Critiques of health behavior change programs in the Global South (and what they miss)

Abstract

Background: Critics have raised several concerns about health behavior change in public health programs. However, there has been very little reflection about behavior change critiques specific to the Global South and, in particular, what health psychology has come to mean within those critiques. The aim of this paper was threefold: to describe existing critiques of behavior change, to reflect on how health psychology has been written into those critiques, and to determine what theoretical resources critiques may overlook. Methods: A critical review of the published English language health behavior change literature from 1990 to 2015 was conducted. Particular emphasis was placed on reviewing literature that was critical of behavior change in the Global South. Findings: The paper presents four types of critiques (instrumental, social-collectivist, ethical and governance); argues that critiques, despite their critical orientation, tend to be highly 'psychologized'; and that critiques may overlook important theoretical resources from critical psychology such as discourse, class and globalization. Discussion: It is hoped that this paper will stimulate further debate about the role of critique in health psychology in the Global South.