Medical Sociology in Africa PDF
Preview Medical Sociology in Africa
Medical Sociology in Africa Jimoh Amzat • Oliver Razum Medical Sociology in Africa 2123 JimohAmzat OliverRazum DepartmentofSociology AG3Epidemiology&InternPublicHealth UsmanuDanfodiyoUniversity FacultyofHealthSciences Sokoto UniversityofBielefeld Nigeria Bielefeld Germany ISBN978-3-319-03985-5 ISBN978-3-319-03986-2(eBook) DOI10.1007/978-3-319-03986-2 SpringerChamHeidelbergNewYorkDordrechtLondon LibraryofCongressControlNumber:2014930888 © SpringerInternationalPublishingSwitzerland2014 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthe materialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation, broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionorinformation storageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology nowknownorhereafterdeveloped.Exemptedfromthislegalreservationarebriefexcerptsinconnection withreviewsorscholarlyanalysisormaterialsuppliedspecificallyforthepurposeofbeingenteredand executed on a computer system, for exclusive use by the purchaser of the work. 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Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Preface Theoverallobjectiveofthisbookistoprovidetheoreticalandpragmaticdiscussions onmedicalsociology(sometimesreferredtoashealthsociology)withAfricanillus- trations.Itisanattempttoexaminethevariousthemesandtopicsinmedicalsociology withtheaimofprovidingadequateexplanationsininstructivestyles. Itisparticu- larly important to write from a local lens but through international perspectives. Medical sociology, although a branch of sociology, has attracted transdisciplinary relevance—especially in psychology, anthropology, health economics, medicine, nursing, history of medicine, and others. This book provides a frame of reference for those interested in the issue of society, culture, and health in general. It also intendstoprovideagloballyrenownedsourceandreferenceforacademics,public health practitioners, undergraduates, and graduate students who want to improve theirunderstandingofmedicalsociology. This book emerges from the context of African experiences and perspectives, drawingclassicalillustrationsandreferencesfromAfrica.Thisbookisadequately localisedintheAfricancontextbutwithaglobaloutlook.Theepistemologicalstance ofAfrican sociology is rooted in deep cultural interpretations. Such perspective is necessarybecauseAfricafacesthemajorityofpublichealthproblems.Thebookwill beusefulintheteachingofmedicalsociologyatalllevels.Itrepresentsacompilation ofdetailedideasaboutthesignificanceandrelevanceofmedicalsociology.Thebook presentsashiftfromtheoreticalpreceptstopracticalmindsetwithinapedagogical milieu that will aid the understanding of sociocultural or sociological approach in thestudyandunderstandingofhealthproblems,andmoreimportantlyinthetopical descriptionsofmedicalsociology.Thisbookisorganisedbasedonthematicissues inmedicalsociology.Inordertorepresentcurrentperspectives,recentdirectionsin the field will be presented.As outlined in the table of contents, the work will also presentmoreresearchagendasformedicalsociology. Africa bears the greatest brunt of many health problems, especially malaria, HIV/AIDS,andmaternal-andchild-relatedmorbiditieswhicharepartofthehealth targetsoftheMillenniumDevelopmentGoals(MDGs),settoachieveconsiderable alleviation of disease burden. These morbidities are preventable through effective health and illness behaviours, but millions of fatalities due to the aforementioned diseases still occur in the continent every year. Millions of others are affected by v vi Preface temporaryandpermanentdisabilitiesannually.Whiletherehasbeenprogressover theyearsatthegloballevel,thereisstillinsufficientprogressinAfrica,morespecif- ically in sub-SaharanAfrica (SSA) where the disease burden adversely affects the developmentprocesses,therebyaccountingforaviciouscycleofunderdevelopment. TheprevalenceofmedicalproblemsinAfricaisrootedintheinterplayofsocial,po- litical,cultural,andmedicalfactors;itisalsowithinthisholisticcontextthatdisease burdencanbeunderstoodandresolved.Infact,increasedfocusonsocial/community barrierstocarecouldproveeffectiveinreducingthediseaseburdeninAfrica.The ideaoftheinterplayofthismyriadoffactorsisnotnew,butthefactorscontinueto explaindiseaseburdenandpersistovertheyears. Inordertoaccountforaholisticperspective,thesocialandculturaldimensionsof humanhealthmustbeadequatelyconsidered.Thisbookpresentsmedicalsociology asthestudyofthesocialpatterningofhealthandillness(seeChap.1)bysituating healthproblemsasamajor(social)problemconfrontingthehumanbeing.Thefirst chapteralsopresentsabriefhistoryofmedicalsociologyandthetopicalcoverage of the discipline to advance the relevance of the discipline in health studies and provideadequateexplanationsforstudents.Thenotionofhealth,disease,andillness asconceptualtoolsisthepreoccupationofChap.2,startingwiththedebateofhow healthshouldbedefined.Theillustrationsofthesocialmanifestationofillnessand culturalbeliefsofillnesscausationfromAfricancontextshowtherelevanceofthe culturalmilieuintheunderstandingofhealth(seeChap.2).Theconceptsofhealth andillnessbehavioursareacentralpartofthediscourseinmedicalsociology(see Chap.3).Itisvitaltounderstandhealthriskbehaviours,andthefactorsinfluencing suchbehaviours. Thisbookisalsoverystrongintheoreticaldiscourse.Itpresentsthefundamental theories in sociology under the main broad headings. The notions of the sick role byTalcottParsons, theexplanationofsuicidebyEmileDurkheim, andsocialcap- italtheoryofhealthconstitutethelandmarksinfunctionalistexplanationofhealth in sociology (see Chap. 5). Then the book presents many fundamental theoreti- cal standpoints that could guide medical sociological thinking, including Marxist analysis/political economy of health, fundamental cause theory, feminist analysis of health, Weber’s social action and bureaucratic rationality health belief model, theoryofplannedbehaviour,Suchman’sstagesofillnessandmedicalcare,Ander- sen’smodelofhealthcareutilisation,socialconstructionofillness,labellingtheory, andGoffman’stheoriesofstigmaandtotalinstitution.Whilesomecriticismsofthe theories are also presented, some adaptations toAfrican contexts were illustrated stressingtheneedforaholisticview. Ingeneral,asociologyofhealthshouldprovideaholisticmilieuintheconsider- ationofhealthdiscoursebyaccountingforamultitudeofdynamicsandsituational indices within the social and cultural spheres responsible for the health of the population. Specifically, a sociology of health problems inAfrica should provide comprehensive explanations considering the social patterning of health and the community indices and sociocultural factors influencing population health. It is a well-known fact that social determinants of health (SDH) (see Chap. 4), or what couldalsobereferredtoasfundamentalcausesofdisease,haveaglobalrelevance. Preface vii However, theimpactsoftheseSDHaremorepronouncedinthecontextofAfrica, especiallyintheexplanationofdiseaseofpovertysuchasmalariaandHIV/AIDS. Thequestionoffundamentalcauseshasasignificantlinkwiththepoliticaleconomy of health (PEH) (see Sects. 6.3, 6.4), health inequalities without neglecting health transition, and the emerging disease mix, especially as a result of lifestyle factors responsibleformostchronicdiseases(seeSects. 3.3.1and4.6).Therefore, asoci- ologyofhealthproblemsinAfricaisfirmlyrootedintheconsiderationofthesocial productionofhealth(seeChap.6),interpretiveperspectiveorsocialconstructionof health(seeChaps7and8),SDH(seeChap.4),lifestylefactors,andriskbehaviours (seeChap.3). The concepts of medicalisation, pharmaceuticalisation, geneticisation, demedi- calisation,remedicalisation,medicalenhancement,andmodelsofclient-practitioner relationsareadequatelyexaminedwithsomecurrentillustrations(seeChap.9).For instance,themedicalisationofpregnancy,beauty,anddeathareexplainedasillustra- tionsinordertoexposereaderstohowmedicalisationispenetratingallfacetsoflife. TheexaminationofmedicalpluralisminAfrica(thecoexistenceoftraditionaland modernhealthcaresystems)providesanotheropportunitytoexaminetherealities ofhealthcareinAfrica(seeChap.10).Subsequently,thecurrentwavesofsociology ofbioethicsarepresentedbyintroducingthemeaningandvarietiesofbioethicsand coreareasofmoralperplexitiesinhealthcaretoadvancethesociologicalrelevance inbioethicaldiscourse(seeChap.11).Lastly,thehopeofpresentingmoreAfrican illustrationsinformsthechapteronthesociologyofhealthproblemsinAfrica(see Chap.12). Therefore,wehopethatstudents,instructors,andresearchersinterestedinmedical sociology(orsocialdimensionsofhealth)andwithinterestinAfricawillfindthis bookaninformativeandacademicresource. Acknowledgments This is to acknowledge the Alexander von Humboldt Foundation for providing a GeorgForsterPostdoctoralFellowshiptoJimohAmzatthroughwhichthisbookwas written and the host institution, University of Bielefeld, AG3 Epidemiology and InternationalPublicHealth,forprovidingasupportiveacademicenvironment. ix Contents 1 SociologyandHealth ........................................... 1 2 Health,Disease,andIllnessasConceptualTools ................... 21 3 HealthBehaviourandIllnessBehaviour .......................... 39 4 SocialDeterminants/ContextofHealth ........................... 61 5 FunctionalistPerspectiveonHealth .............................. 83 6 SocialProductionofHealth ..................................... 107 7 TheInterpretivePerspectiveinMedicalSociology:PartI........... 129 8 TheInterpretivePerspectiveinMedicalSociology:PartII .......... 155 9 MedicalisationandClient-PractitionerRelations .................. 185 10 MedicalPluralism:TraditionalandModernHealthCare........... 207 11 TowardsaSociologyofBioethics................................. 241 12 ASociologicalStudyofHealthProblemsinAfrica ................. 265 Index ............................................................ 285 xi Abbreviations ACT artemisinin-basedcombinationtherapy ADHD attention-deficit/hyperactivitydisorder AHPs alliedhealthprofessions AIDS acquiredimmunodeficiencysyndrome ANC antenatalcare ASA AmericanSociologicalAssociation BwO body-without-organs CAM complementaryandalternativemedicine CE communityengagement CHVs communityhealthvolunteers CHWs communityhealthworkers CODESRIA CouncilfortheDevelopmentofSocialScienceResearchinAfrica COPD chronicobstructivepulmonarydisease CSWs commercialsexworkers DHS DemographicandHealthSurveys DNA deoxyribonucleicacid DTCP directconsumerpurchase ELSI ethical,legal,andsocialimplications FBOs faith-basedorganisation HB healthbehaviour HBM healthbeliefmodel HGP HumanGenomeProject HIV humanimmunodeficiencyvirus HMM homemanagementofmalaria HRG high-riskgroup ICT informationandcommunicationtechnology IPTp intermittentpreventivetreatmentduringpregnancy IRBs institutionalreviewboards ITN insecticide-treatednet IVF invitrofertilisation LGBT lesbians,gay,bisexual,andtransgender MCH maternalandchildhealth xiii
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