Spatial Determinants of Health and Culture : health promotion project for TB and HIV Co-Infection in Kisumu- Kenya
Pietilä, Milka (2024)
2024
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https://urn.fi/URN:NBN:fi:amk-2024053119450
https://urn.fi/URN:NBN:fi:amk-2024053119450
Tiivistelmä
The aim of this qualitative cross-sectional study was to reveal the cultural beliefs and customs of people in Kisumu County and the culturally sensitive means used by service deliverers in Kisumu to benefit infection prevention. The objectives of the study were to reveal the cultural beliefs and customs of people in Kisumu regarding Tuberculosis (TB) and human immunodeficiency virus (HIV) informed by service deliverers working in Kisumu County and to reveal the culturally sensitive means used to guide TB and HIV positive clients. Another objective of the study was to assess the realization of Spatial Determinants of Health (SDH) in infection prevention.
The health promotion project was carried out in the Lumumba sub-county hospital in Kisumu, Kenya in collaboration with a local non-governmental organisation, the Community Health Support Programme (COHESU). COHESU recruited key informants from various facilities in Kisumu East Sub-County through purposive sampling according to the inclusion and exclusion criteria. All project and study participants were from the service sector. The key informants included nurses, pharmacists, nutritionists, clinical officers, and community health workers. This is the second report and study from the TB and HIV co-infection health promotion project in Kisumu. The author of this study was involved in the development of the theoretical background and plan and participated in the implementation of the entire project. Data for this study was collected through open-ended interviews with seven key informants after health promotion. The data were analysed using inductive and deductive methods of thematic analysis. The SDH was implemented as the framework for the deductive analysis and the Health Belief Model was used as the theoretical framework for the project and interviews.
Addressing health issues in the local language at cultural events such as weddings, funerals, circumcisions, and chief barazas, as well as emphasising the work of community health volunteers and voluntary testing for early detection, were seen as culturally sensitive means of infection prevention. Sensitising traditional spiritual healers and religious leaders to infectious diseases is also a culturally sensitive way of raising awareness. Providing quality healthcare services for treatment and diagnosis could help in the fight against delayed diagnosis. The interview questions were constructed according to the individual-centred HBM, but the responses were community-centred. The SDH were recognised by the service deliverers. Each region has its own SDH that need to be considered and recognised to achieve effective health promotion outcomes and better universal health coverage and policies. This was a small-scale interview study so the data cannot be generalised to a wider population. The recommendation for further research is to address these SDH in infection prevention with ethnographic research in the area and use this data to develop more culture-centred and culturally sensitive health promotion and increase local as well as global cultural competence for infection prevention.
The health promotion project was carried out in the Lumumba sub-county hospital in Kisumu, Kenya in collaboration with a local non-governmental organisation, the Community Health Support Programme (COHESU). COHESU recruited key informants from various facilities in Kisumu East Sub-County through purposive sampling according to the inclusion and exclusion criteria. All project and study participants were from the service sector. The key informants included nurses, pharmacists, nutritionists, clinical officers, and community health workers. This is the second report and study from the TB and HIV co-infection health promotion project in Kisumu. The author of this study was involved in the development of the theoretical background and plan and participated in the implementation of the entire project. Data for this study was collected through open-ended interviews with seven key informants after health promotion. The data were analysed using inductive and deductive methods of thematic analysis. The SDH was implemented as the framework for the deductive analysis and the Health Belief Model was used as the theoretical framework for the project and interviews.
Addressing health issues in the local language at cultural events such as weddings, funerals, circumcisions, and chief barazas, as well as emphasising the work of community health volunteers and voluntary testing for early detection, were seen as culturally sensitive means of infection prevention. Sensitising traditional spiritual healers and religious leaders to infectious diseases is also a culturally sensitive way of raising awareness. Providing quality healthcare services for treatment and diagnosis could help in the fight against delayed diagnosis. The interview questions were constructed according to the individual-centred HBM, but the responses were community-centred. The SDH were recognised by the service deliverers. Each region has its own SDH that need to be considered and recognised to achieve effective health promotion outcomes and better universal health coverage and policies. This was a small-scale interview study so the data cannot be generalised to a wider population. The recommendation for further research is to address these SDH in infection prevention with ethnographic research in the area and use this data to develop more culture-centred and culturally sensitive health promotion and increase local as well as global cultural competence for infection prevention.