Chimbwete-Phiri, Rachel (2018) The reproduction and negotiation of knowledge in HIV/AIDS consultations in Malawi. PhD thesis, University of Warwick.

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Abstract

This study investigates the extent to which clients and health professionals in antenatal clinics in a rural hospital in Malawi reproduce and negotiate knowledge about HIV/AIDS during group counselling and educational talks. Malawi is a developing country with economic and public health challenges, particularly in the area of HIV/AIDS. While there have been achievements in getting people tested to check their HIV status, efforts have been hampered by inadequate compliance with HIV/AIDS treatment, especially in the area of prevention of HIV transmission from mother to child.

The study argues that analysis of the discourse of patients and health professionals in antenatal HIV/AIDS consultations can lead to a clearer understanding of different systems of knowledge that have a bearing on outcomes of treatment utilisation and preventive practices. To do this, the study utilises interactional data from healthcare professionals and pregnant women, hospital documents and interviews to assess the extent to which clients are involved in the exploration of knowledge about HIV/AIDS prevention, management, and treatment. The study employs a discourse analytical approach, particulary interactional sociolinguistics which is supplemented by critical discourse analysis.

The study observes that the health professionals use collaborative discourse strategies to increase patient participation during the consultations, such as question and answer exchanges, local knowledge resources such as stories, metaphor, and humour. However, the study also reveals that the interaction is constitutive of power asymmetries reinforced by social and institutional structures which constrain the agency of the pregnant women in the discourse of HIV/AIDS. It observes that there is a tension between medical knowledge and other forms of local knowledge, which are influential yet partially elided from the discourse. The study closes with recommendations for the improvement of actual healthcare practices in order to reinforce client participation.

Item Type:	Thesis (PhD)
Subjects:	P Language and Literature > P Philology. Linguistics Q Science > Q Science (General) R Medicine > R Medicine (General)
Library of Congress Subject Headings (LCSH):	HIV infections -- Malawi -- Prevention, HIV infections, AIDS (Disease), HIV infections -- Africa, Sub-Saharan -- Prevention, Discourse analysis
Official Date:	August 2018
Dates:	Date Event August 2018 Published
Institution:	University of Warwick
Theses Department:	Centre for Applied Linguistics
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Schnurr, Stephanie ; MacDonald, Malcolm
Sponsors:	Commonwealth Scholarship Commission in the United Kingdom
Format of File:	pdf
Extent:	xi, 292 leaves: illustrations, maps.
Language:	eng

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