A Qualitative Investigation of the Psychosocial Impact of Chronic Low Back Pain in Ghana

Introduction: Chronic low back pain (CLBP) is a global health concern associated with multidimensional/biopsychosocial levels of affectation in developed countries, with holistic management requiring consideration of these factors. There has been minimal research exploring the psychosocial impact of CLBP, and the factors influencing it, in African contexts, with none in Ghana. Objectives: To explore the psychosocial impact of CLBP among patients with CLBP in Ghana. Design: Qualitative study using individual semistructured face-to-face interviews, underpinned by Straussian grounded theory principles and critical realist philosophy. Participants: Thirty patients with CLBP attending physiotherapy at two hospitals in Ghana. Results: Five categories: loss of self and roles, emotional distress, fear, stigmatisation and marginalisation, financial burden, and social support and three mechanisms: acquired biomedical/mechanical beliefs from healthcare professionals (HCPs), sociocultural beliefs and the socioeconomic impact of CLBP were derived. Conclusion: CLBP adversely affects multidimensional/biopsychosocial aspects of individuals experiencing CLBP in Ghana. This delineates the need for a biopsychosocial approach to care. There is the need for HCPs in Ghana to reassess current CLBP management strategies to address the influence of adverse HCPs biomedical inclinations on patients’ psychosocial consequences. Population-based education strategies and consideration of formal support systems for persons with disabling CLBP may also be beneficial

Learner autonomy in developing countries

Learner autonomy may have special relevance now in developing countries, where a dissonance often exists between what formal education offers and what many learners want or need. Globalization and its technologies are providing new means of accessing knowledge, but school language lessons remain largely unchanged. Almost by default, successful language learners in developing country contexts are autonomous learners who can exploit out-of-school resources, while some of the most effective pedagogy involves promoting autonomy as a means of confronting low-resource challenges. This chapter argues for more research into both these phenomena, in order to increase understanding of them and to enable identification of principles for practice. It also emphasizes the need for such research to be conducted with and by local teachers and learners

Beyond the enclave: towards a critical political economy of China and Africa

This article provides a political economy framework for analysing China’s engagements with Africa. It situates the rise of China in the context of the changing balance of power in the world system and particularly China’s re-entry into spheres of influence in Africa that have been the purview of the former European colonial powers for two centuries or more. It begins by arguing that current approaches to China, Africa and international relations are fragmented in particular ways which prevents the development of a more critical political economy. It then examines a pervasive theme in China–Africa relations, which assumes that the Chinese work through enclaved investments to secure the resources of low-income economies, though in this sense the Chinese are no different from other investors. Where they do differ is in their bundling of aid, trade and FDI and their use of imported labour, which has been termed ‘surgical colonialism’. The article does not dispute the existence of Chinese enclaves, but argues that we need more empirical evidence on the levels of labour importation in relation to local labour market conditions. This requires a more nuanced understanding of state–capital dynamics in those countries where the Chinese operate although the model appears to be one of elite brokerage. However, the enclaved investments and inter-elite bargaining are only part of the story and the closing sections analyse the role of independent Chinese businesses in Africa’s social and political development, which moves us beyond the enclave

Sand in the Engine: The Travails of an Irrigated Rice Scheme in Bwanje Valley, Malawi

The establishment of the Bwanje Valley Irrigation Scheme (BVIS) in Malawi is a striking example of informed amnesia in development assistance. Despite the lessons learned earlier concerning a process approach to participatory irrigation development in Africa, in the case of BVIS outside interveners designed an irrigation system and parachuted it into Bwanje Valley as a black-boxed technology. Using a sociotechnical approach, this article analyses the travails of this irrigation scheme, showing that the conventional irrigation factory mindset is ill-suited for creating durable water networks. Achieving tangible improvements in rural livelihoods is better served by the interactive prototyping of water networks in situ, ensuring that new irrigation schemes are embedded in existing landscapes and complementary to existing livelihood strategies rather than supplanting them.