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Limitations of the study
In the delineation of the scope of the study, several decisions had to be made on the areas of and perspectives on public health curricula in sub-Saharan Africa to include and exclude in the study. With regard to the theoretical conceptualisation of the study, a choice was made in favour of poststructuralism (Chapter 3) and no comparisons with findings derived from other perspectives were therefore made. Although various types of curricula were highlighted in the literature review (Section 3.3.2), this inquiry did not consider the full spectrum of types of curriculum, but only limited itself to two types of curricula: the official curriculum (public health curriculum documents) and the hidden curriculum (as reported by academic staff members).
An investigation including other types of curriculum as point of departure could have enriched the findings. This pertains especially to the exclusion of the views of student experiences of a gendered curriculum (the experiential curriculum). Inclusion of students’ voices would have enriched the study by interrogating their constructions of gender and by showing to what extent students demanded tuition on gender issues and whether they felt they were getting sufficient teaching on gender. The operational curriculum was also excluded from the study. Observing exactly what the lecturers were teaching on gender, how they presented their constructions of gender and which methodologies, examples and case studies they used would have enhanced the depth of this study. However, these decisions were tradeoffs that had to be made in order to navigate an already complex conceptual framework. These exclusions did not in any way compromise the rigour with which the study reported in this thesis was conducted and the quality of the data obtained. With adequate resources and time, the mentioned gaps could still be investigated and the findings compared with findings from this study. A second limitation of the study is that descriptions of courses in official curriculum documents were not detailed enough to give a thorough version of the courses. Some schools also gave greater details than others. Accordingly, the findings from the official curriculum documents are only a reflection of what the researcher could ‘scrape’ from the available documents. To try and address this limitation, two schools were used as case studies to try and elicit a more elaborate picture of the public health curriculum through in-depth interviews. (See Sections 4.1.1.2 and 4.2.2.2.) However, again the findings from these two cases cannot be generalised to make conclusions about the other schools that were not studied in depth, as each has different contexts and histories that are different from the selected case studies. In addition, the curriculum documents were collected in 2006 and the reader who may be reading this thesis today should note that a lot of curriculum changes have since taken place in various schools. Another limitation is that the content described on paper was not necessarily what was actually taught. Changes in classroom content are not always accompanied by change in the official curriculum document. This limitation would have been overcome by an investigation into the operational curriculum through direct observation and recording of what was actually taught in the classroom.
A third limitation of the study is that only anglophone countries in sub-Saharan Africa were included due to the difficulty of translations and interpretations. (See Figure 4-2.) The findings of this study are therefore only limited to anglophone schools of public health in sub- Saharan Africa, although the other schools could still learn useful lessons from the findings. With availability of resources, this study could be replicated in francophone and lusophone countries in sub-Saharan Africa. Due to their different historical contexts, different or additional findings on the construction of gender could have enhanced the perspectives developed from the study for this thesis.
Structure and content of the MPH curriculum
Some of the schools laid the ground for the MPH curricula by clarifying the concept of public health. Most of their definitions were in agreement with the current and much broader concept of public health as encompassing actions taken to protect or improve the health of the public (Hamlin, 2002; Orne et al, 2007). (See also Section 2.2.1.) Key concepts in public health that were highlighted are “the protection, preservation and promotion of the health of communities and populations” (School 1200), underpinned by pillars of “equity, efficiency and effectiveness in the provision of health care services” (School 2200). These discourses circulate widely in current public health literature and practice (ASPH, 1999; Griffiths et al, 2003; Hamlin, 2002; Sein & Rafei, 2002) and demonstrate the intention of the schools to make a paradigm shift and re-orient the curriculum from curative measures only to the inclusion of disease prevention (Bloom, 2007; Gruskin & Tarantola, 2002; Mokwena et al, 2007; Sim et al, 2007; World Bank, 2002). Although it was beyond the scope of this inquiry to evaluate the public health curriculum per se, IJsselmuiden et al (2007) raise the issue that the public health curriculum in Africa is still largely biomedical in content, a paradigm that leans more towards the curative than the preventive side. The question therefore remains whether schools of public health in actual fact ‘practice what they preach’ in their MPH programmes or whether the official representation of the curriculum is more rhetoric and less reality.
Chapter 1: Introduction
1.1 A focus on gender
1.2 Problem statement and research questions
1.3 Research design and methodology
1.4 Significance of the inquiry
1.5 Organisation of the thesis
1.6 Conclusion
Chapter 2: Gender in higher education and the public health education environment
2.1 Gender on the agenda in higher education
2.2 The public health environment in higher education
2.3 Conclusion
Chapter 3: Towards a poststructuralist framework of inquiry
3.1 Poststructuralism
3.2 Gender as a construct in this inquiry and its relationship to poststructuralism
3.3 Curriculum as a construct in this inquiry and its relationship to poststructuralism
3.4 Conclusion: a conceptual framework for this inquiry
Chapter 4: Research design and methodology
4.1 Research design
4.2 Research methodology
4.3 Validity and reliability, trustworthiness and credibility
4.4 Ethical considerations
4.5 Limitations of the study
4.6 Conclusion
Chapter 5: Institutional representations of gender
5.1 Structure and content of the MPH curriculum
5.2 Representation of gender in the structures of the public health curriculum
5.3 Gender discourses emerging from the public health curriculum
5.4 Dominant, marginalised and silent discourses on gender in the public health curriculum
5.5 Conclusion
Chapter 6: Lived experiences of gender and curriculum
6.1 Staff members’ constructions of gender
6.2 Resources that shaped participants’ constructions and understandings of gender
6.3 The construction of gender in academic courses
6.4 Conclusion
Chapter 7: Reconceptualising gender in the public health curriculum
7.1 A poststructuralist perspective of gendered discourses in the public health curriculum
7.2 Curriculum as gender text
7.3 Reconceptualising gender in the curriculum
7.4 My personal deconstruction of poststructuralism
7.5 Beyond a poststructuralist interpretation of the public health curriculum
7.6 Epilogue: The bricolage
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