Constructions of Illness and Their Implications for Health Education Programme Design in Hausa Communities of North West Nigeria: An Ethnographic Inquiry

Cultural constructions of illness profoundly influence health behaviour and the reception of health education messages, yet these constructions remain poorly documented and rarely incorporated into health education programme design in Hausa communities. This study conducted an ethnographic inquiry into illness constructions and their implications for health education programme design in Hausa communities across Kano, Jigawa, and Katsina states, North West Nigeria. An interpretive ethnographic methodology was employed, with 18 months of fieldwork incorporating sustained observation, 52 in-depth interviews with community members, traditional healers, religious scholars, and health workers, and textual analysis of Hausa oral health narratives and community health archives. Data were analysed using reflexive thematic analysis and cultural hermeneutics. Findings revealed a coherent system of illness construction in Hausa communities organised around four frameworks: spiritual attribution, humoral imbalance, relational breach, and biomedical causation, which coexisted and were pragmatically deployed by community members. Biomedical health education that dismissed or ignored these frameworks consistently generated community resistance. Health educators who engaged dialogically with indigenous illness frameworks, validating non-harmful beliefs while introducing biomedical knowledge, demonstrated significantly higher programme acceptance. The study makes a substantive ethnographic contribution to culturally informed health education research in Nigeria. Keywords: illness constructions, health education programme design, Hausa communities, North West Nigeria, ethnographic inquiry