The construction of critical knowledge for the development of human health : an evaluation of a health promotion intervention in a rural community in Mexico, 1997-1999

摘要

This study is about the power dimensions of health promotion seen from theudperspective of a rural community in Mexico. Drawing upon the conception of healthudpromotion proposed in the Ottawa Charter 1986, health promotion is examined here asuda device of hegemonic power and also as a possibility to subvert domination. Theudassumptions underpinning this thesis are based in the works of Antonio Gramsci, PierreudBourdieu and Paulo Freire. The work of Michel Foucault also helped in theuddevelopment of particular concepts of health and health promotion. It is argued in thisudthesis that the control of power is achieved by controlling meaning in social networksudand that, because of the unique capacity of health to involve the objective andudsubjective dimensions of the human person, the discourse and practice of healthudpromotion are outstanding means for the control of meaning. This thesis has three mainudcomponents: the analysis of power and knowledge and of the official discourse andudpractice of health promotion; the design of a pedagogic intervention aiming to achieveudchanges in adult learners subordination patterns and the description and evaluation ofudthat intervention. The pedagogic intervention focused on processes rather than onudcontents and brought problems of students' reality to deconstruction through dialogue.udThis study has a qualitative methodological approach and is presented as a case study.udThe empirical data were collected through fieldwork observations during theudimplementation of the intervention. It is proposed in this study that dialogue can be audmeans to triangulate data. The analysis of data is done here with the aid of process andudoutcome indicators capable of monitoring changes in the students' position in the faceudof power. This thesis showed that there was a possibility to achieve changes inudstudents' patterns of subordination through pedagogic practices where they constructedudknowledge embedded in their values and meanings to face their health problems.