Socio-cultural Context of Overweight

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For decades the global and national policymakers’ concern in sub-Saharan Africa (SSA) including Tanzania has been on the enormous impact of malnourishment and infectious diseases like malaria, tuberculosis and HIV/AIDs. While prospects of eliminating these conditions ‘grim’, non-communicable diseases (NCDs) such as diabetes, hypertension and some forms of cancers are now recognized as new ‘silent killers’. For example, 20% of all deaths in Tanzania in 2005 were attributable to NCDs. Propelling the upsurge in cases of these ‘new’ diseases is the growing prevalence of overweight, which has joined underweight and infectious diseases as major health challenges. If the pace of overweight is not thoroughly checked, NCDs are projected to overwhelm the health system which is already struggling with unrelenting infectious diseases and undernourishment. This situation poses a challenge to government as to the type of interventions that are needed.

Based on previous research on prevalence and health consequences caused by overweight, researchers and international organizations underscore the need for urgent lifestyle-change programs. However, there is very limited information on how overweight is framed in both empirical research and health policy documents in Tanzania. It is also not clear as to how policymakers at national level and community stakeholders articulate the influence overweight has on population’s health. Furthermore, very little is known about how communities that have experienced malnourishment for decades interpret overweight and its relationship to health. The ways in which people subjectively perceive, interpret and evaluate the condition have important consequences on action, behaviour and wellbeing of the general population. Thus, intervention strategies and policies that build on such local knowledge may prove to be contextually effective. Unfortunately, there is no research that has focused on such information in Tanzania.

This study seeks to examine the emerging overweight discourse in health policy research and community response in Tanzania. It also seek to understand the impact of such situated perspectives on practices of people concerning body image and size so as to advise for appropriate policy options and effective intervention programs in Tanzania. The study has three main objectives:

1) To do a systematic review of the literature on overweight, including health policy related documents and reports, and to analyze the heterogeneous discourses, debates and theoretical bodies of knowledge that have characterized overweight in Tanzania since mid-1980s

2) To examine the discourse in the narratives of community stakeholders including the members of ward health committees, community health workers, traditional healers and religious leaders concerning overweight in low socio-economic status neighbourhoods of Morogoro, Tanzania To elicit the social and cultural meanings attached to overweight and its relationship to health among adult men and women living in low socio-economic status neighbourhoods where malnourishment has persisted for decades.

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