‘I was thinking we would be spoon-fed’: Community co-researchers’ perceptions of individual empowerment in participatory health research in Swaziland

ABSTRACT

Empowerment is an influential concept in global public health. Current theoretical models, which were developed in resource-rich countries, conceptualise individual-level empowerment as a process (or outcome) of developing positive self-perceptions, critical thinking expertise and new behaviours. They neglect the social and structural aspects that were central to early conceptualisations of empowerment, and may be culturally biased. My aim was to elucidate lay-people in Swaziland’s perspectives about individual-level empowerment. Twenty-one focus group discussions with lay-community ‘co-researchers’ were collected longitudinally over 14 months of a participatory health research process. Findings generated using interpretive analysis of epiphanies highlighted the salience of socio-historic context, in limiting the co-researchers’ expectations and experiences, and shaping their perceptions, of empowerment. The findings demonstrate that the co-researchers perceived: working independently and collaboratively; developing new perceptions of others, and technical (health and research) expertise; using expertise to take action; and accessing material resources were important aspects of empowerment. They indicate that individual-level empowerment models utilised in global public health might be enhanced by incorporating social and structural dimensions. These dimensions are needed to capture the relations and interactions which mediate socially excluded people’s agency to access the social and material resources needed to secure their right to health.

KEYWORDS:

• Empowerment
• participation
• social exclusion
• health and development
• HIV and AIDS

Acknowledgements

The author is extremely grateful to the 10 co-researchers who participated in the study for sharing their ideas and knowledge, and allowing the author to write about their experiences. The author thanks her Ph.D. supervisors Helen Keleher, Charles Livingstone, Andrea Whittaker, Bruce Missingham, Jane Fisher and Karin Hammarberg, for their contributions to designing, and/or writing about the study. The author greatly appreciates the time, consideration and constructive feedback provided by the anonymous reviewers of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author.

ORCID

Michelle Brear http://orcid.org/0000-0002-5990-5061

Additional information

Funding

The author’s research was supported by an Australian Postgraduate Award and a Monash University Postgraduate Excellence Award.