Health advocacy and practice: Exploring the influence of social structures on the health related lifestyles of adults in the Asokwa community in Kumasi, Ghana

ABSTRACT The increasing prevalence of non-communicable diseases (CNCDs) in Ghana has necessitated a shift in the health recovery paradigm from a curative to a preventive one (Ministry of Health [MOH], 2008). Currently CNCDs are set to overtake communicable disease in terms of morbidity and mortality rates (MOH, 2008) and in 2008 alone, 86,200 persons lost their lives as a result of ailments from this disease in Ghana (WHO, 2012). The Regenerative Health and Nutrition Program (RHNP) was adopted in 2005 and piloted in 2006 by Ghana's MOH with the aim of promoting healthy lifestyles, dietary practices, mother and child care practices that would help eliminate and prevent prospective diseases that impact on the health and general well-being of Ghanaians (Tagoe and Dake, 2011: 2). In spite of the usefulness of such a health program, the focus on what is described as healthy' or unhealthy' lifestyles assume primacy of individuals agency to prevent or reduce prevalence rates of non-communicable diseases with a limited focus on socio-cultural structures and practices as well as social statuses that shape lifestyle behaviours. This study therefore explores and examines overall predisposing or risk-reducing factors that influence health-related lifestyles of men and women in the Asokwa community in Ghana. The main objective is to find out how gender roles intersect with other social statuses in influencing an individual's health related lifestyles. The specific objectives are to examine the intersecting relationship between gender roles and other social statuses such as level of education, occupation, marital status, age and religion in their influence on awareness and practice of healthy lifestyle messages. In addition, this study examines the influence of the RHNP as a healthy advocacy program on residents in the Asokwa community. To address these research objectives, the feminist theories of intersectionality and gender (Crenshaw, 1991 in Staunces & Sondergaard, 2001), structuration theory (Giddens, 1976 in Dyck &Kearns, 2006) and the time-space constraint approach (Kwan 1999a) are used. The theory of intersectionality and gender roles helped in explaining how the gendered expectations of behaviour of men and women intersect with other statuses as they influence health behaviour. The time-space constraint approach provided guidelines to the analysis of the time use and mobility in space of informants. In addition, the structuration theory helped explain the relationship that exists between an individual and the structures that form the society within which he or she finds himself. A sample of 100 informants was surveyed including 16 case studies. From the study it was found that the RHNP through its advocacy program has increased the awareness of healthy living among the people. The receipt and application of messages from these health campaigns was indeed influenced partly by the availability of facilities as well as individual statuses. The study finds that although gender roles and marital status seem to be important, they mutually intersect with other statuses in influencing the diet and physical activity of informants.

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