Public health „expert‟ knowledge and technical „solutions‟ to environment-related
diseases are often embedded in biomedical perspectives that emphasise objectivity
and rationality. However, such perspectives tend to sidestep the ways in which
knowledge and solutions are shaped by social and cultural contexts. Public health
interventions have therefore been evaluated in terms of the „failure‟ of their intended
recipients to „comply‟ with them and in relation to public „misperceptions‟ of risks to
their health. This research was developed in an attempt to understandhow social and
cultural beliefs and perceptions mediate health and the way that they contribute to,
escalate or reduce risks to health. The study explores these attributes in the context
of two issues: firstly, environment-related health risks pertaining to malaria and
diarrheal diseases, and secondly residents‟ perceptions and views of public health
interventions and programmes. The research was carried out in two villages in rural
northern Tanzania to explore the complexities of villagers‟ behaviours in their
everyday lives in order to help understand common public health concerns such as:
why do some public health programmes succeed and others fail? Why do some
individuals who know how to protect themselves against a particular disease choose
not do so? And why are control and prevention of preventable infectious diseases
problematic? The study employed an ethnographic approach based on a sociocultural
perspective. Focus groups and interviews were the main tools for data
collection, and analysis was done inductively through development of key themes.
Research findings show that social and cultural values, especially in relation to social
capital, frame health-related risks in such a way as to shape the vulnerability and
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resilience of citizens to environment related illnesses. The thesis demonstrates a
number of ways in which adherence to socio-cultural norms and practices takes
precedence over potential concerns about risks to individual health.