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Local Churches and Health: an Examination of Four

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Local Churches and Health: an Examination of Four Local churches and Health: An examination of four local churches’ contribution to direct health outcomes on the Copperbelt Province of Zambia. By Kabwe Maybin Kabwe Student Number:204514409 Submitted in Partial Fulfilment of the Ac ademic Requirement for the Masters Degree of Theology and Development in the School of Religion and Theology , Pietermaritzburg Supervisor: Rev. Dr. Prof. Steve De Gruc hy Dec ember 2008 DEDICATION I humbly dedicate this thesis to my family namely my dear wife Songwe and the my children, Mubanga, Mumba and Theophilus and the church at Grace Reformed Baptist Church; whose encouragement, support and understanding graciously made it possible for me to be away from home and church duties in order to complete my studies. Kabwe Maybin Kabwe. i DECLARATION I, Kabwe Maybin Kabwe, hereby declare that this whole dissertation, unless specifically indicated to the contrary in the text, represents my original work. I also declare that I have not otherwise submitted this dissertation in any form for any degree purpose or examination to any university. __________________________ _____/_____/________ Kabwe Maybin Kabwe Date As supervisor, I agree to the submission of this thesis _________________________ _____ /______/_________ Prof. Steven De Gruchy Date ii ACKNOWLEDGEMENT I am deeply indebted to acknowledge and thank a number of people for their contribution in the writing and completion of this dissertation. Primarily, I thank God and my Savior Jesus Christ for having granted me breath thus far to complete my studies. I am also greatly indebted to Rev. Dr. Prof Steve De Gruchy whose inspiration and passion in his lectures inspired me to pursue a Masters in Theology and Development studies. He did not just inspire me in his lectures, but also gave himself to supervise this work throughout the time of writing. I wish to express my appreciation to him for his pastoral heart, wisdom, patience, encouragement, positive criticism and assistance in bringing this work to completion. I also want to acknowledge my dear colleagues and course mates with whom I shared much encouragement during the research study in the ARHAP team namely my dear friends Roy Hamalyang’ombe and Mary Mwiche who always provided good company and support each time we made those long trips from Zambia to RSA for studies and research work. My appreciation also goes to Grace Reformed Baptist Church for their understanding, spiritual, moral and financial support they rendered to me during my studies. I want also to say a big thank you to Dr Kathy Stuebing for sparing her valuable time to proof read my work. Last but not least, I thank dear wife Songwe for having being there for me and taking care of our family when I was absent from home during the busy time of study and research, especially during those days when I was home in the body but not available, I love you and thank you. The Germans would say -Vielen Dank! iii ABSTRACT The research explores and examines the relationship that exists between religion and health. Four church health related activities were examined as case studies to assert their direct and indirect contribution to health and well being of communities on the Copperbelt Province of Zambia. The main thrust and perspective of the study is a theological position on the contribution of the Christian Church toward holistic health care and provision. The study is rooted in a large field of study called African Religious Health Assets Program [ARHAP] which has developed a theory to help establish the link that exist between religion and health in health care. The insights from the ARHAP theoretical framework are engaged in this study to identify the religious health assets known as tangible and intangible in each institution and how they contribute to health promotion and care. Key informants from each of the four religious health institutions were interviewed to establish and examine the kind of religious health assets they have and on how they affect and contribute to health outcomes. Through these case studies of four Christian religious health institutions, in Ndola and Masaiti districts, the thesis has shown that religious health institutions have diverse assets that enhance and contribute directly and indirectly to better health outcomes. These assets [referring to what is present in these institutions] are labeled as ‘religious health assets’ in this thesis. The findings of the thesis indicate that Christian religious health institutions have assets, which could be aligned and leveraged in public health policy for the well being of people and communities. iv ABBREVIATIONS/ ACRONYMS ABCD Asset Based Community Development AIDS Acquired immunodeficiency Syndrome ARHAP African Religious Health Assets Program ARV Antiretroviral ATR African Tradition Religion BUSA Baptist Union of South Africa CCZ Christian Council of Zambia CHAZ Church Health Association of Zambia CMAZ Church Missionary Association of Zambia CSO Central statistical Office DHMD District Health Management Boards DHMT District Health Management Teams DTCC Dawn Trust Community Center EFZ Evangelical Fellowship of Zambia FBO Faith Based Organization FHMRHC Fiwale Hill Mission Rural Health Centre GDP Gross Domestic Product HAZ Hindu Association Zambia HBC Home Based Care HIV Human Immunodeficiency Virus ICOZ Independent Churches of Zambia ICRC Isubilo Community Resource Center ICZ Islamic Council of Zambia IGAs Income Generating Activities IMF International Monetary Fund MOH Ministry of Health MMD Movement for Multiparty Democracy NBAZ Northern Baptist Association of Zambia NFBHNs National Faith Based Health Networks OVC Orphans and Vulnerable Children PIRHANA Participatory Inquiry in Health Assets Networks and Agency v PLWHA People Living with HIV and AIDS RE Religious Entities RHA Religious Health Assets SAP Structural Adjustment Program SSA Sub Saharan Africa STDs Sexually Transmitted Diseases TB Tuberculosis TDRC Tropical Disease Research Centre THPAZ Traditional Healers and Practitioners in Zambia UKZN University of Kwazulu Natal UTH University Teaching Hospital VCT Voluntary Counseling and Testing WHO World Health Organization ZBA Zambia Baptist Association ZCCM Zambia Consolidated Copper Mines ZEC Zambia Episcopal Conference ZINGO Zambia Interfaith Networking Group ZNAN Zambia National AIDS Network ZPA Zambia Privatization Agency vi TABLE OF CONTENTS PAGES Dedication …………………………………………………………………… i Declaration …………………………………………………………………… ii Acknowledgment …………………………………………………………… iii Abstract………………………………………………………………………….. iv Abbreviations …………………………………………………………………… v Table of Contents …………………………………………………………… vi CHAPTER ONE: GENERAL INTRODUCTION TO THE STUDY 1.1 Introduction……………………………………………………….......... 1 1.2 Background…………………………………………………………… 1 1.3 Motivation for research…………………………………………………… 2 1.4 Research problem and objectives…………………………………………. 4 1.5 Research Design and methodology…………….…………………….. 5 1.6 Geographical location of the study……………………………………….. 8 1.7 Summary of research findings…………………………………………….. 8 1.8 Summary of theological insights…………………………………………... 10 1.9 Structure and content of dissertation…………………………………… 12 1.10 Conclusion……………………………………………………………… 13 CHAPTER TWO: HEALTH DEVELOPMENT AND THE IMPACT OF STRUCTURARL ADJUSTMENT PROGRAMMES ON HEALTH 2.1 Introduction…………….………………………………………………… 14 2.2 Zambia’s demography and health statistics……………………………… 14 2.2.1 Demography……………………………………………………… 14 2.2.2 Health facilities and infrastructures………………………………. 15 2.2.3 Development of health sector during the Kaunda government…… 16 2.3 The change of government and introduction of new health policies …… 18 2.4 Impact of Structural Adjustment Program on health……………………… 19 2.5 Health reforms………………………………………………………… 20 2.5.1 The results of health reforms……………………………………… 21 2.6 Impact of privatization on livelihoods of people………………………… 23 vii 2.7 HIV and AIDS impact on health services……………………………..... 26 2.8 Religion in Zambia ………………………………………………………. 28 2.9 Religious health services and Networks………………………………… 29 2.10 ARHAP relationship to the thesis…………………………………………. 32 2.11 Conclusion………………………………………………………………... 32 CHAPTER THREE: AFRICAN RELIGIOUS HEALTH ASSETS (ARHAP) Introduction 3.1 Descriptive overview of ARHAP……………………………………….. 33 3.1.1 The vision of ARHAP……………………………………………. 33 3.1.2 Goals and objectives of ARHAP…………………………………. 34 3.2 Definition of ARHAP terms……………………………………………… 35 3.2.1 Religion…………………………………………………………… 35 3.2.2 Health …………………………………………………………… 36 3.2.3 Assets……………………………………………………………… .37 3.2.4 Agency…………………………………………………………… .37 3.2.5 Religious entities………………………………………………… 38 3.3 ARHAP research projects………………………………………………… 38 3.4 ARHAP in Zambia……………………………………………………….. 40 3.4.1 ARHAP findings in Zambia……………………………………… 44 3.5 ARHAP Conceptual framework………………………………………… 46 3.5.1 Tangible and intangible religious assets…………………………… 48 3.5.2 Tangible religious assets……………………………………………49 3.5.3 Intangible religious assets………………………………………… 50 3.6 ARHAP research findings from Zambia and Lesotho…………………… 50 3.6.1 Definition of ARHAP cluster PIRHANA findings……………… 53 3.7 Conclusion………………………………………………………………… 54 CHAPTER FOUR: RESEARCH FINDINGS 4.1 Introduction……………………………………………………………… 55 4.2. Background and profile of religious institutions………………………… 55 4.2.1 Bethel city Church…………………………………………………. 56 viii 4.2.2 Fiwale Hill Mission Rural Health Center…………………………. 57 4.2.3 Dawn Trust community Center…………………………………… 58 4.2.4 Isubilo Community Resource Center……………………………… 59 4.3 Category of interviewees…………………………………………………
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