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Title: A Critical Analysis of Urban Environmental Health Discourses in Promoting Community Participation: Focus on Addis Ababa, Ethiopia
???metadata.dc.contributor.*???: Dr. Hailom Banteyerga
Getachew, Alemu
Keywords: Critical discourse analysis
Issue Date: Jun-2013
Abstract: This study analyzed environmental health, particularly sanitation discourses with a critical discourse analysis approach to see how community participation is promoted. Since the adoption of the Alma-Ata Declaration in 1978, community participation has been promoted as a global discourse of health promotion. This is based on the belief that health is a matter of life and death and it has to be owned by the people. Drawing on Norman Fairclough’s (2003) approach to discourse analysis, global views on environmental health and approaches to the promotion of community participation, power relations in environmental sanitation discourses have been focused for investigation in this study. The study employed mixed methods design although the emphasis is on the qualitative data. The required qualitative data were taken from 5 key policy and strategy documents, 13 environmental health communication resources, 4 scripts of environmental sanitation education lesson observations, 13 scripts of individual in-depth interviews and 4 scripts of focus group discussions. Survey data from 250 respondents were also used to complement the qualitative data. All in all, the study involved 281 participants including seven key informants, six individual in-depth interviewees, 18 FGDs discussants and 250 survey respondents. Participants were selected using multi forms of strategies. The data analysis utilized mainly latent level content and critical discourse analyses. The findings revealed that though community participation has consistently been promoted as a nodal policy discourse of environmental health in general, and environmental sanitation in particular, communities were not participating in the planning, implementation, monitoring and evaluation of policies, programs and interventions as intended. The analysis also showed that in the environmental health education materials, as well as during the actual communication practices, the promotion of community participation has been left aside. The environmental sanitation packages and the awareness raising lessons were found dominated by bio-medical information; iii whereas, community participation is a social practice which requires behavioral change. Moreover, though the policy discourses acknowledged the role of communities’ indigenous knowledge to maintain sustainable environmental sanitation, the waste management and disposal oriented environmental sanitation discourses demonstrated the usual top-down flow of information. It also emerged from the analysis that the unspoken exclusion of communities from the process of designing, implementing, monitoring and evaluating their respective environmental health activities as promised in the policy and program documents resulted in silence and resistance. This is to say that communities were not empowered to develop attitudes of responsibility and participation essential to own the environmental sanitation interventions. They rather considered participation as political affiliation and developed sense of mistrust. The communities took the health extension workers as political agents of the government and resisted to take part even at grass-root level activities. In Ethiopia, low community participation is a contributing factor to poor environmental sanitation observed in the capital. Finally, it is recommended that the Ethiopian government needs to use participatory communication where communities participate in agenda setting, operational strategies and accountability of results. The present health communication strategy is top down and does not impact change of behavioral practices towards environmental sanitation. It is also suggested that more research needs to be done on community health communication discourses to get better insight into community assumptions and beliefs of health in general and environmental sanitation in particular. There should be more studies on communication strategies and ways of operationalization of health communication activities and community actual responses to such communications. The author strongly believes that unless we bring transformation on community perceptions and beliefs on development, where health is an important component, we cannot ensure sustainable growth and better life style
Appears in Collections:Thesis-Foreign Language and Literature

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