Crystal Andvik

MA Philosophy in Health Promotion, University of Bergen, Norway

1. Could you give a sketch of your most recent project and how you started it?

As a master student at the Research Centre of Health Promotion and Development, I was encouraged to take part in an existing research group at the Centre in which to focus my master thesis on. The working group I joined was created during my first semester of studies (fall of 2008) based on the increasing awareness and interest of social determinants of health found in the World Health Organization publication on Commission on the Social Determinants of Health (WHO, 2008).

The working group, Social Determinants of Health in Very Poor Ruralities (SDHVPR), was led by Prof Maurice B. Mittelmark at the University of Bergen, in collaboration with the International Union of Health Promotion and Education (IUHPE)and the Department of Health of England. Each of us analyzed qualitative and/or quantitative data from various countries including: India, the Philippines, Peru, Haiti, Ghana,Tanzania and Saskatchewan (Canada). The aim of the project was to identify protective health factors of women at childbearing age living in poor ruralities. I did qualitative research in a northern district of Ghana with my advisor, Torill Bull, and fellow researcher, Mary Duah-Owusu.

Local Ghanaian women seated during one of our focus group interviews


2. During the time that you began your project until now, how have your views of the issue, people, and the project changed?

I was not sure what to expect beforehand as this was my first time ever conducting research of this nature. I had been to a couple West African countries prior to my work in Ghana, so I had some knowledge on how people lived in this area of the world. I really never thought that women could thrive in these extremely impoverished places. However, through our interviews and discussions with the local people, I learned that many of the women not only were surviving in such harsh conditions, but actually thriving. Many of these women just needed the tools and resources to get started. The success stories they talked about were quite remarkable. People from a locally-established NGO were teaching women how to peanut farm as well as animal husbandry. From these income generating activities, women were able to use their money to roof their homes, send their children to school, buy supplies for cooking as well as cloth -a symbol of beauty- for themselves. Despite the disease, health problems and death they faced daily, these women were successful in their work, and were proud to share their stories with us.

3. What major challenges throughout the project did you face?

I think the biggest challenge was spending so many days sitting alone and writing the results for my master’s thesis. It was hard at times for me to find the motivation to keep reading/analysing data and bring everything together on paper. However, being part of a working group was a great advantage, as we met almost weekly to collaborate and motivate each other when feeling stuck or unable to go further with the data.

4. Can you discuss some of your major discoveries?

Along with what I mentioned earlier (Question 2) where we found women thriving in these harsh conditions, several elements of health promotion emerged from the findings of my research, including, empowermentsalutogenesis and influences of globalisation:

Empowerment: the local NGO has introduced income generating activities as well as teaching women and men ways in which to work together to build capacity and resources. We saw the success of the local people, both men and women, taking control of their lives and creating healthier lifestyles and environments for themselves and community.

Salutogenesis: coping techniques were revealed when it comes to dealing with life and death by not blaming other people or the system. Many women would say, ‘God gives, God takes.’ Also, the ability of the women to confide in someone for relief and comfort, whether it was a friend, mother or even husband.

Globalization: the NGO’s intervention programmes have improved women’s capacity in an effort to fight against extreme poverty; however, individualism is on the rise and those considered most vulnerable, such as the elderly and widowed, are uncared for. Trends are also changing: for example, a man is now expected to build a house for his family before marrying. Previous traditions allowed families to live together on compounds, which meant they could share the burdens of household duties and caregiving.

Women pounding cassava for fufu, a local food


5. How do you see your research impacting the lives of those you worked with?

I think our research can and will help the local NGO’s and partners to learn and better understand what programmes they implement are successful in empowering the people they are working with to create and sustain healthier lifestyles within their communities, including poor rural places.

6. How do you see your research impacting the field of health promotion? Did you have any publications or presentations?

Our objective of this working group on SDHVPR was to contribute to the health equity work stimulated by the WHO’s 2008 publication. Several reports, master theses and articles were written and published on the work done by each member:

Publications: Bull T, Duah-Owusu M and Andvik C. “My happiest moment is when I have food in stock”: Poor women in northern Ghana talking about their happiness. International Journal of Mental Health Promotion, 2010; 12(2):24-31.

Presentations: Electronic poster, Geneva, Switzerland- 20th IUHPE World Conference on Health, Equity and Sustainable Development

7. What are your plans for future work/research?

I would like to continue this kind of work/research with women in developing countries. I hope to take part in implementing health programmes and income-generating activities in rural places. I’ve considered continuing my research and eventually applying for a PhD programme in this field. At this time I have not yet done so, but my options are open for such an opportunity.

8. Anything else we should know about you?

My husband and I took up sailing about 3 years ago when we bought our first sailboat-32ft! Our goal is to one day sail the world from Seattle, USA (my home town) to Bergen, Norway (his home town). You can also email me for more information on my work:

Published: April 2011

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