“Creating poverty chances”: young people confront gambling harms in Malawi

Commercialised gambling products have spread rapidly through African countries in recent years and have been woven into the everyday experiences of young people. Research to date has documented this phenomenon through conventional social science methodologies, establishing an important body of knowledge. Absent from this work is research that adopts participatory and creative methods, often argued to be particularly well suited to empowering marginalised groups to co-produce research. In this piece, we describe a co-creative participatory approach to working with 24 young people in Malawi to explore experiences of commercial gambling and its impacts in their communities. Our approach was co-developed with the young people and produced a substantial body of community interviews, photovoice pieces and creative representations of the research findings. Here we focus on a song written and recorded by one of the young people that draws on and represents themes of distress, addiction, poverty, and false hope, which were present in the data the young people generated across the study

Arts-based approaches to promoting health in sub-Saharan Africa:A scoping review

Introduction: Arts-based approaches to health promotion have been used widely across sub-Saharan Africa (SSA), particularly in public health responses to HIV/AIDS. Such approaches draw on deep-rooted historical traditions of indigenous groups in combination with imported traditions which emerged from colonial engagement. To date, no review has sought to map the locations, health issues, art forms and methods documented by researchers using arts-based approaches in SSA. Methods: Using scoping review methodology, 11 databases spanning biomedicine, arts and humanities and social sciences were searched. Researchers screened search results for papers using predefined criteria. Papers included in the review were read and summarised using a standardised proforma. Descriptive statistics were produced to characterise the location of the studies, art forms used or discussed, and the health issues addressed, and to determine how best to summarise the literature identified. Results: Searches identified a total of 59 794 records, which reduced to 119 after screening. We identified literature representing 30 (62.5%) of the 48 countries in the SSA region. The papers covered 16 health issues. The majority (84.9%) focused on HIV/AIDS-related work, with Ebola (5.0%) and malaria (3.3%) also receiving attention. Most studies used a single art form (79.0%), but a significant number deployed multiple forms (21.0%). Theatre-based approaches were most common (43.7%), followed by music and song (22.6%), visual arts (other) (9.2%), storytelling (7.6%) and film (5.0%). Conclusions: Arts-based approaches have been widely deployed in health promotion in SSA, particularly in response to HIV/AIDS. Historically and as evidenced by this review, arts-based approaches have provided a platform to facilitate enquiry, achieved significant reach and in some instances supported demonstrable health-related change. Challenges relating to content, power relations and evaluation have been reported. Future research should focus on broadening application to other conditions, such as non-communicable diseases, and on addressing challenges raised in research to date

“I see salt everywhere”: A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi.

The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants’ experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants’ beliefs about NCDs and their impact (e.g., “… it spreads all over your body and kills you—snake’s poison is similar to diabetes poison”), while the focus groups provided more basic accounts (e.g., “diabetes is a fast killer”). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma

The growth of sports betting in Malawi: corporate strategies, public space and public health

Objectives: Gambling is increasingly positioned as a public health issue, with links to a wide range of harms for individuals, communities and societies. Malawi has experienced a rapid rise in the availability of high street and online sports betting services, situated in a context of extreme inequality and poverty. We aim to document the strategies through which a leading sports betting firm have established a market worth MK2.1bn, to inform future initiatives to mitigate gambling-related harm. Study design: A case study of strategies deployed by a leading firm to grow a sports betting market in Malawi. Methods: We undertook a qualitative media analysis of articles from six major Malawian news outlets and combined this with photographic evidence relating to company advertising and presence in Malawian public space. Data were analysed thematically and triangulated to generate a typology of corporate strategies. Results: We collected 39 articles and 15 photographs. After we screened the articles, we analysed 27 and identified seven corporate strategies: adopt a mobile network franchise model; use media coverage; purchase high-visibility advertising; sponsor locally; build association with (European) football; appeal to aspects of hegemonic masculinity; construct narratives of individual and collective benefit. Conclusion: Malawi has been exposed to a sophisticated set of corporate strategies aimed at growing a sports betting market. These strategies have been successful, and it is likely that a range of foreseeable gambling-related harms are affecting Malawi. We offer suggestions for how policy-makers and public health professionals might respond

How Have Arts-Based Approaches Been Used to Promote Health in Sub-Saharan Africa?

No abstract available

'They say "easy money", telling you to predict the games': an interview study with sports bettors in Lilongwe, Malawi

The gambling industry in Malawi has grown rapidly over the last 5 years. Fuelled by mobile technologies and roadside kiosks, sports betting has become particularly visible. A leading company has positioned its products as a means for Malawians to generate an income and frame sports betting as a skill. In this chapter we present findings from interviews with 10 young men in Lilongwe, Malawi, who bet on sports and explore how the company leverages interest in football to engage these men in other forms of gambling. The results reveal aspects of how Malawian men respond to the strategies used by the betting provider to grow its market

Young people and gambling in sub-Saharan Africa: towards a critical research agenda

No abstract available