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Communication, HIV Prevention and Faith-Health Intersection: an Exploration Of Communication, HIV Prevention and Faith-Health Intersection: An Exploration of Perspectives among Christian Leaders in Rwanda A thesis presented to the faculty of the Center for International Studies of Ohio University In partial fulfillment of the requirements for the degree of Master of Arts Jean Claude Kwitonda August 2010 © 2010 Jean Claude Kwitonda. All Rights Reserved. 2 This thesis titled Communication, HIV Prevention and Faith-Health Intersection: An Exploration of Perspectives among Christian Leaders in Rwanda by JEAN CLAUDE KWITONDA has been approved for the Centre of International Studies by Rafael A. Obregon Associate Professor of Media Arts and Studies ____________________________________________ Rafael A. Obregon Director, Communication and Development Studies _____________________________________________ Daniel Weiner Director, Center for International Studies 3 ABSTRACT KWITONDA, JEAN CLAUDE, M.A., August 2010, Communication and Development Studies Communication, HIV Prevention and Faith-Health Intersection: An Exploration of Perspectives among Christian Leaders in Rwanda (119 pp.) Director of Thesis: Rafael A. Obregon This research explores the opinions of religious leaders in Rwanda projected in their interpretation of a salient narrative and HIV prevention methods. The study established that the intersection of faith and health is something that is still of a highly contested terrain. The study also reveals that ABC has been communicated using behavioral messaging at the detriment of the foremost experiential, stage-matched approach of communication. Yet, religious leaders’ opinions reflect fluctuating feelings about their roles in health and faith. The plight of religious leaders finds expression in their vacillating stances that are constantly evaluated, constructed and reconstructed. In order to validate and illustrate these findings, I locate data analysis in the theory of narrative persuasion, Problematic Integration theory and some vital problematics of narrative theorizing. The study concludes and recommends that narrative mode is a viable alternative communication avenue for effectively reaching religious leaders in Rwanda and (perhaps) beyond. Approved: ______________________________________________________________ Rafael A. Obregon Associate Professor of Media Arts and Studies 4 ACKNOWLEDGEMENTS I would like to mention some of the many people who, in one way or another, helped me accomplish this research and to whom I am grateful. Because of lack of space and confidentiality reasons, I will single out a few here, but each and every one of them deserves my everlasting gratitude. My thanks go to my supervisor Dr. Obregon Rafael who, on top of his busy schedules as the Director of Communication and Development program and professor in the school of Media Arts and Studies, accepted to be the chair of this thesis. His timely feedback has been very valuable to this thesis in many ways. I am equally thankful to Dr. Howard Steve and Dr. Sallar Anthony for accepting my request to have them as committee members. I am especially grateful for their feedback. I am also grateful to all the religious leaders who gave me their time and probably used their financial resources in order to participate and contribute to this study. I cannot forget MPAGAZEHE Aloys, a friend, pastor and former classmate for his generosity in coordinating the focus group at his church. Father KARAMUKA Eric also played a generous role by calling participants, traveling and participating in the focus group. I cannot forget Professor Babrow Austin of the Scripps School of Communication, Ohio University, for introducing me to and modeling the pleasures of 5 health communication scholarship. His classroom instructions and advice contributed to the state of this thesis. I am thankful to Benegusenga Aline for taking some field notes during the discussions, doing (open) coding of the data and introducing me to some participants. Her presence was welcome and encouraging. I would like to thank Kigali Institute of Education for lending me their recording equipment. 6 DEDICATION To Aline, the best idea I have ever had. 7 TABLE OF CONTENTS Abstract ............................................................................................................................... 3 Acknowledgements ............................................................................................................. 4 Dedication ........................................................................................................................... 6 List of Tables .................................................................................................................... 10 List of Figures ................................................................................................................... 11 List of Acronyms and Abbreviations ................................................................................ 12 Chapter One: Introduction ................................................................................................ 13 Aims .............................................................................................................................. 16 Chapter Two: Review of Literature & Research Questions ............................................. 23 Hermeneutics and Religious Culture ............................................................................ 23 Hermeneutics, Religious Culture and Social Change ................................................... 26 The Synergetic Potential between Religion and Health ............................................... 29 Perceived Risks and Barriers to Communication ......................................................... 31 Behavioral Change Communication in Rwanda ........................................................... 34 How ABC Has Been Communicated to the Public ...................................................... 34 The Socio-Cultural Interactions Between ABC and Spirituality in Rwanda ............... 35 Case Study from Population Services International (PSI) in Rwanda ......................... 36 Chapter Three: Methodology ............................................................................................ 41 Negotiating Access and the Experience of Doing Research in Rwanda ...................... 42 The Focus Group Discussion Process ........................................................................... 43 The Coding Procedure .................................................................................................. 46 8 Reliability Measures ..................................................................................................... 48 Validity Measures ......................................................................................................... 49 Ethical Considerations .................................................................................................. 51 Chapter Four: Results ....................................................................................................... 53 Participants ................................................................................................................... 53 The Roman Catholic Church ........................................................................................ 53 The Seventh Day Adventists Church ............................................................................ 53 Association des Eglises Pantecostales du Rwanda ....................................................... 54 The Pentecostal Churches of Rwanda: ADEPR ........................................................... 54 The Anglican Church .................................................................................................... 54 Findings ........................................................................................................................ 54 Reponses and Lessons Learned From the First Research Question (How do Religious Leaders in Rwanda Respond to a Dialogue .................................................................. 59 that is Grounded in the Practice of Ordinary Hermeneutics?) ...................................... 59 Responses and Lessons Learnt From the Second Research Question .......................... 62 (What is the Perceived Role of Religion in Public ....................................................... 62 Health Among Religious Leaders in Rwanda?) ........................................................... 62 Responses and Lessons Learned from the Third Research Question ........................... 68 (How do Religious Leaders in Rwanda Integrate New Information?) ......................... 68 Responses and Lessons Learned From the Fourth Research Question: How Has ABC ...................................................................................................................................... 76 Been Communicated By and to Religious Leaders in Rwanda? .................................. 76 9 Chapter Five: Discussion .................................................................................................. 86 Motivational Interviewing and the Narrative Mode ..................................................... 86 The Interpretive Process and Routes of Persuasion ...................................................... 88 Communication and Problematic Integration of Varying Responsibilities .................. 92 Implications Emerging from Narrative Sense-Making ................................................
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