An Ethnographic Study of Health Promotion Activities in Rural Papua New Guinea
Rationale: Health disparities in developing countries require health promotion strategies that are congruent with the worldview of the community. Collective societies with close kinship ties such as those in rural PNG equate social harmony with health. For health promotion programs to be adopted a consensual decision making strategy is needed and the community empowered to develop culturally appropriate means of integrating innovations into common practice.
Background: Papua New Guinea (PNG), like many other developing countries suffers from a preponderance of health inequities particularly in rural areas. Stagnant health indicators are exacerbated by limited access to health services and inadequate resources. These issues are magnified by widespread health literacy problems and a lack of awareness regarding high risk behaviors.
Methods: This qualitative study used a descriptive, ethnographic approach to explore the influence of cultural health beliefs, consensual decision making practices, and the role of social capital on the adoption of health promotion activities. The primary sites were rural villages in the highlands of PNG that participated with the CBHC program. In-depth interviews using open ended questions were the primary data collection method. Questions focused on traditional and current beliefs about health and illness, kinship obligations, community resources, and participation in village activities.
Results: The following themes were identified using thematic analysis of the data: 1) A synthesis of traditional health beliefs and innovative practices influences how health promotion activities are perceived and implemented; 2) Relational harmony is seen as essential for the maintenance of health; 3) Strong kinship ties and consensual decision making is the norm in rural villages, however women continue to have a limited voice; 4) Religious practices are viewed as integral to societal stability and psychosocial health.
Implications: Developing a comprehensive understanding of sociocultural influences on the adoption of health promotion practices can help nurses facilitate community empowerment and sustainability of community based health care programs in rural areas.