antecedent of community engagement. The concept encircles engaged scholarship activities involving students and academic staff in the form of providing community service, as well as professional engagement, which entails the application of their professional expertise. A university that conducts such activities is said to be a socially responsive institution, which means it is socially beneficial, generally reachable and structurally flexible (David 2017:184). The process of community engagement requires participants to be socially and culturally responsive to reach out to minorities and disadvantaged individuals. Community engagement activities seek to identify and also find solutions to the challenges affecting community members and to develop the leadership skills of health professionals (Vargas et al. 2012:23). Therefore, being socially responsive may be interpreted as an indicator of the presence of community engagement. According to Coetzee (2012:510), for community engagement to be effective, the facilitators need to understand all elements of community life and understand their behaviours, to determine the immediate and long-term needs. In that way, the engagement activities will be socially responsive. Thus they will address not just one element of the community but will influence or touch the lives of many individuals. The need for a socially responsive approach in education, research and services means that the institution of education should recognise the need to design, implement and evaluate their teaching and learning activities, research and service to the community in relation to the social issues within the community. In their daily operations, academic staff must recognise the need to align their core businesses to the needs of the population they are located in and serving.

The process of community engagement, extracted from the findings of concept analysis, consists of three phases as discussed below.

Community engagement leads to more effective health and educational programmes, both in the health sector and at the higher education institution. In the health sector, programmes are effective when they address community challenges, and they help to identify, mobilise and develop relevant community assets and capacity (Sobrero & Jayaratne 2014:140). Effective programmes are needed for an effective health system (Gooden et al. 2013:639). Secondly, the community engagement process develops collaboration. The term ‘engagement’ in ‘community engagement’ refers to collaboration between the university and a targeted community, either at the regional, national or global level (Escrigas et al. 2013:xxxv). This leads to partnership and reciprocity, which is facilitated by a mutually beneficial exchange of knowledge and resources.

Thirdly, community engagement is a process that leads to development in the community and its people. This is because the engaging institutions conduct transactional, transitional and transformational activities that may bring about development in the community and its people. Community development includes a number of areas, covering economic, social, demographic and cultural aspects (Rabinowitz 2018:Online). Fourthly, community engagement leads to integration of teaching, research and services at institutions of higher education. According to the Carnegie Foundation (2015:40), service learning is a method through which community engagement is integrated with teaching and service at the university. This is important because it facilitates the mutual benefit of the students, academic staff and community members. To integrate community engagement with teaching and research, a higher education institution may use a more popular approach called ‘intersecting’. This is practised by incorporating the engagement activities of the department or individual academic staff into either their teaching or research programmes or both (Preece 2017:7). For most higher education institutions, engagement activities are usually in a form of services. Through scholarship of engagement, academic staff and students utilise their knowledge and research to apply to real and pressing social problems and issues, thereby allowing integration of research and teaching to community services (Jacob et al. 2015:116).

Fifthly, the community engagement process is an effective indicator of student learning that develops skills such as critical thinking, communication skills, relationships with other students and faculty members as well as overall satisfaction with their learning (Carnegie Foundation 2015:35). Improving skills is facilitated by learning from the community in the process of community engagement. Moreover, service learning, which is one of the forms of community engagement, offers opportunities to cultivate community-centric behaviours in students (Jacob et al. 2015:131). Sixthly, the community engagement process may lead to capacitated, reflective and innovative graduates. For example, in service learning, students are afforded an opportunity to engage with other, different forms of knowledge and experiences beyond what is found in the traditional curriculum (Jacob et al. 2015:168). Capacitated students have the potential to develop into future leaders who are able to tackle health issues in society. It is vital for Health Science programmes to produce reflective graduates because reflection, especially in community engagement, boosts students’ understanding of the programme content, increases obligation to the discipline and promotes a greater sense of civic responsibility (Jacob et al. 2015:159). As a result of exposure to experiential learning pedagogies in community engagement, students tend to be innovative because of the real-life experience. Innovative students are needed in the health field because they are not only prepared for work but may create ideas, leading to a globalised world (Smith-Tolken & Bitzer 2017:30). The above results were used to construct a conceptual map, as displayed in Figure 1. The logic and practical application of community engagement constitutes a cyclical process because it is not a once-off activity but goes through phases. Academic staff members and students need to go through phases, to perform community engagement. Thereafter, they are required to restart the process if one of the antecedents identified in this research is experienced in the community.