The Level of Health of Individuals, Case Study Example

Culture plays a critical role when it comes to determination of the level of health of individuals, families and the community at large.  The behaviour of these groups of people has significant implication as far reacting to a particular health problem is concerned.  The PEN-3 Model was developed by Airhihenbuwa (1995, 1999) with the aim of incorporating culture as a key factor in health promotion and disease prevention interventions.  The model is meant to assist public health practitioners and communities at large to come up with the best strategies to tackle health problems affecting particular groups of people. The model consists of three dimensions, that is, cultural identity, relationships and expectations and cultural empowerment.

The PEN-3 model will be applied in the context of HIV/AIDS among Africans in South Africa.  The HIV/AIDS has impacted heavily on South Africa. The country currently has the  highest HIV prevalence in the world (UNAIDS, 2009).  The prevalence currently stands at 12% of the total population. The cultural orientation of the citizens has been a big challenge as far as efforts to combat the scourge are concerned.  The high prevalence rates can be attributed to social cultural factors like polygamy, which is still common in most parts of rural South Africa, gender inequality and male dominance. Also, violence against women is another factor (Brody, 1987).  The country has one of the highest violence statistics in the world, especially sexual violence, with the obvious implications of increasing the spread of HIV. Other factors include stigma and discrimination of sufferers, lack of knowledge and misconceptions of HIV and cultural practices that frown on the use of condoms.

The relationship and expectation dimension of the model focuses on how the family and friends are important in healthcare decision making. This group of people plays a key role when it comes to changing perceptions. Therefore those suffering from HIV need to be empowered to change their perception regarding HIV as a curse. Under the cultural empowerment, there is need to promote the positive sides of culture that will reduce the spread of the disease. Promotion of values that leads to behaviour change is very crucial.

Cultural identity provides the best entry of determining the most appropriate intervention aimed at curbing the spread of HIV in South Africa.  Identity markers influence decision making a good being seen in the way funding of ARV’s by western governments is carried out. South Africa is a country where identities based on race and tribe has and continues to shape the life of each person. “HIV/AIDS-related stigma produced through these multiple identities that are manifested in individuals in the contexts of families and communities” (Garrett, 2000). What everyone’s knowledge/beliefs about forms of identity, what is crucial is that cultural identity is an important HIV intervention point of entry. The points of intervention under this model relate to the person himself, the extended family and the neighborhood. For example, an intervention programme at the personal level would be training wives on the best ways of condom use while at the same time encouraging husbands to be supportive of the same. Interventions and health education programmes should target extended families because of the influence they have on the family. E.g., interventions should focus on using mother-in-laws and grandparents due the respect they have the family set up. In utilizing the neighborhood model of identity, it is important that communities have the ability to relate to billboard advertising and communication channels about the disease (Garrett, 2000). The intervention should resonate with the reality on the ground. For example, in South Africa, some billboards on HIV/AIDS prevention in white communities have black/African faces on them. This could give the whites a false sense of security that the disease does not affect them, which is not true.

In conclusion therefore, the PEN-3 model is an effective method of addressing the problem HIV which continues to affect millions, especially in developing countries. Culture is an important aspect of different groups of people and health care interventions should be aware of this fact.

References

Airhihenbuwa, C. (1995). Health and culture: Beyond the western paradigm. Thousand Oaks, California: Sage

Brody, H. (1987). Stories of sickness. New Haven: Yale University Press

Garrett, L. (2000). Betrayer of trust: The collapse of global public health. NewYork: Hyperion Publishing