Understanding health discourses from a livelihoods perspective; family and community management in the malaria control programme in Sierra Leone.

Brewah, Paul (2021) Understanding health discourses from a livelihoods perspective; family and community management in the malaria control programme in Sierra Leone. Doctoral thesis, University of East Anglia.

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Abstract

Malaria is a global health problem. Despite the national malaria control programmes, it continues to be a major cause of death and disease in many sub-Saharan countries. The current study draws on data collected in 2016-2017 in Moyamba district Southern Sierra Leone, to explore the role of family and community management in dealing with health problems like malaria. The research question was: 'How are family and community management perspectives reflected in discourses concerning incidents of malaria in Sierra Leone? ‘The study used a multi-qualitative methodological design and a discourse analysis of texts and transcripts to examine how knowledge about family and community management in relation to malaria was generated. The study’s conceptual framework was drawn from the Sustainable Livelihoods Framework which views capacities as determined by assets and resources that influence household and community responses to malaria. In-depth individual interviews (n=54), focus groups discussions (n=3) and a policy documents review (n=6) were conducted with a snowball sample from a cross–section of rural and Moyamba town communities. Key discourses found to characterise family and community management were Social capital, Volunteering, Coping strategies. and Leadership. Social capital was seen to create relations of trust that facilitated collective action. Volunteering was seen to provide human resources to complement the health workforce and improve access to services and health information. Coping was seen as enabling families and communities to undertake preventive actions, diversify livelihoods, adopt treatment pluralism and religion to withstand malaria threats. Leadership discourses highlighted strong leaders influencing uptake of services. Policy makers and stakeholders in malaria control should therefore work towards establishing cross-level learning communities that can accommodate competing discourses to provide more understanding of family and community management approaches that can contribute to reducing the mortality and morbidity from malaria and improving health outcomes.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Chris White
Date Deposited: 09 Dec 2021 11:21
Last Modified: 09 Dec 2021 11:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/82618
DOI:

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