Behavioural change and what do the poor think about themselves and their compatriots?

Professor Brandon Barnes is a new professor at the University of Johannesburg (UJ) in South Africa and leads the Critical Health Studies thematic area in the Department of Psychology. His research focuses on health, psychology and behaviour change in the Global South. I read the press release about his inaugural speech and found a few things I have not come across before in development literature, particularly asking ‘poor people’ what they think about themselves and ‘things’, specifically their health.

201610 profbarnesProf Barnes argues that health behaviour change forms part of a set of powerful discourses of 'behavioural citizenship' that draws on common sense ideas of race, class and geography and provides a moral framework for how the poor should think and behave in relation to their own and their compatriots' 'development'. However, the consequences of behavioural citizenship include stifling talk about class-based struggles for health and equality.

"The notion that your thoughts influence your behaviour and in turn your health has become a pervasive feature of modern society. Funders, policy makers, academics, governments, consultants,  industry, non-governmental organizations and change agents spend significant resources to encourage people to eat healthier, exercise more, engage in safe sex, consume alcohol in moderation, get enough sleep, go for regular medical check-ups, and to take their medication, to name a few," says Prof Barnes.

In the global South, behaviour change programmes are often framed by discourses of 'development' and attempt to promote the uptake and sustained use of 'simple' technologies such as improved cook stoves, oral rehydration solutions, insecticide treated bed nets, improved water storage vessels and condoms, he said.

"Resistance to behaviour change programmes is more politically interesting than what is currently represented in the literature, such as non-adherence, programme/implementation failure or methodological deficiencies," he argued.

Discussing the faeces-throwing protests in at Cape Town's airport where local people from the Cape Flats settlements dumped faeces in public places in protest against the poor sanitation in the areas where they live as an example, he said: "Health behaviour change programmes represent much more than just health and development in the way the mainstream imagines. It also forms part of a powerful set of discourses of behavioural citizenship about how the poor should develop.

"Those discourses state that the poor should take up programmes and partner with government; they should be patient with interim solutions while the City figures out a long term solution to the 'problem' of low income settlements; and residents should also express their grievances in appropriate ways.

"Behaviour then is not just about 'behaviour change' to adopt development programmes, but also in how people should 'behave' in terms of how they resist those programs," he said.

By drawing on a number of theoretical resources from psychology and public health, Prof Barnes’ work critically engages with health behaviour change programmes and what they have come to mean, asking questions such as: How effective are health behaviour change programmes in resource-limited contexts? What do behaviour change interventions overlook? How are behaviour change interventions resisted by their intended beneficiaries?

His work is based on several behaviour change studies in household air pollution, child respiratory health, water and sanitation, child lead exposure and mental health.

Applying behavioural change theory to land and mountain management

Although Prof Barnes is working on health, these same types of questions could be asked about behavioural changes about sustainability, sustainable land management approaches, sustainable mountain development approaches and how different groups of people resist changing their behaviour for one reason or another. Unless one understands why they resist, it is difficult to design programmes that overcome resistance and promote compliance, learning and a change of attitudes. In the NEPAD TerrAfrica programme on Sustainable Land Management, many NGOs, researchers and government agencies work with small-scale farmers in African countries and together discover ways to farm better and protect/or develop the soil.

The TerrAfrica programme has produced guidelines for best practices in sustainable land man­agement (SLM), with an aim to disseminate these promising practices and create a framework for invest­ment in SLM in Sub-Saharan Africa. The one thing that makes farmers change their farming ways is when sustainable farming actually produces more crop each year, and allows the farmers to make profits.

Press release sourced from https://www.uj.ac.za/newandevents/Pages/UJ%E2%80%99s-Prof-Barnes-on-class-based-struggle-and-health-behaviour-change.aspx