9 Conclusions
9.1 Contributions
We have two types of contributions in this thesis. The first is the contribution to practice. We provide a way to organize health care, by addressing reflective and automatic motivation through a set of ideas that are flexible and can be recreated and adapted to a local context by CHWs, designers and health care providers in other places.
The second contribution is to theory. The capability approach provides us with an analytic lens that allow us to identify some barriers to achieve a diabetes-friendly lifestyle, however the approach doesn’t account for motivation. The approach is built on the assumption of people as rational beings, as such it is assumed that as long as people have the freedom to choose the functionings they wish to achieve, they will choose the functioning they find the most valuable. However, we argue that this assumption of rationality undermines the fact that people can wish to achieve two competing functionings simultaneously, and that there isn’t necessarily a rational choice behind the functioning that in the and is achieved. In the case of this thesis, this tug-of-war represents the desire to have a diabetes-friendly life while at the same time having the desire to enjoy the fruits of the current lifestyle.
On the basis of this, we provide an expansion to the capability framework by including the aspect of reflective and automatic motivation to help us understand how this tug-of-war manifests and can be addressed through design.
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