The feasibility of implementing asset-based approaches to health in a Saudi rural/peri-urban community context: the case of Al-Jumum

Batarfi, Sabreen Saleh (2026) The feasibility of implementing asset-based approaches to health in a Saudi rural/peri-urban community context: the case of Al-Jumum. PhD thesis, University of Glasgow.

Abstract

This thesis examines the feasibility of implementing asset-based approaches to health (ABA) in Saudi communities, addressing a significant gap in public health research within the Kingdom of Saudi Arabia and broader global south contexts. The study explores the factors that influence the feasibility of implementing asset-based approaches, operationalised through examining community assets, policy impacts, implementation barriers, and key influencing factors.

Employing a qualitative methodology grounded in critical realism and methodological bricolage, the research was adapted from an initial rural focus to concentrate on Al-Jumum, a small city that serves rural communities. The study's three empirical focal points —healthy city initiatives, volunteering programmes, and health coaching—served as proxies for examining ABA feasibility through existing interventions sharing characteristics which align with broad ABA principles. Data collection utilised a three-stage approach: initial interviews with citizens and primary care centre workers, focus groups exploring collective perspectives, and individual interviews with local and national policymakers. This was supplemented by observational methods and documentary analysis of health policies and community records.

Asset mapping reveals diverse tangible and intangible community resources across Al-Jumum. However, analysis conducted using a realistic evaluation framework identifies significant implementation challenges. The analysis reveals four key tensions that fundamentally shape implementation feasibility. First, governance structures create complex dynamics between hierarchical control and community empowerment, where emerging bottom-up initiatives must navigate traditional top-down approaches. Second, gender dynamics present both barriers and opportunities, requiring careful balance between respecting traditional norms and fostering inclusive participation. Third, tensions between individual versus collective approaches highlight challenges in balancing personal empowerment with community mobilisation within culturally appropriate frameworks. Fourth, findings illuminate both the conservative and transformative potential of asset-based approaches, revealing how implementation strategies must negotiate between incremental change and systemic transformation.

This research makes four original contributions to knowledge. First, it advances implementation science methodology by demonstrating how existing health interventions can serve as implementation pathways for asset-based approaches, offering a novel framework for leveraging established programs rather than creating entirely new structures. Second, it develops context-specific methodological approaches for assessing asset-based community development implementation in global south contexts, addressing gaps in culturally responsive evaluation frameworks. Third, it contributes to global south health policy scholarship by providing empirical evidence of how international health promotion models can be adapted within global south cultural and governance systems. Fourth, it informs health systems transformation policy by demonstrating the need for reduced dependency on centralised control and greater policy flexibility to enable community-driven health approaches in Saudi Arabia and similar contexts, with implications for how health systems can integrate bottom-up and top-down approaches more effectively.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Additional Information: Supported by funding from a Saudi Government Scholarship.
• Subjects: H Social Sciences > HT Communities. Classes. Races; R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
• Colleges/Schools: College of Social Sciences > School of Social & Environmental Sustainability
• Funder's Name: Saudi Government Scholarship
• Supervisor's Name: Hunter, Dr. Alistair and Whitelaw, Dr. Alexander
• Date of Award: 2026
• Depositing User: Theses Team
• Unique ID: glathesis:2026-86230
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 10 Sep 2026 13:12
• Last Modified: 10 Sep 2026 13:13
• Thesis DOI: 10.5525/gla.thesis.86230
• URI: https://theses.gla.ac.uk/id/eprint/86230