Recreating Social Capital through nurturing Ubuntu in Community Health Clubs for disease prevention

Main Article Content

Juliet Anne Virginia Waterkeyn

Abstract

Whilst the concept of Social Capital is well known in Western literature as a measure of a functional community, the indigenous African ethical code known as Ubuntu is seldom referred to in community development programmes. We undertook exploratory research to better understand the extent to which values of Ubuntu are still recognised today and if such values could be co-opted into Community Health Club programmes to address the many common diseases that could be prevented by group action.


Method: A questionnaire was developed to identify key aspects of Ubuntu as lived experience in modern day Zimbabwe and how this ethic may manifest in the ordinary lives of Zimbabweans. The survey consisted of 40 questions with a mixture of quantifiable multiple-choice questions using a Lickert scale and qualitative open-ended questions. 100+ respondents were purposely selected representing a proportionate distribution of demographics. The quantitative data was cleaned and analysed in Excel with frequencies and percentages. The qualitative data was analysed using ‘Applied Thematic Analysis’. A Focus Group Discussion with Shona and Ndebele community development officers was held to ensure a deeper cultural interpretation of findings.


Results: The ethical code of Ubuntu was understood by 95% of the 102 final respondents, who reported they had been brought up with such values. However, socialisation of children in norms and values of Ubuntu had dropped to 75% in the current generation of parents. Social networks in both rural and urban areas were high with all but 11% belonging to a regular group, and 45% having 21 or more friends within walking distance.


 


For the rural areas 64% of respondents considered ‘Ubuntu’ to be high, 68% thought ‘honesty’ is high; ‘child safety’ in rural areas is considered moderate by 50% and high by 48% but only 9% would leave the door unlocked when going out. Only 4% could cite examples of non-Ubuntu behaviour in rural areas which included disrespect to elders, child disobedience, alcohol abuse, witchcraft and gender-based violence.


In urban areas, the inverse was found: only 16% thought there was any Ubuntu at all, and 81% thought there was a high level of non-Ubuntu behaviour, with a low level of ‘honesty’, no ‘personal security’ and low ‘child safety’. 81% cited examples of erosion of Ubuntu values, such as lack of trust and reciprocity, substance abuse, little social support and immorality in sexual behaviour.


People who are guided by values of Ubuntu invest highly in community which may generate high social networks and reciprocity, although levels of trust still remain low. Unlike Ubuntu, ‘Social Capital’ is not an ethical code but is the ‘common good’ that may be the outcome if Ubuntu is practiced sufficiently by a large enough group.


Conclusion: Ubuntu is a living and valuable attribute of traditional Zimbabwean culture and could be resuscitated particularly in areas, where society is in transition from rural to urban lifestyle, to provide a secular code of ethics to promote gender equity and equality, through consensus building and preventing disease within Community Health Clubs, thereby addressing many ills of modern African society.

Keywords: Ubuntu, Unhu, Zimbabwe, Community Health Clubs, Social Capital, women’s equality.

Article Details

How to Cite
WATERKEYN, Juliet Anne Virginia. Recreating Social Capital through nurturing Ubuntu in Community Health Clubs for disease prevention. Medical Research Archives, [S.l.], v. 11, n. 11, dec. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4460>. Date accessed: 16 may 2024. doi: https://doi.org/10.18103/mra.v11i11.4460.
Section
Research Articles

References

1. World Health Organization. The Ottawa Charter for Health Promotion. Published 1986. Accessed October 30, 2023. https://iris.who.int/bitstream/handle/10665/53166/WH-1987-May-p16-17-eng.pdf?sequence=1%20Accessed%20October%2025,%202023.

2. Wolf J, Johnston RB, Argaw Ambelu, et al. Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. The Lancet. 2023;401(10393):2060-2071. doi:https://doi.org/10.1016/s0140-6736(23)00458-0

3.World Health Organisation. World Malaria Report 2020. www.who.int. Published 2020. https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2020

4. Heilbroner RL, Icek Ajzen, Fishbein M, Thurow LC. Understanding Attitudes and Predicting Social Behaviour. Prentice Hall; 1980.

5.Bandura, A. The anatomy of the stages of change. American Journal of Health Promotion. 1997;12(1):8-10.

6. Berkman LF, Kawachi I. Social Epidemiology. Oxford University Press; 2000.

7. Waterkeyn J. Cost-Effective Health Promotion and Hygiene Behaviour Change through Community Health Clubs in Zimbabwe. PhD Thesis. 2006. doi:https://doi.org/10.17037/PUBS.00682348

8. Pathberiya N. To vaccinate or not to vaccinate: an analysis of compulsory Covid 19 vaccination from a human rights perspective. In: Conference Proceedings. Bar Association of Sri Lanka; 2022.

9. Mandela N. Accessed October 25, 2023 https://www.youtube.com/watch?v=HED4h00xPPA

10. Tutu D. No Future without Forgiveness. Doubleday; 1999.

11. Mungi Ngomane. Everyday Ubuntu: Living Better Together, the African Way. Transworld Digital; 2019

12. Ellen Johnson Sirleaf. This Child Will Be Great. Harper Collins; 2009.

13. Gelfand M. The Genuine Shona: Survival values of an African Culture. Mambo Press. Zimbabwe 1973:57,140.

14. Dube MW. I am because we are: Giving primacy to African indigenous values in HIV and AIDS prevention. In Murove M.F. ed. African ethics: An anthology of comparative and applied ethics, University of KwaZulu-Natal Press. 2009:188-213

15. Manyonganise M. Oppressive and liberative: A Zimbabwean woman’s reflections on ubuntu. Verbum et Ecclesia. 2015; 36(2) :1438. doi:https://doi.org/doi.%20org/10.4102/ve.v36i2.1438

16. Waterkeyn JA, Waterkeyn AJ. Creating a culture of health: hygiene behaviour change in community health clubs through knowledge and positive peer pressure. Journal of Water, Sanitation and Hygiene for Development. 2013;3(2):144-155. doi:https://doi.org/10.2166/washdev.2013.109

17. Hygiene Promotion in Burkina Faso and Zimbabwe: New Approaches to Behaviour Change. Blue Gold Series World Bank-WSP/AF. 2002;(7). Accessed 2002. http://documents.worldbank.org/curated/en/330721468179071607/Hygiene-promotion-in-Burkina-Faso-and-Zimbabwe-new-approaches-to-behaviour-change

18. Africa AHEAD Website. https://africaahead.org/countries/ Accessed October 25, 2023.

19. Government of Zimbabwe. National Water Policy. 2012:26. Accessed October 22, 2023. http://ncuwash.org/newfour/wp-content/uploads/2017/08/National-Water-Policy.pdf

20. Government of Zimbabwe. National Sanitation and Hygiene Strategy. 2017:2. Available from: http://newfour.ncuwash.org/wp-content/uploads/2017/08

21. Hirai M, Cole A, Munyaka M, Mudhuviwa S, Maja T, Cronin A. Use of group maturity index to measure growth, performance, and sustainability of community health clubs in urban water, sanitation and hygiene (WASH) program in Zimbabwe. Journal of Water, Sanitation and Hygiene for Development. Published online October 5, 2020. Doi:https://doi.org/10.2166/washdev.2020.023

22. Azurduy L, Stakem M, Wright L. Assessment of the Community Health Club Approach: Koinadugu District, Sierra Leone; CARE International; 2007. Accessed 1BC. https://africaahead.org/wp-content/uploads/2015/08/Capstone-report-on-CHCs.pdf

23. Waterkeyn J, Okot P, Kwame V. Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health Clubs. In: 31st Water Engineering & Development Centre Conference. Loughborough University; 2005

24. Rosenfeld JA. Incremental Improvements to Community Water Supply Systems through Community Health Clubs in the Umzimkhulu Local Municipality. In: In Conference Proceedings of the Water Institute of South Africa; Institute of South Africa; 2008.

25. Maksimoski N, Waterkeyn A. The Community Health Club Approach in Informal Settlements: Case Study from Ethekwini Municipality, KZN, South Africa. In: In Proceedings of the Water Institute of South Africa Conference; 2010.

26. Boone P, Elbourne D, Fazzio I, Fernandes S, Frost C, Jayanty C, King R, Mann V, Piaggio G, dos Santos A, Walker P. Effects of community heath interventions on under 5 mortality in rural Guinea Bissau (EPICS): a cluster-randomized controlled trial. 2016. Lancet Glob Health. (4) e328-35. Doi: 10.1016/ s2214-109X(16)30048-1.

27. Deffner J, Kluge T, Müller K. Pressure of Urbanisation and a Sustainable Sanitation Infrastructure: Experiences with a Research Driven Planning Method in Northern Namibia. Published online 2012. https://www.researchgate.net/publication/268443264

28. Beesley J. “When others see what we are achieving, they want to join”: A Community Health Club Set up by SWIFT Inspires Improvements in Hygiene and Sanitation in Mwandiga I; SWIFT Consortium: London, UK. 2016. Feeny E, ed. Published online 2016. https://oxfamilibrary.openrepository.com/bitstream/handle/10546/609240/cs-hygiene-sanitation-water-community-mwandiga-drc-010416 en.pdf;jsessionid=0E5C646E1A40DE8393825CFE03A38541?sequence=1

29. Ministry of Health Environmental Health Desk. Roadmap for CBEHPP: Community Based Environmental Health Promotion Programme. Rwanda. Published 2010. https://www.ircwash.org/sites/default/files/Republic-2010-Roadmap.pdf. Accessed November 7, 2023.

30. Waterkeyn JAV, Matimati R, Muringaniza A, et al. Comparative Assessment of Hygiene Behaviour Change and Cost-Effectiveness of Community Health Clubs in Rwanda and Zimbabwe. Healthcare Access - Regional Overviews. Published online December 17, 2019. doi:https://doi.org/10.5772/intechopen.89995

31. Ntakarutimana A, Kagwiza JN, Bushaija E, Tumusiime DK, Schuller KA. Reduction of Hygiene-Related Disease and Malnutrition in Rwanda. Journal of Social, Behavioral & Health Sciences. 2021 ;15(1) :76-86. doi:https://doi.org/10.5590/JSBHS.2021.15.1.06

32. Niaone M, Bendjemil S, Rosenfeld J, Berggren R. Community Health Clubs for Water, Sanitation and Hygiene (WASH) improvement in Rural Burkina Faso. Annals of Global Health. 2016;82(3):495-496. doi: https://doi.org/doi.org/10.1016/j.aogh.2016.04.352

33. Africa AHEAD website. https://africaahead.org/courses2/ Accessed October 25, 2023

34. Waterkeyn J, Nyamandi VK, Nguyen Huy Nga. A Comparative Study of the Efficacy of Community Health Clubs in Rural Areas of Vietnam and Zimbabwe to Control Diarrhoeal Disease. IntechOpen eBooks. Published online February 16, 2022. doi:https://doi.org/10.5772/intechopen.97142

35. TED. Building Common-Unity One Club at a Time | Jason Rosenfeld | TEDxSanAntonio. www.youtube.com. Accessed October 26, 2023. https://www.youtube.com/watch?v=ug3D0B4gcjs.

36. Brooks J, Adams A, Bendjemil S, Rosenfeld J. Putting heads and hands together to change knowledge and behaviors: Community Health Clubs in Port-au-Prince, Haiti. 34 (4). Waterlines. Published online 2015. doi:10.3362/1756-3488.2015.033

37. Clarissa M, Minyoung C, Rosenfeld J, Ghaddar S, Escareno J, Dominguez E. Mi bienestar mental cuenta: Providing culturally relevant mental health education via community health clubs along the Texas Mexico border at San Antonio. In: Conference Proceedings. University of Texas Health Science center.

38. Africa AHEAD Website. https://africaahead.org/ Accessed November 4, 2023.

39. Hanifan LJ. The Rural School Community Center. Annals of the American Academy of Political and Social Science. 1916; 67:130-138. doi.org/10.1177/000271621606700118

40. Putman R. Bowling Alone: America’s declining Social Capital. J Democracy. 1995; 6:65-78.18.

41. Macrotrends. https://www.macrotrends.net/countries/ZWE/zimbabwe/literacy-rate#. Accessed October 22, 2023.

42. Kawachi I, Colditz GA, Ascherio A, Rimm EB, Giovannucci E, Stampfer MJ, Willett WC. A Prospective Study of Social Networks in Relation to Total Mortality and Cardiovascular Disease in Men in the USA. Journal of Epidemiology & Community Health. 1996;50(3):245-251. https://doi.org/doi.org/10.1136/jech.50.3.245

43. Waterkeyn J, Cairncross S. Creating demand for sanitation and hygiene through Community Health Clubs: A cost-effective intervention in two districts in Zimbabwe. Social Science & Medicine. 2005;61(9):1958-1970. doi.org/10.1016/j.socscimed.2005.04.012

44. Waterkeyn J. Decreasing Communicable Diseases through Improved Hygiene in Community Health Clubs. In: 31st Water Engineering & Development Centre Conference. Loughborough University; 2005

45. Rosenfeld J, Berggren R, Frerichs L. A Review of the Community Health Club Literature Describing Water, Sanitation, and Hygiene Outcomes. Int J Environ Res Public Health. 2021;18:1880. doi:https://doi.org/doi.org/10.3390/ijerph18041880

46. Rosenfeld JA. Social Capital and Community Health Clubs in Haiti. 2019. doi.org/10.3390/ijerph18041880

47. Ntakarutimana A, Ekane N. Performance of community health clubs in transforming sanitation and hygiene conditions. Conference contribution. In: Proceedings of 40th WEDC Conference. Loughborough University.; 2017. https://hdl.handle.net/2134/31522

48. Coleman J. Social Capital in the creation of human capital. Am J Sociology. 1988; 94: S95-12.

49. Guest G, MacQueen K, Namey E. Introduction to Applied Thematic Analysis. In: Applied Thematic Analysis. Sage Publication.; 2012:3-20.