This is the first anthropological study contrasting different representations of stroke in two sites in sub-Saharan Africa. It draws on data collected during one year of qualitative research fieldwork in rural (Hai) and urban (Dar-es-Salaam) Tanzania, using a mix of qualitative methods such as extensive ethnographic fieldwork and case studies. Using a power relations framework crafted from concepts developed by Foucault and Bourdieu, I analyse the way stroke is constructed and negotiated in the two sites. Stroke discourses and practices are products largely of the interplay of social, cultural, historical and economic processes. I examine these interactions at the individual, family, and community levels. My findings show that although there are several competing discourses about stroke in each site, one tends to become dominant. A given discourse acquires a dominant position by virtue of being associated with a stronger power base rooted in local and regional processes. Different stroke discourses lead to the pursuit of different remedies which range from hospital to a variety of traditional and faith-based healing. Social negotiations characterise the selection of treatment, and people commonly combine several options to obtain care. I outline potential community based stroke interventions to improve knowledge, awareness and treatment about stroke, such as working with community members who hold symbolic power. I make four health policy recommendations. I emphasize the need for developing health programmes informed by contextual dynamics. Raising awareness is an important first step in implementing such programmes. I highlight the need to learn from successful interventions, such as the effectiveness of interactive and appropriate health messages delivered through popular mass media.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:496801 |
| Date | January 2008 |
| Creators | Mshana, Gerry |
| Publisher | Durham University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.dur.ac.uk/1949/ |
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