Summary of Lotte Meinerts PhD project:
Health
Communication in a Cultural Context. A Study of Iteso Children’s Perceptions
and Practices related to Health and Sickness in Eastern Uganda.
Affiliation:
Institute
of Anthropology, University of Copenhagen
Danish
Bilharziasis Laboratory
Funding:
The
Council for Development Research,
Danida
PhD Thesis:
The
Quest for a Good Life. Health and Education among Children in Eastern Uganda.
June 2001. Available from the Institute
of Anthropology, University of Copenhagen
Project Description:
This
anthropological research project about health and education among children
in Uganda is based on one year of fieldwork in 1997 in Kwapa village, Tororo
district, and shorter additional visits in Kwapa and Kampala in 1998 and 2001.
The
focus of the study is on how children and young people experience and learn
about health and sickness in rural Eastern Uganda. Initially I was interested
in Uganda’s School Health Education Programme , which had been initiated in
the late 80’s in response to high levels of morbidity and mortality in general
and to the AIDS pandemic in particular. School
children were regarded as potential
agents of change in society and therefore attracted political interest as
receivers of health and education programmes. I wanted to explore how this health education
programme worked in the everyday routines of the schools and what effects
it had on children’s lives. During the year of my fieldwork in 1997 the Government
of Uganda implemented a Universal
Primary Education programme. This meant that children from families with little
or no schooling tradition suddenly had access to formal schooling. The enrolment
of pupils doubled and the quality of teaching went down seriously. This change
in the schooling situation prompted me to widen my focus on health education
to include the experience and significance
of schooling for health. The main question of the research
was: In what sense is children’s competence in relation to health affected
by going to school?
In
a number of international studies a positive relationship between schooling
and health has been documented. Yet, this study shows that the aims and values
reflected in health education often conflict with
local resources for and understandings of what a ‘good life’ is. This
is one of the reasons why health education has not brought about significant
changes in families health practices in
Kwapa. Other contributing factors are the situations and teaching methods
used in school, communication hierarchies and children’s status in their families.
However, schooling in general is regarded as an important experience, which
is socially recognized as a marker
of identity and competence. It is perceived as a form of cultural capital,
which can be useful for children and their families in their strivings for
a good life, which includes good health. The project critically reviews school
health education in Uganda and modifies the rationale that children can be
taught to be immediate ‘agents of change’ preventing illness and promoting
health in the family, in a context of scarce resources and steep age and gender
hierarchies. Attention is drawn to
students competence in the curative field: seeking health care, buying and
taking medicines.
Three
central analytical themes emerge from this research project in relation to
health practices and learning: Moralities, resources and competence. The interplay of these three themes are crucial
to understand . In health education the focus is too often only on knowledge.
Understanding how people change their health and sickness practices cannot
be attained with conventional studies on knowledge, attitude and practice, which deal superficially with
beliefs and hindrances for practice instead of dealing with values as motivational
forces for action.
Theoretically
the research project draws upon phenomenology,
practice theory and pragmatism. It
contributes to anthropology in the areas of medical anthropology, educational
anthropology and the anthropology of children.
Education
and health are high on the national poverty eradication agenda guiding Uganda’s
development efforts. In this context the study emphasises the intimate relationship
between education and health and thus the need to plan development work with
a view to maximise synergies between the health and education sectors.
The
analytical framework of my study adds to standard development project socio-economic
studies, the importance of raising culture specific questions of morality,
competence and material as well as social resources. The study demonstrates
the relevance of this broader cultural analysis for the efficacy of development
interventions and programmes.
The
importance of children and young people in development is recognised, but
in mainstream development practice children and youth are still seen as passive
beneficiaries rather than as, potentially resourceful, stake – and rights
holders. Specific studies and study approaches are needed to integrate children
and young people in development work in a qualified rather than in a rhetorical
manner. By applying a child-centred
approach the study brings to the forefront important dimensions of children’s
lifeworlds and thereby contributes to an ongoing effort in Uganda (and other
countries) to make schooling a positive force in children’s lives, promoting
health in accordance with their quests for a good life.
As
an immediate outcome of this study and similar research in Kenya applied research
is now being carried out in Uganda and Kenya on how to integrate in health
education a component on better drug use – especially in relation to malaria.
This research is conducted in a collaborative effort by Ugandan, Kenyan, Danish,
and British institutions, including the ministries of health and education,
national curriculum developers and drug authorities in Uganda. In Uganda the
study is being carried out as part of the TORCH (Tororo Community Health)
project – under Danida’s ENRECA (enhancement of research capacity) programme.
Lotte
Meinert
C/O
The Danish Embassy
P.O
box 11243
Kampala
Uganda
Tel:
256 – 077 63 58 77
Email: