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The role of the collective making of identity in health promotion in the Hlokomela project, Hoedspruit, Limpopo, South Africa

A dissertation submitted to the School of Public Health, University of the Witwatersrand, in
fulfillment of the requirements for the degree of Master of Science in Medicine by research
and dissertation.
07 June 2016 / Introduction: Migrant farm workers in South Africa are particularly vulnerable to HIV
infection for a multitude of reasons, including a lack of access to health services and to
health information. Social norms on the farms, including an acceptance of multiple
concurrent sexual partners and transactional sex both for comfort and material gain, tend to
worsen women's powerlessness to manage effectively their sexual reproductive health. High
levels of stigma also mean that the risks of HIV infection cannot easily be spoken about,
further increasing vulnerability. The Hlokomela project sought to use participatory
communication processes to empower peer communicators on the farms to engage farm
workers in regular, structured discussions on HIV /AIDS and other health and wellness
related matters, including difficult conversations around gender inequity. The making of a
collective identity for the project was one of these participatory processes. Its novelty in this
setting warranted research to answer the question "How does (or does) the collective
making of a project identity help to promote health on the farms of Hoedspruit?".
Aim: The aim of the research was to describe and analyse the role of collective identitymaking
in the Hlokomela project, an intervention to address vulnerability to HIV among
migrant and seasonal farm workers in Hoedspruit, Limpopo province, South Africa. The
study aimed also to propose and further develop, in the light of Findings, a conceptual
framework which would help to explain the effects of the various elements of collective
identity-making.
Methods: The research is a qualitative study of the collective identity-making component of
the Hlokomela health project. Elements of a grounded theory approach were adopted in
the three successive data collection site visits, enabling progressive coding of the data as the
collection occurred. Data was collected through two Focus Group Discussions (FGD) with
Nompilos (farm worker volunteer peer communicators and care givers) and two FGDs with
Gingirikani (farm worker volunteer peer communicators chosen by Nompilos and farm
workers to be their deputies on the farms, to facilitate purposive dialogues and thus
increase reach). There were also 10 individual in-depth interviews with other key
stakeholders and three small group interviews (2-3 respondents) with Hlokomela managers
and co-ordinators. All interviews were audio-taped, transcribed and where necessary
translated into English from Xitsonga and Sepedi. The voices of those most directly affected
by the intervention formed the basis for coding and analysis.
Findings: The development of the collective identity through participatory processes was
found to enhance engagement with and among farm workers. This was due to the project's
perceived pertinence and local ownership. The collective identity was seen to be relevant
and expressing a farm worker reality. Farm workers generally described feeling affirmed,
seeing themselves projected into a public space that had hitherto not been open to them.
And also in particular, the agents of the project – the Nompilos and their "deputies" the
Gingirikani – described at length how being associated with Hlokomela gave them the
authority and credentials to work with farm workers on sensitive matters, including
establishing a set of values and norms which would be health-protective but which also
involved a shift in what was considered possible and desirable. There was furthermore a
sense of belonging to the project, not only on the part of the primary "beneficiaries" – farm
workers – but also of other stakeholders, including farm owners/managers, municipal office
bearers, and local health workers. This bridging social capital further augmented the
project's capacity to reach farm workers by, for example, enabling access in working time on
the farms, by donations in money and in kind by the local community, and by making visible
and normal what hitherto had been hidden – particularly in terms of gender equity and a
softening of hegemonic masculinities. Farm workers could take the lead, and women could
take the lead also.
Conclusions: The collective identity-making work of Hlokomela had aided the project's
agents to nurture a new possible, founded in a slightly altered set of values and norms,
which had the potential to reduce vulnerability to HIV infection. The elaboration of a social
institution, largely in the symbolic space, had authorised the project's agents, in their own
eyes as well as those of their peers, to carry out their often difficult work of facilitating
regular dialogues on hitherto rarely broached topics, including gender relations and risky
sexual behaviour.
The findings indicate a need for further research into the cost effectiveness and replicability
of this kind of identity work in similar projects, perhaps with the addition of quantitative
assessments of the extent of projects' reach through collective identity work as well as the
value of collateral beneficial effects to participants in resource poor settings. / MT2016

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/21409
Date04 November 2016
CreatorsCockayne, Patrick William
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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