3.6.3 Intangible Religious Health Assets and their direct and indirect health outcomes In quadrants 1 and 2 of the ARHAP matrix, a second set of religious health assets are identified, as intangible assets these are not visible structures such as mission hospitals, clinic dispensaries and hospices. They are labeled as an intangible or invisible component of religious health assets, which operates at the unseen or invisible level. Conventional health care providers rarely appreciate these intangible assets because they cannot be quantified scientifically in health care provision. These would include activities such as prayer, support groups, faith, hope, motivation, trust, love and all other invisible qualities, which contribute to the well being of individuals and communities.
These intangible religious activities create a positive component to those seeking for health and healing. It is this missing or neglected dimension of human health seeking component found in intangible RHAs, which provides resilience and power to withstand sickness and harsh conditions. Intangible RHAs are activities such as praying and anointing the sick for healing, advocacy or prophetic ministry speaking against vices that dehumanize people and encouraging the sick to keep hoping for the best in times of affliction.
In addition to this, the matrix also present intangible religious assets and their indirect health outcomes. These outcomes impact on the well being of people as indicated in quadrant 2 of theory matrix. In this quadrant the matrix shows important elements such as the core value and meaning of life and the need for people to belong to a community or church family. In these communities, people derive encouragement through shared life experiences. It is argued that all these assets, though not measurable, contribute to better health outcomes in and indirect way.
3.7 Research findings from Zambia and Lesotho, which strengthen the ARHAP
Zambia on WHO research program under the heading, ‗The Nature of the Religious Contribution to Health and Wellbeing in Zambia and Lesotho is summarized in finding number five. 113 Finding number five states that; ‗‗Religion is perceived to contribute in six key ways - tangible and intangible - to health and well being in Zambia. The intangible factors being spiritual encouragement, knowledge giving, and moral formation, and the tangible factors: compassionate care, material support, and curative interventions‖. Similar research findings were found in Lesotho PIRHANA. The full report on findings number five on ‗how religion (borapeli ) is perceived to contribute to holistic wellbeing (bophelo) in tangible and intangible ways‘ can be accessed from the WHO report 2006114.
The figure below shows the Zambia PIRHANA findings on the question, ‗what does religion contribute to health‘ and illustrates the nature of tangible and intangible religious health assets contribution to health.
Zambia PIRHANA findings115 Figure 4
Maramba Chipata Bauleni ARHAP Cluster Total
Hope (13) Spiritual care (8) Faith (6) Spiritual
Encouragement
41
Hope (4) Trust (5)
Prayer (1) Hope (3)
Encouragement (1)
Care (6) Care and support (16) HBC (6) Compassionate care 28
Education (16) Education (5) Education (2) Knowledge giving Training (1) 24
Material support (7) Commodities (4) Support (6) Material Support 17 Morals (2) Behavior change (1) Self control (7) Moral Formation 10 Facilities (3) Reduce illness (2) Healing (4) Curative
Interventions
9
47 42 40 Total 129
113 Detailed information on the PIRHANA findings from Lesotho and Zambia can be accessed on ARHAP website, www.arhap.uct.ac.za p76.
114 ARHAP-WHO report 2006 <http://www.arhap.uct.ac.za/publications.php> p 111
115 ARHAP-WHO report 2006 <http://www.arhap.uct.ac.za/publications.php> pp76,77
The results show that top on the list of the findings is the category marked as ‗intangible assets‟
referring to issues such as, prayer, hope, spiritual care and encouragement followed by care, compassion and home based care and thirdly education and training.
At the regional level the findings show a similar trend see figure 5 below.
Figure 5116
Participant Term Copperbelt Livingstone Chipata Lusaka Total ARHAP Cluster Total Total
Hope 9 12 9 30 Spiritual
Encouragement 68
Faith 8 2 9 19
Spiritual counseling/
support 8 4 3 15
Prayer 3 1 4
Care and
support/compassion 9 8 17 Compassionate
Care 57
Love 14 16 6 4 40
Behavior change 8 3 11 Moral formation 22
Life/positive living 6 1 1 8
Patience 2 2
Temperance 1 1
Healing/health services
5 6 1 4 16 Curative
Interventions 19
Infrastructure 2 2
Human resources 1 1
Sensitization/teaching 8 3 2 13 Knowledge giving 13
Material support/OVC Support
1 1 5 7 Material support 7
Advocacy 2 2 Public engagement 2
TOTAL 188
From the regional findings, it is very clear also that the ARHAP cluster of intangible assets under ‗Spiritual encouragement‘ and tangible assets such as care, support and compassion are
116 ARHAP-WHO report 2006 <http://www.arhap.uct.ac.za/publications.php> pp76,77
presented in ‗compassionate care‘ category are at the top of the list, indicating the appreciation of these assets in health services.
3.7.1 Definition of ARHAP cluster from the PIRHANA findings
ARHAP has worked out definitions for the six clusters of their findings. This thesis will engage and interact with these definitions of ARHAP cluster in chapter five. The following are the six clusters from PIRHANA findings:117
i. Spiritual encouragement this refers to aspects in which religion works to give people an inner strength to proceed with resilience, courage and determination in the midst of ill health, poverty, and misfortune. This includes the terms ―hope, spiritual care, prayer, faith, trust, encouragement‖ and ―hope, faith, spiritual counseling, prayer‖. This category falls under the intangible assets in ARHAP theory matrix.
ii. Compassionate care clusters refers to the activities such as, ―care, care and support, Home Based Care‖, and ―care and support, compassion, love‖. It describes the way in which religion is seen to respond to situations of difficulty with a desire to help and be of assistance. This falls in the category of tangible assets.
iii. Knowledge giving describes the contribution of religion in the areas of ―education,
―training‖, and ―sensitization, teaching‖. This is an intangible asset
iv. Material support clusters together the terms ―material support, commodities, support‖
and ―material support, OVC support‖. It refers to activities such as providing food parcels for the sick and clothing for orphans. This is a tangible asset.
v. Moral formation this refers to activities in which religion contributes to the shaping of human behavior and lifestyle, ―morals, behavior change, self control‖, ―behavior change, life/positive living, patience, temperance‖. This is an intangible asset
117 ARHAP-WHO report 2006 <http://www.arhap.uct.ac.za/publications.php>pp 77-78
vi. Curative interventions this refers to a number of ways in which religious health activities intentionally intervenes to cure ill health in either a biomedical or alternate way, and includes the terms ―facilities, reduce illness, healing‖, and ―healing/health services, infrastructure, human resources‖. This is a tangible asset.118
The findings from PIRHANA research in Zambia and Lesotho shows that religion contributes to health in both tangible and intangible ways. The research report and analysis in the next two chapters will engagement with the ARHAP theory further.