spirit and healing in africa - University of the Free State

1.2 MEANING OF SOCIAL CONSTRUCTIVISM IN HEALTH RESEARCH
The social constructivist model provides the theoretical framework for this research on health,
illness and healing in the African context, because it clarifies the theories about health in such a
way that these constructs can be used for further interdisciplinary research on health. Social
constructivism 5 is an important framework provider for reflection on health in the African
context in at least three ways: first of all, social constructivism draws the attention to social
structures; in doing so, a focus on health-oriented approaches is generated, and this is a crucial
addition to the existing frame of ‘fighting disease’; finally, the social constructivist model offers
new opportunities for Reformed theology to reflect on health, illness and healing.
1.2.1 Social structures
The significance of the social constructivist approach has to do, among other things, with its
focus on social structures that co-determine the perception of health. Health conceptualizations
are the result of how people view reality based on who they are, where they live, what they have
experienced and what kind of information they can access. Health as construct implies that the
personal perspective moulds the reality of health or disease. For example, someone belonging to
the working or low-income classes may define pain in a different way to someone belonging to a
high-income class of the same society, due to the fact that the higher-income class may
experience fewer obstacles in accessing knowledge of diseases, treatment and medication.
Various factors like class, gender, religion, sexuality, ethnic background, education, type of work
and hobbies are important reference points in the social structures that determine the way people
define health, recognize disease, or seek treatment of the health condition. This means that health
is more than the visible condition of the individual, because health is directly related to the social
structures of which the individual is fully part.
The consideration of culture, identity, power relations, gender and class as essential constituents
of health constructions does not only address the dimension of social structures (and hence of the
presence of power and knowledge as parameters of human organizations), but it also implies that
the social constructs reflect tendencies or changes within the social organization. The social
constructivism approach thus offers a helpful frame for exploring and discerning transformation
5. Social constructivism should not be confused with social constructionism. Both concepts have to do with the
development of social phenomena, yet the difference is in the emphasis. Social constructionism is about the
construction of phenomena that are related to social contexts, while social constructivism puts the emphasis on how
individuals construct meaning on the basis of available knowledge. Lev Vygotsky, a cognitive psychologist and a
social constructivist theorist, stresses the critical importance of one’s social context for cognitive development and
meaning-making.
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