Title: Culture and bodies: an interdisciplinary approach to non-communicable disease prevention in Malawi and Tanzania.
Funder: Medical Research Council

Abstract: The incidence of non-communicable diseases such as hypertension and diabetes is rapidly increasing in countries in SubSaharan Africa, like Malawi and Tanzania. In 2010, there were more than 2 million deaths from non-communicable diseases in the region, which was a 46% increase from 1990. Many people in Malawi and Tanzania, as elsewhere in SubSaharan Africa, are moving from rural areas into cities. Here, calorie-dense foods and drinks are easily accessible, and opportunities to be physically active reduced. These factors, together with traditional cultural norms, such as a larger body size being associated with respect and attractiveness, contribute to increasing risk of non-communicable diseases in both countries. People's understandings and responses to non-communicable diseases draw on biomedical, as well as traditional, knowledges; traditional healers, as well as medical doctors and nurses, are consulted in attempts to understand (and treat) the symptoms of non-communicable diseases. If interventions to prevent non-communicable diseases in Sub-Saharan Africa are to be effective, it is essential they reflect not only Western experiences and biomedical accounts, but also local knowledges, perceptions and values. However, as these local knowledges and values are often deeply-rooted and unspoken, traditional research methods, such as surveys and interviews, are often inadequate to describe them. Community arts offer an alternative approach. They have great potential to allow researchers to access people's cultural, emotional and historical beliefs and practices, and then to work creatively together with local communities to develop non-communicable disease interventions that reflect these beliefs and practices. In this project, we aim to develop an interdisciplinary partnership of medical and social science, and arts and humanities researchers, and local arts organisations in Malawi and Tanzania to learn together as we work closely with local communities to create culturally-relevant approaches to non-communicable disease prevention in Malawi and Tanzania. We will do this using a variety of methods drawn from the different disciplines we represent. We will first analyse existing survey data from both countries, and conduct a review of previous arts-based health promotion initiatives in the region. This information will inform pilot projects in Malawi and Tanzania working with people living in or near cities to use community arts to access local knowledges, perceptions and values, and to develop a culturally-relevant intervention activity. By the end of the project, we will produce a framework describing ways of using community arts in non-communicable disease prevention. This will allow us to apply for more finding to test, refine and evaluate the framework in other settings in Malawi, Tanzania, throughout Sub-Saharan Africa, and beyond. The project will allow partners to develop new interdisciplinary understandings and skills around gaining access to complex local knowledges, perceptions and values, and working closely with local people to develop innovative approaches to noncommunicable disease prevention. Participation in the project will build research skills capacity in the UK, Malawi and Tanzania. Local communities will benefit from involvement in the project through becoming more aware of how to prevent non-communicable diseases in ways that are culturally-relevant for them. We will publicise our findings widely to local residents, and to local, national and international policymakers, practitioners and other researchers, through face-to-face and online events, and conferences, and through local, national and social media. We will also have a dedicated project website which will host project news and outputs (translated into local languages, where appropriate), as well as an online resource bank to support other researchers to use similar approaches to non-communicable disease prevention.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS;2.4 SURVEILLANCE AND DISTRIBUTION
Health categories: GENERIC HEALTH RELEVANCE