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What role has culture played in this health issue

Millennium Development Goals – Uganda and Goal 1

The Sociological Imagination Template
This document is designed to help students apply the Sociological Imagination Template in the Millennium Development Goals Essay. Students are asked to analyse one country’s progress towards one MDG.
In terms of the historical, structural and cultural factors, some of those listed below will be very relevant to your health issue in the selected country, others will be less relevant and some not relevant at all. Your role as a critical thinker is to select and highlight to the reader the combination of factors that are having the greatest impact on the MDG in the selected country.

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HISTORICAL FACTORS:    How has the past influenced the current situation? Rather than providing a complete history of the country, highlight major events or ideas that have impacted the status of the health problem of concern.
Every aspect of society, including the structural and cultural factors discussed below, have been informed by historical ideas and events.
Consider all levels, from the individual/local to the country’s relationship with other countries, internationally
Has the country experienced war or conflict? What challenges has the country faced?
What form of government has it been? What cultural and social change has taken place in recent years?

STRUCTURAL FACTORS:    How have various social institutions influenced this health issue? Select the structural factors having the greatest impact on the health problem of concern.
Government – What form of government is in place today? What form of political system? Is the government capable and willing to make changes that would improve health outcomes? What are the priorities of the government?
Economy – How does the economy function? Which sectors are the largest (e.g. agriculture, industry)? Are there challenges – e.g. debt, restrictions, informal, black market? To what extent is poverty an issue? What proportion of the population are marginalised, economically? Is there income inequality?
Employment / earnings – What is the basis of the economy? How do people support themselves? How equitable is the distribution of wealth? Are there employment opportunities?
Education – Is education available? Affordable? Who has access? Which levels are provided? What are the literacy levels? What type of education?
Land – Who has ownership and control over land? What are people’s relationships with land?
Media – Is the media independent from government and other bodies? Who controls it? What forms are most used – print, electronic, audio? Is it accessible to all sectors of the population?
Health Care – What is the health system like? Does it draw on traditional methods, knowledge and beliefs? Are there sufficient traditional healers? What about biomedical infrastructure and personnel? Are there enough health professionals in this place, and are they from the needed professions? How is the health system organised? Is health care affordable? Does it reflect the biomedical model or the social model of health? Are all sectors of health care used (popular, folk, professional)? What are common assumptions about causation and health? What is the situation in terms of pharmaceutical + technical resources for health care? Are there emergency response services?
Rural / Urban – What proportion of the population lives in cities? In the country? What are the implications of this for health and health care?
Built Environment – How do buildings, city or community design, the use of space etc. impact people?
Public health infrastructure – To what extent does this place have infrastructure for water and waste?
Transport – How do people get around? Is there a transport network? Is it reliable / affordable? Road / rail / water / air?
Ethnicity – Is there diversity in ethnic origins of the population? How does this affect social life? Do ethnic identities influence the structure of society? Are some ethnic groups more dominant than others?
Religion – Are there different religions in this place? If so, which ones? Does religion play a role in the political, economic or judicial life of the country? Does religion play a role in how society is organised and functions? How does religion influence health beliefs and behaviours?
Age – How are adults, children, elderly etc. understood? Do children work? Who looks after children and the elderly? When does adulthood start?

Gender – What are common norms around femininity and masculinity? Are there clear gender roles, or a sexual division of labour? Is this society based on patriarchy or matriarchy? How does gender affect health?
Social hierarchies – What are other social systems of influence and privilege that structure society? Are there strong differences in Socio Economic Status (SES), class, social status, or caste? Are there opportunities for social mobility?
Housing – What types of housing are present? Do people own or control their housing? Is this social determinant of health causing illness or strain on people?

CULTURAL FACTORS:    What role has culture played in this health issue?
Culture involves a wide range of thoughts, systems and behaviours. It influences other aspects of the template – the organization of society (social structure, above) and historical developments (above) as well. Aspects you may wish to consider include:
•    Causation of health and illness, the functioning of the human body
•    Preferred health care
•    Belief systems, values, attitudes and beliefs, ways of explaining and understanding, including traditional or local beliefs about the health problem of concern
•    Response to Biomedicine
•    Practices, habits, everyday ‘lived’ experience affecting the health problem of concern
•    Culturally-related barriers to health care

CRITICAL ANALYSIS:     Responds to the main points identified in the historical, structural and cultural sections and then looks at the implications or areas of intervention. 2-3 paragraphs of critical analysis are to be provided before the conclusion.
What is happening? Briefly summarise main findings – Who is being affected? Where? Why? How?
What combination of social determinants is impacting this health issue? What are the main factors? Has it always been this way? If not, what has changed? Why or how has it changed? Is it possible for the people affected to change the situation? How much agency do they have?
What does this mean?  What are the implications of the above analysis for:
For the people most affected by this health issue – people who live in this context? For governments, NGOs and the global community ? For health professionals – in this context or from elsewhere?
What could we do about it? What recommendations could be made? At what level would recommendations be directed? (individual, community, state, international).  Based on your research, what may be some predictions for the future or observations about this situation? (future-oriented)

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