|
|
AEGIS European Conference on African Studies
11 - 14 July 2007
African Studies Centre, Leiden, The Netherlands
Show panel list
Examining Health in the Livelihood Framework: A combined Risk-Vulnerability-Resilience Approach
| Panel |
39. Livelihood, Vulnerability and Health. Moving beyond existing frameworks
|
| Paper ID | 553 |
| Author(s) |
Obrist, Brigit ; Kessy, Flora ; Mshinda, Hassan ; Tanner, Marcel
|
| Paper |
No paper submitted
|
| Abstract | Based on recent research on the “diseases of poverty” AIDS, Malaria and TB in Africa, this paper examines advantages and disadvantages of the Sustainable Livelihood (SL) framework for the study of the links between health, poverty and development. Up to now, most research in this field is guided by an epidemiological approach. This approach is efficient in identifying the relative and the attributable risk of AIDS, malaria and TB, risk groups, the cost effectiveness of potential interventions and perceptions as well as behavior associated with these diseases. It may also be linked with economic studies on prevention and treatment costs and their association with equity as measured by wealth indices. But the epidemiological risk approach and economic studies on the costs of commodities tell us little about the social burden of AIDS, malaria and TB. Why do the poor have more negative health outcomes and use prevention and treatment less often? These questions call for a vulnerability approach that examines not only people’s exposure to measured and perceived risk but also the means they have to cope with the risk of falling ill. Once risk studies have been conducted and risks groups as well as cost effective interventions have been identified, we need to assess people’s access to resources which help them to prevent, heal or live with AIDS, malaria and TB.
People’s access to resources is at the centre of interest in the SL framework. Even if the emphasis is on gaining a livelihood, not on staying healthy, the SL framework can be easily refined to address this issue. It directs attention to how people can actually access (claim and make use of) assets available within households and communities to cope with AIDS, malaria and TB. However, the SL framework is less suited for a social analysis of people’s access to health(-related) services provided by the government and the civil society. Such an analysis examines social institutions (rules, norms, values) that inhibit and facilitate access to health care on the household, community, intermediate, district and national level.
Increased attention to factors facilitating access brings resilience into sharper focus. A functioning health system enables people to lead healthy lives and provides cascading layers of resilience that not only protect them but support and empower them to live with or overcome health risks. The crucial question thus is which practices and processes help people affected by AIDS, malaria and TB to adapt to this risk and thus build resilience, both from their own point of view and from an expert’s point of view. In this sense resilience can be seen as means to and an end of health development. The paper concludes that a combined risk-vulnerability-resilience approach opens innovative and constructive lines of inquiry.
|
|