Health Promotion and Non-communicable Disease Prevention and Control: A Discourse Analysis of Health Education Practices of Health Workers at Axum Town
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Date
2018-05
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AAU
Abstract
This thesis aimed to explore health promotive and non-communicable disease (NCD)
preventive discourses as enacted in the health education practices of health workers and their clients’ talks. Thus, the study sought to: (i) examine meanings attached to NCDs by community members of Axum town; (ii) analyse how discourses of NCD
prevention are constructed in the study setting; (iii) explain practices/activities that
are enacted to promote health and prevent NCDs; (iv) reveal inhibiting discourses in
promoting health and preventing NCDs; and (v) identify discursive strategies that
could strengthen health workers’ health education practices. To this effect, the study
employed qualitative research approach. And discourse data were gathered through
audio recording of health extension workers’ (HEWs’) health teachings, focus group
discussions of network members and in-depth interviews of health workers, women
development army (WDA) leaders, and community members (patients and their family
members). To analyse the data, Fairclough’s three-dimensional model in tandem with
Gee’s method of discourse analysis was employed.The study revealed the following findings on the side of the people: (i) local people associated NCDs with different notions; they associated NCDs to some people,namely the rich; (ii) the community considered NCDs as diseases that could occur due to the act of evil spirit. With regard to HEWs, the findings show that HEWs engage themselves in teaching their clients on NCD prevention by emphasizing the discourse of ‘prevention first’, disclosing NCD cases, and encouraging participants reflect on their local views during the health education sessions. They were observed empowering their clients to prevent NCDs as per the philosophy of the health extension program (HEP). In addition, health workers were also found enacting healthy practices such as eating healthy food, staying active, having early medical check-up and avoiding risks which were also recognized as healthy practices by members of the community. Moreover, the study disclosed that the community’sinherent assumptions and cultural practices were inhibiting factors in the promotionof healthy practices to prevent NCDs. The participants of the study think that
advocacy, experience sharing, and empowerment are good strategies in the
promotion of preventative practices against NCDs.The study recommends that it is important that schools and other public institutionson top of the Ministry of Health should be involved in the cultural transformation with regards to beliefs and thinking related to NCDs in that NCDs are preventable and arenot limited to certain groups of people. Every one of us is vulnerable to NCDs if we fail to take appropriate precautions. What the HEWs are doing is the right course of action and needs to be supported with resources and trainings. More research needs to be done focusing in health communication and promotion practices with reference to use of language especially and empowerment of communities.
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Keywords
Health education