spirit and healing in africa - University of the Free State

processes within a particular society. So, in the case of health as a social construct, it means that
the considerations of the various health conceptualizations (including the social factors and the
structures influencing those constructions) allows for a certain flexibility pertaining to health
responses, meaning that illness etiologies are not conclusively fixed but develop in response to
the social and contextual factors of health, illness and healing.
1.2.2 Health-orientated approach
The social constructivist approach to health research has offered an insight into a dimension of
health that should also receive attention: the value-charged health ideas and goals that are
present in any social order. As mentioned previously, most definitions of ‘health’ use a diseaseorientated
approach focused on identifying, classifying and treating diseases thereby perceptions
and underlying ideas about health and healing are not addressed. This negative or diseaseorientated
perspective has dominated research into health and health-care for a long time. More
recently, however, there seems to have been a shift towards a more positive health-orientated
approach. It has been argued that healthcare in Africa can be provided (even) more effectively if
the focus is also on a taxonomy of health instead of primarily on pathology and technology (see
for example Janzen 1981; Cochrane 2006b), because a taxonomy of health implies the existence
of multiple conceptions of health, and it acknowledges the ideas and beliefs that constitute those
conceptions. A health-orientated approach, thus, includes the more subjective issues of health,
illness and healing, since people’s perceptions of health have come to play an important role in
determining what ‘health’ is, and subsequently what kind of health intervention would be best in
relation to those perceptions.
The importance of a health-orientated approach is made clear, for example, by the African
Religious Health Assets Programme (ARHAP) 6 , an interdisciplinary program that focuses on
assets (in their broadest sense of capabilities, skills, resources, links, infrastructure, associations,
organizations and institutions) already present for and accessible to the individual or community
searching for a health intervention. The asset-based program of ARHAP draws attention to those
who are in need of healing over and above “the logics and power of technological solutions and
command-driven medical or health institutions” (Cochrane 2006b:3). It also focuses on the
patients’ specific context within its own assets and potential, unlike the more conventional
approach which focuses on needs and deficits. In so doing, the ARHAP goes one level deeper
because it discloses the importance of intangible assets (for example, prayer, resilience,
motivation, locale, knowledge, responsibility, commitment, sense of meaning, belonging and
6. See www.arhap.uct.ac.za (accessed on 24 October 2011).
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