A Comparative Study Of Health Literacy and How Rural Communities Understand Hypertension Information in Uganda And Tanzania

Open Access
Freer, Robert J
Graduate Program:
Adult Education
Doctor of Philosophy
Document Type:
Date of Defense:
February 23, 2015
Committee Members:
  • Ladislaus M Semali, Dissertation Advisor
  • Adnan A Qayyum, Committee Chair
  • Jamie Myers, Committee Member
  • Sinfree Bullock Makoni, Committee Member
  • Health
  • Literacy
  • Education
  • Hypertension
  • Africa
This comparative dissertation examines health literacy and how rural communities understand hypertension information in Kabale, Uganda and Moshi, Tanzania. Commonly defined as an individual’s ability to access, understand, and use information to promote and maintain positive health and well-being, health literacy as it relates to hypertension has yet to be problematized and compared within an African context. Often described as a silent killer due to a lack of physical symptoms, hypertension afflicts more than one-fourth of the world’s adult population. In Africa, hypertension is the leading cause of cardiovascular disease on the continent and is expected to outnumber deaths attributed to more well-known infectious diseases by the year 2030. Based on the analysis of interviews, focus groups, as well as direct and indirect observation, the results of this comparative research study revealed significant barriers to access, understanding, and use of hypertension information for research participants diagnosed with hypertension. These barriers led to a low utilization of health services and reinforcement of cultural perceptions of the supernatural. Additionally, behavior modification messages targeting food choice were met with frustration and confusion as support and resources for implementing such plans were limited. Current top-down, population-based health literacy initiatives developed by Western agencies that target infectious diseases are ubiquitous but have had a limited effect. They are often devoid of context, full of technical medical jargon, and situate health literacy within a Western paradigm of behavioral psychology. This further promotes Western hegemonic ideologies and denies African identity and ways of knowing. This comparative research study undergirds the need to examine current discourses that inform health literacies and take a Freirean approach to the co-creation of knowledge.