A Critical Analysis Of Urban Environmental Health Discourses In Promoting Community Participation Focus On Addis Ababa Ethiopia

This study analyzed environmental health, particularly sanitation discourses with arncritical discourse analysis approach to see how community participation is promoted.rnSince the adoption of the Alma-Ata Declaration in 1978, community participation hasrnbeen promoted as a global discourse of health promotion. This is based on the belief thatrnhealth is a matter of life and death and it has to be owned by the people. Drawing onrnNorman Fairclough’s (2003) approach to discourse analysis, global views onrnenvironmental health and approaches to the promotion of community participation,rnpower relations in environmental sanitation discourses have been focused forrninvestigation in this study.rnThe study employed mixed methods design although the emphasis is on the qualitativerndata. The required qualitative data were taken from 5 key policy and strategy documents,rn13 environmental health communication resources, 4 scripts of environmental sanitationrneducation lesson observations, 13 scripts of individual in-depth interviews and 4 scriptsrnof focus group discussions. Survey data from 250 respondents were also used torncomplement the qualitative data. All in all, the study involved 281 participants includingrnseven key informants, six individual in-depth interviewees, 18 FGDs discussants and 250rnsurvey respondents. Participants were selected using multi forms of strategies. The datarnanalysis utilized mainly latent level content and critical discourse analyses.rnThe findings revealed that though community participation has consistently beenrnpromoted as a nodal policy discourse of environmental health in general, andrnenvironmental sanitation in particular, communities were not participating in thernplanning, implementation, monitoring and evaluation of policies, programs andrninterventions as intended. The analysis also showed that in the environmental healthrneducation materials, as well as during the actual communication practices, the promotionrnof community participation has been left aside. The environmental sanitation packagesrnand the awareness raising lessons were found dominated by bio-medical information;rniiirnwhereas, community participation is a social practice which requires behavioral change.rnMoreover, though the policy discourses acknowledged the role of communities’rnindigenous knowledge to maintain sustainable environmental sanitation, the wasternmanagement and disposal oriented environmental sanitation discourses demonstrated thernusual top-down flow of information. It also emerged from the analysis that the unspokenrnexclusion of communities from the process of designing, implementing, monitoring andrnevaluating their respective environmental health activities as promised in the policy andrnprogram documents resulted in silence and resistance. This is to say that communitiesrnwere not empowered to develop attitudes of responsibility and participation essential tornown the environmental sanitation interventions. They rather considered participation asrnpolitical affiliation and developed sense of mistrust. The communities took the healthrnextension workers as political agents of the government and resisted to take part even atrngrass-root level activities. In Ethiopia, low community participation is a contributingrnfactor to poor environmental sanitation observed in the capital.rnFinally, it is recommended that the Ethiopian government needs to use participatoryrncommunication where communities participate in agenda setting, operational strategiesrnand accountability of results. The present health communication strategy is top down andrndoes not impact change of behavioral practices towards environmental sanitation. It isrnalso suggested that more research needs to be done on community health communicationrndiscourses to get better insight into community assumptions and beliefs of health inrngeneral and environmental sanitation in particular. There should be more studies onrncommunication strategies and ways of operationalization of health communicationrnactivities and community actual responses to such communications. The author stronglyrnbelieves that unless we bring transformation on community perceptions and beliefs onrndevelopment, where health is an important component, we cannot ensure sustainablerngrowth and better life style.

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