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Labib K, Tijdink J, Sijtsma K, Bouter L, Evans N, Widdershoven G. How to combine rules and commitment in fostering research integrity? Account Res 2024; 31:917-943. [PMID: 36927256 DOI: 10.1080/08989621.2023.2191192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
Research integrity (RI) is crucial for trustworthy research. Rules are important in setting RI standards and improving research practice, but they can lead to increased bureaucracy; without commensurate commitment amongst researchers toward RI, they are unlikely to improve research practices. In this paper, we explore how to combine rules and commitment in fostering RI. Research institutions can govern RI using markets (using incentives), bureaucracies (using rules), and network processes (through commitment and agreements). Based on Habermas' Theory of Communicative Action, we argue that network processes, as part of the lifeworld, can legitimize systems - that is, market or bureaucratic governance modes. This can regulate and support RI practices in an efficient way. Systems can also become dominant and repress consensus processes. Fostering RI requires a balance between network, market and bureaucratic governance modes. We analyze the institutional response to a serious RI case to illustrate how network processes can be combined with bureaucratic rules. Specifically, we analyze how the Science Committee established at Tilburg University in 2012 has navigated different governance modes, resulting in a normatively grounded and efficient approach to fostering RI. Based on this case, we formulate recommendations to research institutions on how to combine rules and commitment.
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Affiliation(s)
- Krishma Labib
- Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joeri Tijdink
- Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Klaas Sijtsma
- School of Social and Behavioral Sciences, Department of Methodology and Statistics, Tilburg University, Tilburg, the Netherlands
| | - Lex Bouter
- Department of Philosophy, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam Public Health Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Natalie Evans
- Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam Public Health Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Rubinstein EB, Heinemann LL. A crisis of confidence? Intervening in vaccine hesitancy in North Dakota. Med Anthropol Q 2024; 38:298-312. [PMID: 38847386 DOI: 10.1111/maq.12873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/03/2024] [Indexed: 08/31/2024]
Abstract
In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state-funded and physician-led "Vaccine Champion" ("VaxChamp") program. Glossing the primary problem as one of "provider confidence," the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly. Although the program hit its quantitative benchmarks, a qualitative inquiry into the program's history and context reveals multiple crises of confidence, many beyond the bioscientific domain of the program's focus. Drawing from work in medical and linguistic anthropology, we describe and analyze the "multiple levers of vaccine confidence" at play in the intervention and its surrounding context, as well as how these crises of confidence emerged.
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Affiliation(s)
- Ellen B Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, North Dakota, USA
| | - Laura L Heinemann
- Department of Cultural and Social Studies, Creighton University, Omaha, Nebraska, USA
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3
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Bønnelycke J, Larsen M, Jespersen AP. Pregnancy As Window of Opportunity? A Danish RCT on Physical Activity During Pregnancy. Med Anthropol 2024; 43:441-454. [PMID: 39046335 DOI: 10.1080/01459740.2024.2376007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Pregnancy is seen as a window of opportunity for health interventions, with the potential to produce long-term health changes for mother and child. The RCT FitMum investigates the effects of different regimes of physical activity during pregnancy. We suggest that rather than hitting a window of opportunity, the trial works in choreography with different timescapes through the processes of management of time. These timescapes are characterized by linear progression and futurity, alongside composite, complex time. We reconceptualize the intervention as a navigation of flows and passages in collective efforts, providing a situated and sustainable approach to interventions.
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Affiliation(s)
- Julie Bønnelycke
- Department of Applied Business Research University College Lillebælt & University of Copenhagen, Odense, Denmark
| | - Maria Larsen
- Zealand University Hospital & University of Copenhagen, Koge, Denmark
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Molenaar J, Beňová L, Christou A, Lange IL, van Olmen J. Travelling numbers and broken loops: A qualitative systematic review on collecting and reporting maternal and neonatal health data in low-and lower-middle income countries. SSM Popul Health 2024; 26:101668. [PMID: 38645668 PMCID: PMC11031824 DOI: 10.1016/j.ssmph.2024.101668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/27/2024] [Accepted: 04/02/2024] [Indexed: 04/23/2024] Open
Abstract
Data and indicator estimates are considered vital to document persisting challenges in maternal and newborn health and track progress towards global goals. However, prioritization of standardised, comparable quantitative data can preclude the collection of locally relevant information and pose overwhelming burdens in low-resource settings, with negative effects on the provision of quality of care. A growing body of qualitative studies aims to provide a place-based understanding of the complex processes and human experiences behind the generation and use of maternal and neonatal health data. We conducted a qualitative systematic review exploring how national or international requirements to collect and report data on maternal and neonatal health indicators are perceived and experienced at the sub-national and country level in low-income and lower-middle income countries. We systematically searched six electronic databases for qualitative and mixed-methods studies published between January 2000 and March 2023. Following screening of 4084 records by four reviewers, 47 publications were included in the review. Data were analysed thematically and synthesised from a Complex Adaptive Systems (CAS) theoretical perspective. Our findings show maternal and neonatal health data and indicators are not fixed, neutral entities, but rather outcomes of complex processes. Their collection and uptake is influenced by a multitude of system hardware elements (human resources, relevancy and adequacy of tools, infrastructure, and interoperability) and software elements (incentive systems, supervision and feedback, power and social relations, and accountability). When these components are aligned and sufficiently supportive, data and indicators can be used for positive system adaptivity through performance evaluation, prioritization, learning, and advocacy. Yet shortcomings and broken loops between system components can lead to unforeseen emergent behaviors such as blame, fear, and data manipulation. This review highlights the importance of measurement approaches that prioritize local relevance and feasibility, necessitating participatory approaches to define context-specific measurement objectives and strategies.
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Affiliation(s)
- Jil Molenaar
- Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
- University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium
| | - Lenka Beňová
- Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Aliki Christou
- Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Isabelle L. Lange
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
- Center for Global Health, Technical University of Munich (TUM), Munich, Germany
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5
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Chiumento A, MacBeth A, Stenhouse R, Segal L, Harper I, Jain S. A vision for reinvigorating global mental health. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003034. [PMID: 38564495 PMCID: PMC10986999 DOI: 10.1371/journal.pgph.0003034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Anna Chiumento
- Social Work, School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Angus MacBeth
- Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Rosie Stenhouse
- Nursing Studies, School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Lotte Segal
- Social Anthropology, School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ian Harper
- Social Anthropology, School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Sumeet Jain
- Social Work, School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Bemme D, Roberts T, Ae-Ngibise KA, Gumbonzvanda N, Joag K, Kagee A, Machisa M, van der Westhuizen C, van Rensburg A, Willan S, Wuerth M, Aoun M, Jain S, Lund C, Mathias K, Read U, Taylor Salisbury T, Burgess RA. Mutuality as a method: advancing a social paradigm for global mental health through mutual learning. Soc Psychiatry Psychiatr Epidemiol 2024; 59:545-553. [PMID: 37393204 PMCID: PMC10944435 DOI: 10.1007/s00127-023-02493-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/23/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE Calls for "mutuality" in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. METHODS We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. RESULTS Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained responsive to all collaborators' needs and critiques. This resulted in a social paradigm that calls for GMH to (1) move from a deficit to a strength-based view of community mental health, (2) include local and experiential knowledge in scaling processes, (3) direct funding to community organizations, and (4) challenge concepts, such as trauma and resilience, through the lens of lived experience of communities in the global South. CONCLUSION Under the current institutional arrangements in GMH, mutuality can only be imperfectly achieved. We present key ingredients of our partial success at mutual learning and conclude that challenging existing structural constraints is crucial to prevent a tokenistic use of the concept.
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Affiliation(s)
| | | | | | | | | | - Ashraf Kagee
- Stellenbosch University, Stellenbosch, South Africa
| | | | | | - André van Rensburg
- University of Kwazulu-Natal, Centre for Rural Health, Durban, South Africa
| | - Samantha Willan
- South African Medical Research Council, Cape Town, South Africa
| | | | - May Aoun
- Save the Children, New York, USA
| | | | - Crick Lund
- King's College London, London, UK
- University of Cape Town, Cape Town, South Africa
| | - Kaaren Mathias
- University of Canterbury, Christchurch, New Zealand
- Burans, Herbertpur Christian Hospital, Atten Bagh, India
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Perkins J, Nelson S, Birley E, Mcswiggan E, Dozier M, McCarthy A, Atkins N, Agyei-Manu E, Rostron J, Kameda K, Kelly A, Chandler C, Street A. Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts. BMC Health Serv Res 2024; 24:172. [PMID: 38326871 PMCID: PMC10848363 DOI: 10.1186/s12913-024-10645-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.
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Affiliation(s)
- Janet Perkins
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK.
| | - Sarah Nelson
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emma Birley
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emilie Mcswiggan
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Marshall Dozier
- Library Academic Support Team, Library & University Collections, and Information Services University of Edinburgh, Argyle House, 3 Lady Lawson Street, Edinburgh, EH3 9DR, Scotland, UK
| | - Anna McCarthy
- Department of Social Work, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
| | - Nadege Atkins
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Eldad Agyei-Manu
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Jasmin Rostron
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Koichi Kameda
- Centre Population et Développement (CEPED), 45 Rue Des Saints-Pères, 75006, Paris, France
| | - Ann Kelly
- Department of Global Health and Social Medicine, King's College London, Bush House North East Wing, 30 Aldwych, London, WC2B 4BG, England, UK
| | - Clare Chandler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England, UK
| | - Alice Street
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
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Suchman L, Gitome S, Nyando M, Kwena ZA, Wekesa P, Okumu S, Ndunyu L, Okoli C, Tijani A, Jegede A, Idiodi I, Nmadu G, Dimowo S, Maluwa A, Atuyambe L, Birabwa C, Alitubeera P, Kaudha B, Kayego A, Jumbe T, Mtalimanja I, Vallin J, Sinha E, Phillips BS, Amongin D, Bukusi E, Holt K, Kamanga M, Liu J, Malata A, Omoluabi E, Waiswa P. Many Cooks in the Kitchen: Iterating a Qualitative Analysis Process Across Multiple Countries, Sites, and Teams. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300143. [PMID: 38050043 PMCID: PMC10749643 DOI: 10.9745/ghsp-d-23-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
Establishing and proving methodological rigor has long been a challenge for qualitative researchers where quantitative methods prevail, but much published literature on qualitative analysis assumes a relatively small number of researchers working in relative proximity. This is particularly true for research conducted with a grounded theory approach. Different versions of grounded theory are commonly used, but this methodology was originally developed for a single researcher collecting and analyzing data in isolation. Although grounded theory has evolved since its development, little has been done to reconcile this approach with the changing nature and composition of international research teams. Advances in technology and an increased emphasis on transnational collaboration have facilitated a shift wherein qualitative datasets have been getting larger and the teams collecting and analyzing them more diverse and diffuse. New processes and systems are therefore required to respond to these conditions. Data for this article are drawn from the experiences of the Innovations for Choice and Autonomy (ICAN) Research Consortium. ICAN aims to understand how self-injectable contraceptives can be implemented in ways that best meet women's needs in Kenya, Uganda, Malawi, and Nigeria. We found that taking a structured approach to analysis was important for maintaining consistency and making the process more manageable across countries. However, it was equally important to allow for flexibility within this structured approach so that teams could adapt more easily to local conditions, making data collection and accompanying analysis more feasible. Meaningfully including all interested researchers in the analysis process and providing support for learning also increased rigor. However, competing priorities in a complex study made it difficult to adhere to planned timelines. We conclude with recommendations for both funders and study teams to design and conduct global health studies that ensure more equitable contributions to analysis while remaining logistically feasible and methodologically sound.
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Affiliation(s)
- Lauren Suchman
- University of California San Francisco, San Francisco, CA, USA.
| | - Serah Gitome
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | | | - Sarah Okumu
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | | | | | | | | | | | - Alfred Maluwa
- Malawi University of Science and Technology, Limbe, Malawi
| | - Lynn Atuyambe
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Betty Kaudha
- Makerere University School of Public Health, Kampala, Uganda
| | - Agnes Kayego
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Janelli Vallin
- University of California San Francisco, San Francisco, CA, USA
| | - Elena Sinha
- University of California San Francisco, San Francisco, CA, USA
| | - Beth S Phillips
- University of California San Francisco, San Francisco, CA, USA
| | - Dinah Amongin
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Kelsey Holt
- University of California San Francisco, San Francisco, CA, USA
| | | | - Jenny Liu
- University of California San Francisco, San Francisco, CA, USA
| | - Address Malata
- Malawi University of Science and Technology, Limbe, Malawi
| | | | - Peter Waiswa
- Makerere University School of Public Health, Kampala, Uganda
- Karolinska Institute, Stockholm, Sweden
- Busoga Health Forum, Jinja, Uganda
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Johnson S, Quick KN, Rieder AD, Rasmussen JD, Sanyal A, Green EP, Duerr E, Nagy GA, Puffer ES. Social Vulnerability, COVID-19, Racial Violence, and Depressive Symptoms: a Cross-sectional Study in the Southern United States. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01831-y. [PMID: 37884856 DOI: 10.1007/s40615-023-01831-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND In March 2020, the novel 2019 coronavirus disease (COVID-19) was declared a pandemic. In May 2020, George Floyd was murdered, catalyzing a national racial reckoning. In the Southern United States, these events occurred in the context of a history of racism and high rates of poverty and discrimination, especially among racially and ethnically minoritized populations. OBJECTIVES In this study, we examine social vulnerabilities, the perceived impacts of COVID-19 and the national racial reckoning, and how these are associated with depression symptoms in the South. METHODS Data were collected from 961 adults between June and November 2020 as part of an online survey study on family well-being during COVID-19. The sample was majority female (87.2%) and consisted of 661 White participants, 143 Black participants, and 157 other racial and ethnic minoritized participants. Existing social vulnerability, perceived impact of COVID-19 and racial violence and protests on families, and depressive symptoms were assessed. Hierarchical regression analysis was used to predict variance in depressive symptoms. RESULTS Half of the sample (52%) reported a negative impact of COVID-19, and 66% reported a negative impact of national racial violence/protests. Depressive symptoms were common with 49.8% meeting the cutoff for significant depressive symptoms; Black participants had lower levels of depressive symptoms. Results from the hierarchical regression analysis indicate social vulnerabilities and the perceived negative impact of COVID-19 and racial violence/protests each contribute to variance in depressive symptoms. Race-specific sensitivity analysis clarified distinct patterns in predictors of depressive symptoms. CONCLUSION People in the South report being negatively impacted by the confluence of the COVID-19 pandemic and the emergence of racial violence/protests in 2020, though patterns differ by racial group. These events, on top of pre-existing social vulnerabilities, help explain depressive symptoms in the South during 2020.
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Affiliation(s)
- Savannah Johnson
- Duke University, Durham, NC, USA.
- Duke Global Health Institute, Durham, NC, USA.
| | - Kaitlin N Quick
- Duke Global Health Institute, Durham, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Justin D Rasmussen
- Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | | | | | | | | | - Eve S Puffer
- Duke University, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Gonçalves BA, Matos CCDSA, Ferreira JVDS, Itagyba RF, Moço VR, Couto MT. COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review. CAD SAUDE PUBLICA 2023; 39:e00041423. [PMID: 37556613 PMCID: PMC10494688 DOI: 10.1590/0102-311xpt041423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.
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11
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Shim JK, Foti N, Vasquez E, Fullerton SM, Bentz M, Jeske M, Lee SSJ. Community Engagement in Precision Medicine Research: Organizational Practices and Their Impacts for Equity. AJOB Empir Bioeth 2023; 14:185-196. [PMID: 37126431 PMCID: PMC10615663 DOI: 10.1080/23294515.2023.2201478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND In the wake of mandates for biomedical research to increase participation by members of historically underrepresented populations, community engagement (CE) has emerged as a key intervention to help achieve this goal. METHODS Using interviews, observations, and document analysis, we examine how stakeholders in precision medicine research understand and seek to put into practice ideas about who to engage, how engagement should be conducted, and what engagement is for. RESULTS We find that ad hoc, opportunistic, and instrumental approaches to CE exacted significant consequences for the time and resources devoted to engagement and the ultimate impacts it has on research. Critical differences emerged when engagement and research decisionmaking were integrated with each other versus occurring in parallel, separate parts of the study organization, and whether community members had the ability to determine which issues would be brought to them for consideration or to revise or even veto proposals made upstream based on criteria that mattered to them. CE was understood to have a range of purposes, from instrumentally facilitating recruitment and data collection, to advancing community priorities and concerns, to furthering long-term investments in relationships with and changes in communities. These choices about who to engage, what engagement activities to support, how to solicit and integrate community input into the workflow of the study, and what CE was for were often conditioned upon preexisting perceptions and upstream decisions about study goals, competing priorities, and resource availability. CONCLUSIONS Upstream choices about CE and constraints of time and resources cascade into tradeoffs that often culminated in "pantomime community engagement." This approach can create downstream costs when engagement is experienced as improvised and sporadic. Transformations are needed for CE to be seen as a necessary scientific investment and part of the scientific process.
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Affiliation(s)
- Janet K Shim
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Nicole Foti
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Emily Vasquez
- Department of Sociology, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Stephanie M Fullerton
- Department of Bioethics & Humanities, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Michael Bentz
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, New York, USA
| | - Melanie Jeske
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Sandra Soo-Jin Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, New York, USA
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12
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Martínez-Hernáez Á, Bekele D. Structural competency in epidemiological research: What's feasible, what's tricky, and the benefits of a 'structural turn'. Glob Public Health 2023:1-14. [PMID: 36609203 DOI: 10.1080/17441692.2023.2164903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Structural competency is an emerging paradigm for both the training of health professionals and the creation of a common language addressing structural processes that determine health disparities. However, its application to the field of epidemiological design and research is absent. Based on our previous proposal of a tool for Structural and Intercultural Competency in Epidemiological Studies, the SICES guidelines, in this article we analyse the possibilities and challenges of a 'structural turn' in epidemiology. In terms of possibilities, we recognise the value of paradigms from multiple parts of the world, such as social and sociocultural epidemiology, critical epidemiology and collective health, in facilitating a structural turn in epidemiological studies. In this framework, structural competency would provide a new angle by focusing not only on what to research (e.g. inequalities), but with what skills and attitudes (e.g. cultural and epistemic humility). The challenges lie in the inclusion of reflexivity and a comprehensive view in the context of a positivist epidemiology oriented towards obtaining evidence from a biomedical, but not social, perspective.
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Affiliation(s)
| | - Deborah Bekele
- Medical Anthropology Research Centre, Universitat Rovira i Virgili, Tarragona, Spain
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13
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Salmen CR, Magerenge R, Ndunyu L, Prasad S. Rethinking our Rigor Mortis: Creating space for more adaptive and inclusive truth-seeking in community-based global health research in Kenya. Glob Public Health 2022; 17:4002-4013. [PMID: 31206350 DOI: 10.1080/17441692.2019.1629609] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
As global health researchers, we have long embraced the conviction that the answers to complex problems of poverty and disease will reveal themselves if only we apply enough scientific rigor. Yet, at the community level, our group of American and Kenyan investigators has begun to question whether our veneration of rigor is itself contributing to the intractability of certain types of global health problems. Here, we illustrate examples from our experience among the remote island communities of Lake Victoria, Kenya, and join a chorus of emerging voices, to examine how our culture of control as global health scientists may marginalise truth-seekers and change-makers within communities we seek to serve. More broadly, we seek to acknowledge the limitations of control over truth that rigorous academic research affords. We suggest that by relinquishing this pervasive illusion of control, we can more fully appreciate complementary modes of answering important questions that rely upon the intrinsic resourcefulness and creativity of community-based enterprises taking place across sub-Saharan Africa. While such inquiries may never solve all problems facing the diverse populations of the continent, we advocate for a deeper appreciation of the inherent capacity of adaptive, locally contextualised investigations to identify meaningful and enduring solutions.
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Affiliation(s)
- Charles R Salmen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.,The Mfangano Community Health Field Station, Mfangano Island, Kenya
| | - Richard Magerenge
- The Mfangano Community Health Field Station, Mfangano Island, Kenya.,Ekialo Kiona Center, Organic Health Response (OHR), Mfangano Island, Kenya
| | - Louisa Ndunyu
- The Mfangano Community Health Field Station, Mfangano Island, Kenya.,Department of Public Health, Maseno University, Kisumu, Kenya
| | - Shailendra Prasad
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.,The Mfangano Community Health Field Station, Mfangano Island, Kenya.,Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
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14
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Kingori P, Kombe F, Fehr A. Making global health 'work': Frontline workers' labour in research and interventions. Glob Public Health 2022; 17:4077-4086. [PMID: 36322777 DOI: 10.1080/17441692.2022.2139852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This Special Issue of Global Public Health draws on the concept of 'body work' among those employed to support operationalising, researching, and implementing global health while in direct contact with the bodies of others. This collection brings into sharp focus the specific forms of labour of those occupying positions as frontline workers - those who make global health work. Making Global Health Work includes authors from diverse backgrounds, disciplines, and geographies. Through compelling ethnographies, qualitative interviews, and focus group discussions, they explore 'body work' globally, including: Afghanistan, Bangladesh, Ethiopia, India, Indonesia, Kenya, Malawi, Myanmar, Nigeria, Nepal, Pakistan, Sierra Leone, South Sudan, Tanzania, Thailand, The Democratic Republic of the Congo (DRC), The Gambia, Vietnam, and Zimbabwe. These papers demonstrate that proximity to, and work on, the bodies of others engenders specific forms of (physical, emotional, mental, social, ethical, and political) labour, which occur not only in emergencies and pandemics, but also throughout the quotidian practice of global health. Making Global Health Work provides insights into the provision of maternal healthcare, treatment of multidrug resistant tuberculosis, rapid HIV testing programmes, sleeping sickness and polio eradication campaigns, mass drug administration clinical trials, epidemic preparedness and response, and the management and care of dead bodies. These papers argue for greater attention by global health actors on frontline workers in management of the complexities involved in making global health work.
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Affiliation(s)
- Patricia Kingori
- The Ethox Centre, University of Oxford, Oxford, UK.,The Wellcome Centre for Ethics and Humanities, University of Oxford, UK
| | - Francis Kombe
- School of Applied Social Sciences (Psychology), University of KwaZulu-Natal, Durban, South Africa.,African Research Integrity Network
| | - Alexandra Fehr
- Athena Institute, Vrije Universitiet Amsterdam, Amsterdam, Netherlands.,United Kingdom Public Health Rapid Support Team, London School of Hygiene and Tropical Medicine
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15
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Ortega F, Müller MR. Negotiating human rights narratives in Global Mental Health: Autism and ADHD controversies in Brazil. Glob Public Health 2022; 17:3189-3203. [PMID: 34297640 DOI: 10.1080/17441692.2021.1957493] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Promoting evidence-based treatments and the human rights of people living with mental illness are the two pillars of Global Mental Health (GMH). Critics counter that human rights narratives must also include social justice frameworks. We draw on the cases of autism and ADHD in Brazil to discuss the role of human rights in mental health in the context of GMH. A human rights perspective involves citizenship rights for individuals living with mental distress and provides a framework to problematise the logic of GMH centred on individual rights and rights to treatment. We begin with an overview on human rights discussions in GMH and examine the introduction of human rights discourses in the Brazilian psychiatric reform. We then explore how autism and ADHD became priorities of GMH interventions as well as the constitution of two styles of activism and mobilisation of human rights around these conditions. One follows the universal public health logic and promotes health as a social right. The other follows the logic of parents' associations that redefined those conditions as forms of disability to advocate for specialised services and interventions. Finally, we discuss these forms of human rights mobilisation and their implications for Brazilian mental health and GMH.
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Affiliation(s)
- Francisco Ortega
- Catalan institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Manuela Rodrigues Müller
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, Brazil
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16
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Simmons B, Syvertsen JL. Learning from women who trade sex in Kenya about the antiblackness of Global Health. Soc Sci Med 2022; 313:115246. [PMID: 36215927 DOI: 10.1016/j.socscimed.2022.115246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 07/25/2022] [Indexed: 01/26/2023]
Abstract
Sex work and violence have become co-constituted, routinized, and even sanitized in Global Health journals dispassionately advocating for intervention. This paper situates ethnographically shared experiences of Kenyan sex working women within the global condition of antiblackness. By grounding our conceptual analytic in Black Feminist scholarship, we illustrate how antiblackness subtends the conditions of possibility for women's entry into sex work, their subsequent experiences with interpersonal and institutional forms of predatory violence, and lack of recourse for their material needs and suffering. This analysis requires a meditation on the relationships between the types of violence conditioning Kenyan women's lives and the limitations of Global Health's conceptual logics and disciplinary practice. Our discussion reflects on the ways Global Health practice can neglect conceptual foundations in antiblackness, thus complicit in upholding violence against the very groups it purports to assist. In charging Global Health "as usual" as methodologically violent and sustaining global antiblackness, we call for disciplinary transformations beginning from a shared consciousness regarding the ways global antiblackness structures health inequities. Beyond critique, our meditation is an invitation for all committed to dignified Global Health to contribute creative, non-hierarchically collaborative work engaged with those in material, structural, and immaterial need.
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Affiliation(s)
- Brianna Simmons
- Department of Anthropology, University of California, Riverside, 900 University Ave, Watkins Hall 1320B, Riverside, CA, 92521, USA.
| | - Jennifer L Syvertsen
- Department of Anthropology, University of California, Riverside, 900 University Ave, Watkins Hall 1320B, Riverside, CA, 92521, USA; Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174 W. 18th Ave., Columbus, OH, 43210-1106, USA.
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17
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Watermeyer J, Neille J. The application of qualitative approaches in a post-colonial context in speech-language pathology: A call for transformation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:494-503. [PMID: 35435778 DOI: 10.1080/17549507.2022.2047783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Purpose: Legacies of colonialism continue to influence the profession of speech-language pathology (SLP) around the world. While there is some literature on ways in which we can decolonise the profession, there is little written on these issues in relation to research and practice in the field. In this paper, we discuss how qualitative approaches can be useful particularly in post-colonial contexts to transform research and practice in the profession.Method: Using a reflective framework, we draw on examples from several of our own research and teaching experiences that have embraced a variety of qualitative approaches, conducted across various contexts in the post-colonial South African context.Result: Qualitative approaches can play a central role in achieving transformation goals because they offer opportunities for highlighting the voices of marginalised communities and they are flexible and adaptable to the needs of particular contexts. We reflect on how qualitative approaches can be linked to SLP curricula, practice and research, and consider innovative ways in which such approaches can be embraced within the profession. Specifically focussing on research, we explore issues of access, representation and inclusion, the use of contextually relevant methods, and ethical considerations when working in post-colonial contexts.Conclusion: Many of the points raised in this article are important for all contexts. Embracing qualitative approaches offers opportunities for the SLP profession to transform and meet our mandate of providing culturally safe, appropriate, effective care.
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Affiliation(s)
- Jennifer Watermeyer
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne Neille
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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18
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Ogola E, Pande EO, Dusek A, Singaraju M, Odhiambo J, Mattah B, Karan S, Marshall D, Atieno S, Vigneswari Anebarassou A, Elsayed N, Chikamai L, Carlson A, Muldoon L, Wilsey D, Ndunyu L, Salmen C. Pivoting during the pandemic: adapting research priorities to address community engagement with COVID-19 in Western Kenya. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.38509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Among the many profound disruptions created by COVID-19 around the world, the pandemic has greatly tested community-based research endeavours that rely upon international collaboration and face-to-face interactions in rural communities. Our group of Kenyan and American investigators based on remote Mfangano Island on Lake Victoria experienced numerous challenges due to travel restrictions, safety guidelines, and funding interruptions, forcing us to rapidly adapt objectives as conditions evolved in real time. Here we describe our effort to adjust the priorities of the MOMENTUM study, a longitudinal maternal health study, to support a community-driven response to the initial COVID-19 surge in 2020 and the subsequent Delta wave in 2021. Through a dynamic participatory process, our group identified and implemented three COVID-19 engagement strategies including, (i) printed COVID-19 factsheets for local distribution, (ii) vernacular radio programming on a popular local radio station, and (iii) targeted COVID-19 vaccine promotion among key community opinion leaders. We provide a review of the strengths, challenges, and local perspectives regarding these strategies. Due to notable limitations, such as our inability to compare outcomes with similar control populations, and the nature of the specific strategies designed to address the unique needs of these island populations, this report is not intended to provide definitive or generalizable conclusions regarding the impact of a COVID-19 intervention. We present our experience as an illustrative example of how community-based research collaborations can utilize their embedded networks to develop adaptive responses to unexpected public health threats. Most notably, the transition to virtual collaboration facilitated a long-overdue recentering of operational and strategic leadership into the hands of our Kenyan team. This aligned reality on the ground with our long-stated rhetoric regarding North-South equity in design and implementation. Ultimately, our experience in Kenya suggests that amid ongoing disruptions created by a pandemic, there exists both a responsibility to respond to evolving community needs and an opportunity to remodel global health partnerships for improved equity and long-term impact.
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Affiliation(s)
- Evance Ogola
- Mfangano Community Health Field Station, Ekialo Kiona Center
| | | | | | | | - John Odhiambo
- Mfangano Community Health Field Station, Ekialo Kiona Center
| | - Brian Mattah
- Mfangano Community Health Field Station, Ekialo Kiona Center
| | - Samwel Karan
- Mfangano Community Health Field Station, Ekialo Kiona Center
| | | | | | | | | | | | | | - Lily Muldoon
- Mfangano Community Health Field Station, Ekialo Kiona Center
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19
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Baldwinson R. Global health wars: a rhetorical review of global health critique. MEDICAL HUMANITIES 2022; 48:medhum-2021-012271. [PMID: 35609969 DOI: 10.1136/medhum-2021-012271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 06/15/2023]
Abstract
The critique of global health is a longstanding tradition in the global health humanities (GHH). Typically, this critique takes an expected tack: critics take a slice of global health, identify its rhetoric, expose its power, and elucidate its unanticipated consequences. Here, I subject global health critique to its own approach-conducting a 'rhetorical review' of global health critique in order to ascertain whether it has rhetoric, power and unanticipated consequences of its own. Following this review, I find that global health critique has a rhetoric, and that this rhetoric can be organised into three types: (1) 'global health as mere rhetoric', (2) 'splitting global health', and (3) 'figuring global health war.' Ultimately, I argue that the rhetoric of GHH critique, like the rhetoric of global health, is a rhetoric of consequence-and a rhetoric worth revisiting.
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Affiliation(s)
- Raquel Baldwinson
- English, University of British Columbia, Vancouver, British Columbia, Canada
- History of Science, Harvard University, Cambridge, Massachusetts, USA
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20
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Knight F, Bourassa MW, Ferguson E, Walls H, de Pee S, Vosti S, Martinez H, Levin C, Woldt M, Sethurman K, Bergeron G. Nutrition modeling tools: a qualitative study of influence on policy decision making and determining factors. Ann N Y Acad Sci 2022; 1513:170-191. [PMID: 35443074 PMCID: PMC9546113 DOI: 10.1111/nyas.14778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nutrition modeling tools (NMTs) generate evidence to inform policy and program decision making; however, the literature is generally limited to modeling methods and results, rather than use cases and their impacts. We aimed to document the policy influences of 12 NMTs and identify factors influencing them. We conducted semistructured interviews with 109 informants from 30 low‐ and middle‐income country case studies and used thematic analysis to understand the data. NMTs were mostly applied by international organizations to inform national government decision making. NMT applications contributed to enabling environments for nutrition and influenced program design and policy in most cases; however, this influence could be strengthened. Influence was shaped by processes for applying the NMTs; ownership of the analysis and data inputs, and capacity building in NMT methods, encouraged uptake. Targeting evidence generation at specific policy cycle stages promoted uptake; however, where advocacy capacity allowed, modeling was embedded ad hoc into emerging policy discussions and had broader influence. Meanwhile, external factors, such as political change and resource constraints of local partner organizations, challenged NMT implementation. Importantly, policy uptake was never the result of NMTs exclusively, indicating they should be nested persistently and strategically within the wider evidence and advocacy continuum, rather than being stand‐alone activities.
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Affiliation(s)
- Frances Knight
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Nutrition Division, United Nations World Food Programme, Rome, Italy
| | | | - Elaine Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Helen Walls
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saskia de Pee
- Nutrition Division, United Nations World Food Programme, Rome, Italy.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.,Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Stephen Vosti
- Department of Agricultural and Resource Economics, University of California, Davis, Davis, California
| | | | - Carol Levin
- Department of Global Health, University of Washington, Seattle, Washington
| | - Monica Woldt
- Helen Keller International, Washington, District of Columbia.,USAID Advancing Nutrition, Arlington, Virginia.,Formerly with Food and Nutrition Technical Assistance Project (FANTA), Washington, District of Columbia
| | - Kavita Sethurman
- Formerly with Food and Nutrition Technical Assistance Project (FANTA), Washington, District of Columbia
| | - Gilles Bergeron
- New York Academy of Sciences, New York, New York.,Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia
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Abstract
Abstract
Considerable investments have been made in Europe and worldwide for developing research data infrastructures. Instead of a general lack of data about data, it has become apparent that a pivotal factor that drastically constrains data use is the absence of contextual knowledge about how data was created and how it has been curated and used. This applies especially to many branches of social science and humanities research, where data is highly heterogeneous, both by its kind (e.g. being qualitative, quantitative, naturalistic, purposefully created) and origins (e.g. being historical/contemporary, from different contexts and geographical places). The problem is that there may be enough metadata (data about data) but there is too little paradata (data on the processes of its creation, curation and use). The aim of this position paper is to draw attention 1) to the need for a better and more systematic understanding and documentation of the contexts of creation, curation and use of research data to make it useful and usable for researchers and other potential users in the future, and 2) to specific obstacles that make the capturing of this particular type of metadata, known as paradata, especially difficult. Failing to understand what information about the creation, curation and use of research data is needed and how to capture enough of that information risks that the currently collected vast amounts of research data become useless in the future.
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22
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Al Akash R, Chalmiers MA. Early marriage among Syrian refugees in Jordan: exploring contested meanings through ethnography. Sex Reprod Health Matters 2021; 29:2004637. [PMID: 34873990 PMCID: PMC8654413 DOI: 10.1080/26410397.2021.2004637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Early marriage remains a central concern among reproductive and sexual rights advocates worldwide. Mainstream researchers have often focused on the negative effects of early marriage on young women, presenting them as powerless victims of social and cultural traditions. Yet the voices and perceptions of young women remain strongly absent in many studies on early marriage. Our study addresses this knowledge gap by utilising participatory and ethnographic methodologies to better understand what early marriage means to those who have experienced it and how these emic perspectives may diverge from humanitarian paradigms. Since the war began in 2011, Syrians have become one of the largest groups of refugees worldwide, with over 5.5 million individuals seeking asylum abroad. Humanitarian organisations have called attention to high rates of early marriage within this population and its unique drivers in the specific context of displacement. We draw upon data collected between 2018 and 2020 during 90 individual interviews and 14 participatory action research meetings to explore how Syrian refugee women conceptualise the practice of early marriage and its drivers after displacement. Our findings reveal that early marriage is perceived as a practice that benefits young women and is justified in terms of its beneficial effects. Participants described early marriage as a rational solution to present-day problems, many of which they associate with the unique context of displacement. Our findings echo prior qualitative studies that illustrate the complexity of attitudes towards early marriage and the importance of understanding the specific contexts in which it is practised.
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Affiliation(s)
- Ruba Al Akash
- Assistant Professor, Faculty of Archaeology and Anthropology, Anthropology Department, Yarmouk University, Irbid, Jordan
| | - Morgen A Chalmiers
- PhD Student, Medical Scientist Training Program, Anthropology Department, University of California San Diego, La Jolla, CA, USA. Correspondence:
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23
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Watermeyer J, Hume VJ, Seabi T, Nattrass R. Complexities in interdisciplinary community engagement projects: some reflections and lessons from an applied drama and theatre project in diabetes care. MEDICAL HUMANITIES 2021; 47:485-495. [PMID: 33990417 DOI: 10.1136/medhum-2019-011822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/31/2020] [Indexed: 06/12/2023]
Abstract
There is a growing interest in using drama techniques and theatrical performance to disseminate health information to lay audiences as part of community engagement projects. This process can be challenging for a number of reasons, however. In this paper, we describe the process and pitfalls of an interdisciplinary project involving the development and performance of a play about diabetes mellitus. The play formed part of a long-term, three-way community engagement project between social science, applied drama and a diabetes clinic in South Africa. Building on a framework derived from a number of applied drama methods, we elicited narratives from key 'storytellers' that were developed and embodied by actors in a new performance called Blood Sugars Creating this play provided insight into working in an interdisciplinary space and highlighted the importance of establishing shared goals and joint ownership of the project right from the outset. This was without doubt a challenging project and the complexities of finding common ground across three disciplines are not to be underestimated. In this paper, we explore the collaboration and its challenges, drawing on the framework of complexity theory. In particular, we examine the layers of complexity that emerged as a result of the interdisciplinary nature of the project and the demands of balancing the authenticity of the stories with the perceived requirements of health messaging. We consider the methodological, conceptual and ethical challenges of this type of research, and discuss some recommendations for teams taking on similar complex multidisciplinary research and intervention projects.
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Affiliation(s)
- Jennifer Watermeyer
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Victoria Jane Hume
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- WiSER, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Tshegofatso Seabi
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- MRC/Wits Population Health and Health Transition Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Rhona Nattrass
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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24
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Hume VJ. Delirium in intensive care: violence, loss and humanity. MEDICAL HUMANITIES 2021; 47:496-506. [PMID: 33168778 DOI: 10.1136/medhum-2020-011908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
Delirium in intensive care is an altered state that can bring with it persecutory paranoias, and sometimes expressions of violence on the part of the patient; it can be deeply disturbing for the person experiencing it as well as for those around them. Although the impacts of delirium on patients' recovery and long-term mental health are well documented, qualitative research in this area remains rare. This article is derived from a narrative and musical study of the experience of delirium in hospital, undertaken better to understand the perspectives of people who have experienced delirium, as well as the healthcare professionals and family members who care for them. Data were collected in South Africa between 2015 and 2017. The study took the form of interviews and focus groups with a total of 15 participants, as well as periods of observation and audio recording in a hospital intensive care unit. Thematic and narrative analysis of the data were carried out alongside the composition of new music incorporating audio recordings from the study. Analysis suggested three key themes emerging from the data. First, the violence experienced and expressed by patients, both within delirious hallucination and in observable reality. Second, the interconnected losses undergone by patients in spaces of intensive care. Third, healthcare professionals' attempts to bring greater humanity into the potentially dehumanising space of intensive care. The results and discussion point to possible relationships between delirium and the working cultures and physical environment of intensive care, and may reinforce the need for sensitive and committed communication between healthcare professionals and patients.
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Affiliation(s)
- Victoria Jane Hume
- WiSER, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Health Communication Research Unit, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
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25
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Biruk C. The Politics of Global Health. POLAR-POLITICAL AND LEGAL ANTHROPOLOGY REVIEW 2021. [DOI: 10.1111/plar.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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26
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Beyond controversies in child mental health: negotiating autism and ADHD diagnosis in France and Brazil. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-021-00234-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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Herrick C, Bell K. Epidemic confusions: On irony and decolonisation in global health. Glob Public Health 2021; 17:1467-1478. [PMID: 34278948 DOI: 10.1080/17441692.2021.1955400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The movement to decolonise global health is gathering pace. In its concern with the fundamental, distal causes of inequality and its call for social justice, the decolonisation movement forces us to question how global health works, for whom, where it is located, its funding practices, power asymmetries, cultures of collaboration and publication. This paper uses a new book by Harvard-based physician-anthropologist Eugene T. Richardson, Epidemic Illusions, as a point of departure for a broader analysis of the nature of global health knowledge, science, authorship, research and practice. Written in a 'carnivalesque' style, the book proceeds through a series of 'ironic (re)descriptions' to argue that global public health is an 'apparatus of coloniality'. In so doing, the book is generative of four ironic turns that we explore through the themes of guilt, humility, privilege and ambiguity. In locating these ironic turns within the broader landscape of global health, we reflect on whether the means of such a book achieve the ends of decolonisation.
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Affiliation(s)
- Clare Herrick
- Department of Geography, King's College London, London, UK
| | - Kirsten Bell
- Department of Life Sciences, University of Roehampton, Whitelands, UK
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28
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McAlvay AC, Armstrong CG, Baker J, Elk LB, Bosco S, Hanazaki N, Joseph L, Martínez-Cruz TE, Nesbitt M, Palmer MA, Priprá de Almeida WC, Anderson J, Asfaw Z, Borokini IT, Cano-Contreras EJ, Hoyte S, Hudson M, Ladio AH, Odonne G, Peter S, Rashford J, Wall J, Wolverton S, Vandebroek I. Ethnobiology Phase VI: Decolonizing Institutions, Projects, and Scholarship. J ETHNOBIOL 2021. [DOI: 10.2993/0278-0771-41.2.170] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Alex C. McAlvay
- Institute of Economic Botany, The New York Botanical Garden, 2900 Southern Blvd, Bronx, NY 10458
| | | | - Janelle Baker
- Anthropology, Athabasca University, Athabasca, Alberta, Canada
| | | | - Samantha Bosco
- 5 Horticulture Section, School of Integrated Plant Sciences, Cornell University, Ithaca, New York
| | - Natalia Hanazaki
- Departamento de Ecologia e Zoologia, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Leigh Joseph
- 7 School of Environmental Studies, University of Victoria, BC, Canada
| | | | - Mark Nesbitt
- Royal Botanic Gardens, Kew, Richmond, Surrey, UK
| | - Meredith Alberta Palmer
- Science and Technology Studies Department, American Indian and Indigenous Studies Program, Cornell University, Ithaca, New York
| | | | - Jane Anderson
- Equity for Indigenous Research and Innovation Coordinating Hub, Anthropology and Museum Studies, New York University, New York, New York
| | - Zemede Asfaw
- Department of Plant Biology and Biodiversity Management, Addis Ababa University, Addis Ababa, Ethiopia
| | - Israel T. Borokini
- Ecology, Evolution and Conservation Biology Graduate Program, Department of Biology, University of Nevada, Reno, Nevada
| | - Eréndira Juanita Cano-Contreras
- Centro de Investigaciones Multidisciplinarias sobre Chiapas y la Frontera Sur, Universidad Nacional Autónoma de México, Chiapas, México
| | - Simon Hoyte
- Department of Anthropology, University College London, London, United Kingdom
| | - Maui Hudson
- Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Ana H. Ladio
- INIBIOMA (CONICET-Universidad Nacional del Comahue), San Carlos de Bariloche, Río Negro, Argentina
| | | | - Sonia Peter
- 20 Biocultural Education and Research Programme, St. James, Barbados
| | - John Rashford
- Department of Sociology and Anthropology, College of Charleston, Charleston, South Carolina
| | - Jeffrey Wall
- Department of Geography, Environment and Geomatics, University of Guelph, Ontario, Canada
| | - Steve Wolverton
- Department of Geography and the Environment, University of North Texas, Denton, Texas
| | - Ina Vandebroek
- Institute of Economic Botany, The New York Botanical Garden, 2900 Southern Blvd, Bronx, NY 10458
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Erikson S. COVID-Apps: Misdirecting Public Health Attention in a Pandemic. GLOBAL POLICY 2021; 12:97-100. [PMID: 38607827 PMCID: PMC8441728 DOI: 10.1111/1758-5899.12888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 04/14/2024]
Abstract
When there is no vaccine for a disease, 'Test, Trace, Treat/Isolate' is the public health go-to directive. During the COVID-19 pandemic, mobile phone apps are designed to improve on this. But COVID-apps have not been effective as a public health tool. Countries spend millions to develop them, yet they have been shown to have terrible return on investment. This commentary explores why COVID-apps are generally championed and provides three brief case studies (Germany, Sierra Leone, Canada) of non-app public health success. In conclusion, I argue that we need to get our public health care priorities straight: Better and more testing; increased investment in manual contact tracing and treatments; hospitalization when necessary; and wrap-around care - assistance with groceries, cleaning, child- or eldercare responsibilities, telehealth doctor appointment hookups - for sick people in home isolation.
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Cancelliere F, Probst U. Being There. ANTHROPOLOGY IN ACTION 2021. [DOI: 10.3167/aia.2021.280201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Conrad W. Watson describes fieldwork as ‘a period of particular heightened intensity’ (1999a: 2) in the introduction of Being There (1999b). The authors of this volume were by far not the first, nor the last, anthropologists questioning and critically reflecting on what it is that they are actually doing when being there in their respective fields. For Watson and others (Borneman and Hammoudi 2009; Geertz 2004; Hollan 2008), this was primarily an epistemological question, following ruptures in the discipline’s identity after the Writing Culture Debates of the late 1980s. Forced to rethink their fieldwork practices, anthropologists saw their understandings of theory-building and knowledge production follow suit. However, the complexities and challenges of ethnographic fieldwork also confronted and still confront many anthropologists with intricate questions of inequalities, power structures and violence that not only need to be theorised but also navigated in the everyday practice of fieldwork.
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Affiliation(s)
| | - Ursula Probst
- Institute for Social and Cultural Anthropology, Freie Universität Berlin, Germany
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Matos CCDSA, Gonçalves BA, Couto MT. Vaccine hesitancy in the global south: Towards a critical perspective on global health. Glob Public Health 2021; 17:1087-1098. [PMID: 33843459 DOI: 10.1080/17441692.2021.1912138] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The complex phenomenon of vaccine hesitancy has been causing increasing global concern. This systematic review aims at analysing the state of art of scientific literature concerning vaccine hesitancy in Latin America and Africa, observing if: (i) they use the same research trends as the global North; and (ii) the parameters recommended by the World Health Organization (WHO) and taken from the experience of the global North are adequate to the Global South's context. This review analyses empirical, qualitative, quantitative, or mixed-study publications, from 2015 to 2020, available at five different databases. The studies produced in the Global South bring up important context-specific issues, such as issues of access (that are not included in the WHO's definition of vaccine hesitancy), cultural and religious issues, reactions to governments, reactions to recent episodes of vaccine tests on populations, and reactions to past of colonial violence. Initiatives to understand the phenomenon based on methodological and conceptual frameworks from the global North alone can cause wrongful conclusions.
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Martinez-Hernaez A, Bekele D, Sabariego C, Rodríguez-Laso Á, Vorstenbosch E, Rico-Uribe LA, Ayuso-Mateos JL, Sánchez-Niubò A, Rodríguez-Mañas L, Haro JM. The Structural and Intercultural Competence for Epidemiological Studies (SICES) guidelines: a 22-item checklist. BMJ Glob Health 2021; 6:e005237. [PMID: 33853845 PMCID: PMC8728389 DOI: 10.1136/bmjgh-2021-005237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/15/2022] Open
Abstract
Structural and intercultural competence approaches have been widely applied to fields such as medical training, healthcare practice, healthcare policies and health promotion. Nevertheless, their systematic implementation in epidemiological research is absent. Based on a scoping review and a qualitative analysis, in this article we propose a checklist to assess cultural and structural competence in epidemiological research: the Structural and Intercultural Competence for Epidemiological Studies guidelines. These guidelines are organised as a checklist of 22 items and consider four dimensions of competence (awareness and reflexivity, cultural and structural validation, cultural and structural sensitivity, and cultural and structural representativeness), which are applied to the different stages of epidemiological research: (1) research team building and research questions; (2) study design, participant recruitment, data collection and data analysis; and (3) dissemination. These are the first guidelines addressing structural and cultural competence in epidemiological inquiry.
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Affiliation(s)
| | - Deborah Bekele
- Medical Anthropology Research Center, Rovira i Virgili University, Tarragona, Spain
| | - Carla Sabariego
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Swiss Paraplegics Foundation, Nottwil, Switzerland
| | | | - Ellen Vorstenbosch
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
| | - Laura Alejandra Rico-Uribe
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
| | - José Luis Ayuso-Mateos
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
| | - Albert Sánchez-Niubò
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- CIBERFES, CIBER Institute of Health Carlos III, Madrid, Spain
- Geriatrics Department, Getafe University Hospital, Getafe, Spain
| | - Josep Maria Haro
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
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Svanberg I. The Importance of Animal and Marine Fat in the Faroese Cuisine: The Past, Present, and Future of Local Food Knowledge in an Island Society. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.599476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Since ecological and climatic conditions limit the possibilities for cereal production, the old-established Faroese traditional food system is principally based on the utilization of animal protein and fat. The diet of the islanders has thus been adapted to the specific environmental circumstances of the area. Historically, fat has provided a high energy and nutritious food source for the hard-working sheep farmers and fishermen. Fat procured from both land and marine animals has formed a vital part of the local food culture. Apart from the insubstantial amount of butter produced in the Faroe Islands, tallow from sheep, fish fat and liver from codfishes, and the blubber from the long-finned pilot whale, has been widely utilized within the households. During the last century, Faroese diet has changed due to external factors such as closer integration into the world economy, modernization, and improved household economy. Although butter, cheese and other dairy products as well as margarine and vegetable oil are nowadays readily available in the convenience shops and supermarkets, tallow, and whale blubber continue to be part and parcel of many of the islanders' cuisine. Today, however, such products are not primarily consumed for their energy content. Instead, it can be seen as a contemporary and regional expression of appraisal toward Faroese cuisine. Appreciating and consuming local food has become an important part of expressing Faroese cultural identity. The traditional diet therefore links the islanders with their history. However, the preparation of Faroese food products is highly dependent on traditional knowledge of how to extract different types of animal fat and process it into locally made dishes. Thus, the long-term survival of traditional Faroese gastronomy is contingent on the maintenance and continuation of this knowledge.
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Dowhaniuk N, Ojok S, McKune SL. Setting a research agenda to improve community health: An inclusive mixed-methods approach in Northern Uganda. PLoS One 2021; 16:e0244249. [PMID: 33411706 PMCID: PMC7790286 DOI: 10.1371/journal.pone.0244249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The United Nations Sustainable Development Goals stress the importance of equitable partnerships in research and practice that integrate grass-roots knowledge, leadership, and expertise. However, priorities for health research in low-and-middle income countries are set almost exclusively by external parties and priorities, while end-users remain "researched on" not "researched with". This paper presents the first stage of a Community-Based Participatory Research-inspired project to engage communities and public-health end-users in setting a research agenda to improve health in their community. METHODS Photovoice was used in Kuc, Gulu District, Uganda to engage community members in the selection of a research topic for future public health research and intervention. Alcohol-Use Disorders emerged from this process the health issue that most negatively impacts the community. Following identification of this issue, a cross-sectional survey was conducted using the Alcohol Use Disorder Identification Test (n = 327) to triangulate Photovoice findings and to estimate the prevalence of Alcohol-Use Disorders in Kuc. Logistic regression was used to test for associations with demographic characteristics and Alcohol-Use Disorders. RESULTS Photovoice generated four prominent themes, including alcohol related issues, sanitation and compound cleanliness, water quality and access, and infrastructure. Alcohol-Use Disorders were identified by the community as the most important driver of poor health. Survey results indicated that 23.55% of adults in Kuc had a probable Alcohol Use Disorder, 16.45 percentage points higher than World Health Organization estimates for Uganda. CONCLUSIONS Community members engaged in the participatory, bottom-up approach offered by the research team to develop a research agenda to improve health in the community. Participants honed in on the under-researched and underfunded topic of Alcohol-Use Disorders. The findings from Photovoice were validated by survey results, thereby solidifying the high prevalence of Alcohol-Use Disorders as the health outcome that will be targeted through future long-term research and partnership.
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Affiliation(s)
- Nicholas Dowhaniuk
- Department of Geography, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- Tropical Conservation and Development Program, University of Florida, Gainesville, Florida, United States of America
| | - Susan Ojok
- Uganda Women's Action Program, Gulu, Uganda
| | - Sarah L. McKune
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- African Studies Program, University of Florida, Gainesville, Florida, United States of America
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Lynch KA, Omisore AD, Famurewa O, Olasehinde O, Odujoko O, Vera J, Kingham TP, Alatise OI, Egberongbe AA, Morris EA, Atkinson TM, Sutton EJ. Designing Participatory Needs Assessments to Support Global Health Interventions in Time-Limited Settings: A Case Study From Nigeria. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021; 20:10.1177/16094069211002421. [PMID: 35185442 PMCID: PMC8855957 DOI: 10.1177/16094069211002421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Social scientists have advocated for the use of participatory research methods for Global Health project design and planning. However, community-engaged approaches can be time and resource-intensive. This article proposes a feasible framework for conducting a participatory needs assessment in time-limited settings using multiple, triangulated qualitative methods. This framework is outlined through a case study: a participatory needs assessment to inform the design of an ultrasound-guided biopsy training program in Nigeria. Breast cancer is the leading cause of death for Nigerian women and most cases in Nigeria are diagnosed at an advanced stage; timely diagnosis is impeded by fractious referral pathways, costly imaging equipment, and limited access outside urban centers. The project involved participant observation, surveys, and focus groups at the African Research Group for Oncology (ARGO) in Ile-Ife, Nigeria. Through this timely research and engagement, participants spoke about diagnostic challenges, institutional power dynamics, and infrastructure considerations for program implementation.
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Affiliation(s)
- Kathleen A. Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Olusola Famurewa
- Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Oluwole Odujoko
- Department of Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Jacqueline Vera
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - T. Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Elizabeth A. Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas M. Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J. Sutton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Marston CA, Matthews R, Renedo A, Reed JE. Working together to co-produce better health: The experience of the Collaboration for Leadership in Applied Health Research and Care for Northwest London. J Health Serv Res Policy 2021; 26:28-36. [PMID: 32486987 PMCID: PMC7734957 DOI: 10.1177/1355819620928368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To improve the provision of health care, academics can be asked to collaborate with clinicians, and clinicians with patients. Generating good evidence on health care practice depends on these collaborations working well. Yet such relationships are not the norm. We examine how social science research and health care improvement practice were linked through a programme designed to broker collaborations between clinicians, academics, and patients to improve health care - the UK National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London. We discuss the successes and challenges of the collaboration and make suggestions on how to develop synergistic relationships that facilitate co-production of social science knowledge and its translation into practice. METHODS A qualitative approach was used, including ethnographic elements and critical, reflexive dialogue between members of the two collaborating teams. RESULTS Key challenges and remedies were connected with the risks associated with new ways of working. These risks included differing ideas between collaborators about the purpose, value, and expectations of research, and institutional opposition. Dialogue between collaborators did not mean absence of tensions or clashes. Risk-taking was unpopular - institutions, funders, and partners did not always support it, despite simultaneously demanding 'innovation' in producing research that influenced practice. CONCLUSIONS Our path was made smoother because we had funding to support the creation of a 'potential space' to experiment with different ways of working. Other factors that can enhance collaboration include a shared commitment to dialogical practice, a recognition of the legitimacy of different partners' knowledge, a long timeframe to identify and resolve problems, the maintenance of an enabling environment for collaboration, a willingness to work iteratively and reflexively, and a shared end goal.
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Affiliation(s)
- Cicely A Marston
- Professor of Public Health, London School of Hygiene and Tropical Medicine, UK
| | | | - Alicia Renedo
- Assistant Professor, London School of Hygiene and Tropical Medicine, UK
| | - Julie E Reed
- Strategic Director, CLAHRC NWL, Patient and Public Engagement and Involvement Lead, National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care for Northwest London, Imperial College London, Chelsea and Westminster Hospital, UK
- Visiting Professor in Improvement Science, School of Health and Welfare, Halmstad University, Sweden
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Montenegro CR, Ortega F. Thinking beyond implementation: context and culture in global mental health. BMJ Glob Health 2020; 5:e004539. [PMID: 33380416 PMCID: PMC7780541 DOI: 10.1136/bmjgh-2020-004539] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Cristian R Montenegro
- Nursing School, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Francisco Ortega
- Institute for Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Alba S, Lenglet A, Verdonck K, Roth J, Patil R, Mendoza W, Juvekar S, Rumisha SF. Bridging research integrity and global health epidemiology (BRIDGE) guidelines: explanation and elaboration. BMJ Glob Health 2020; 5:e003237. [PMID: 33115860 PMCID: PMC7594201 DOI: 10.1136/bmjgh-2020-003237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/30/2022] Open
Abstract
Over the past decade, two movements have profoundly changed the environment in which global health epidemiologists work: research integrity and research fairness. Both ought to be equally nurtured by global health epidemiologists who aim to produce high quality impactful research. Yet bridging between these two aspirations can lead to practical and ethical dilemmas. In the light of these reflections we have proposed the BRIDGE guidelines for the conduct of fair global health epidemiology, targeted at stakeholders involved in the commissioning, conduct, appraisal and publication of global health research. The guidelines follow the conduct of a study chronologically from the early stages of study preparation until the dissemination and communication of findings. They can be used as a checklist by research teams, funders and other stakeholders to ensure that a study is conducted in line with both research integrity and research fairness principles. In this paper we offer a detailed explanation for each item of the BRIDGE guidelines. We have focused on practical implementation issues, making this document most of interest to those who are actually conducting the epidemiological work.
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Affiliation(s)
- Sandra Alba
- Health, KIT Royal Tropical Insititute, Amsterdam, The Netherlands
| | - Annick Lenglet
- Médecins Sans Frontières, Amsterdam, North Holland, The Netherlands
| | | | - Johanna Roth
- European and Developing Countries Clinical Trials Partnership, The Hague, South Holland, The Netherlands
| | - Rutuja Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | | | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, Maharashtra, India
| | - Susan F Rumisha
- National Institute for Medical Research, Dar es Salaam, United Republic of Tanzania
- Big Data Institute, University of Oxford, Oxford, Oxfordshire, UK
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40
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Bell K, Green J. Premature evaluation? Some cautionary thoughts on global pandemics and scholarly publishing. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1769406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Kirsten Bell
- Department of Life Sciences, University of Roehampton, London, UK
| | - Judith Green
- Wellcome Centre for Cultures & Environments of Health, University of Exeter, Exeter, UK
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41
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Hyde ST, Denyer Willis L. Balancing the Quotidian: Precarity, Care and Pace in Anthropology's Storytelling. Med Anthropol 2020; 39:297-304. [PMID: 32282236 DOI: 10.1080/01459740.2020.1739673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Laurie Denyer Willis
- Department of Politics and International Studies, University of Cambridge, Cambridge, UK
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42
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DesLauriers NR, Ogola E, Ouma G, Salmen M, Muldoon L, Pederson BL, Hines K, Ssenkusu JM, Mattah B, Okeyo R, Okinyi P, Magerenge R, Friberg N, McCoy M, Prasad S, Ndunyu L, Salmen CR. The MOMENTUM study: Putting the 'Three Delays' to work to evaluate access to emergency obstetric and neonatal care in a remote island community in Western Kenya. Glob Public Health 2020; 15:1016-1029. [PMID: 32182159 DOI: 10.1080/17441692.2020.1741662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite worldwide improvements in maternal and infant mortality, mothers and babies in remote, low-resource communities remain disproportionately vulnerable to adverse health outcomes. In these settings, delays in accessing emergency care are a major driver of poor outcomes. The 'Three Delays' model is now widely utilised to conceptualise these delays. However, in out-of-hospital contexts, operational and methodological constraints present major obstacles in practically quantifying the 'Three Delays'. Here, we describe a novel protocol for the MOMENTUM study (Monitoring of Maternal Emergency Navigation and Triage on Mfangano), a 12-month cohort design to assess delays during obstetric and neonatal emergencies within the remote villages of Mfangano Island Division, Lake Victoria, Kenya. This study also evaluates the preliminary impact of a community-based intervention called the 'Mfangano Health Navigation' programme. Utilising participatory case audits and contextually specific chronological reference strategies, this study combines quantitative tools with deeper-digging qualitative inquiry. This pragmatic design was developed to empower local research staff and study participants themselves as assets in unravelling the complex socio-economic, cultural, and logistical dynamics that contribute to delays, while providing real-time feedback for locally driven intervention. We present our methods as an adaptive framework for researchers grappling with similar challenges across fragmented, rural health landscapes.
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Affiliation(s)
- Nicholas R DesLauriers
- Medical School, University of Minnesota, Minneapolis, USA.,Organic Health Response, Mfangano Island, Kenya
| | - Evance Ogola
- Ekialo Kiona Centre, Mfangano Island, Kenya.,Department of Public Health, Maseno University, Kisumu, Kenya
| | - Gor Ouma
- Ekialo Kiona Centre, Mfangano Island, Kenya
| | | | | | | | - Kelsi Hines
- Organic Health Response, Mfangano Island, Kenya
| | - John M Ssenkusu
- School of Public Health, Makerere University, Kampala, Uganda
| | | | | | | | | | | | - Molly McCoy
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA
| | - Shailendra Prasad
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA.,Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Louisa Ndunyu
- Department of Public Health, Maseno University, Kisumu, Kenya
| | - Charles R Salmen
- Organic Health Response, Mfangano Island, Kenya.,Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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43
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Ortega F, Behague DP. O que a medicina social latino-americana pode contribuir para os debates globais sobre as políticas da Covid-19: lições do Brasil. ACTA ACUST UNITED AC 2020. [DOI: 10.1590/s0103-73312020300205] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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44
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Watermeyer J, Hume V, Seabi T, Pauly B. “It’s got its own life, and you can’t contain it”: A qualitative study of patient and health professional experiences of diabetes care. J Clin Nurs 2019; 29:240-250. [DOI: 10.1111/jocn.15086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/30/2019] [Accepted: 10/17/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Jennifer Watermeyer
- Health Communication Research Unit School of Human and Community Development University of the Witwatersrand Johannesburg South Africa
| | - Victoria Hume
- Health Communication Research Unit School of Human and Community Development University of the Witwatersrand Johannesburg South Africa
- Wits Institute for Social and Economic Research Johannesburg South Africa
| | - Tshegofatso Seabi
- Health Communication Research Unit School of Human and Community Development University of the Witwatersrand Johannesburg South Africa
- MRC/Wits Population Health and Health Transition Research Unit (Agincourt) Johannesburg South Africa
| | - Bruno Pauly
- Chris Hani Baragwanath Academic Hospital Internal Medicine Diabetes Clinic Johannesburg South Africa
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van de Ruit C. Unintended Consequences of Community Health Worker Programs in South Africa. QUALITATIVE HEALTH RESEARCH 2019; 29:1535-1548. [PMID: 31274060 DOI: 10.1177/1049732319857059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Task shifting from trained clinicians to community health workers (CHWs) is a central, primary health care strategy advocated by global health policy planners in resource-poor settings where trained health professionals are scarce. The evidence base for the efficacy of these programs, however, is limited-in particular, research that identifies their potential unintended consequences. Based on sustained ethnographic study of CHWs working for AIDS projects in South Africa at the height of the country's AIDS epidemic, this article identifies how structural and local factors produced unintended consequences for CHW programs. These consequences were (a) CHWs moonlighting for multiple organizations, (b) CHWs freelancing in communities without regulation, and (c) adverse patient outcomes resulting from uncoordinated care. These consequences stemmed from structural elements of a bureaucratically weak health system and from local grassroots dynamics that jeopardized long-term CHW program sustainability and eroded national health goals.
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Moran-Thomas A. Struggles for maintenance: Patient activism and dialysis dilemmas amidst a global diabetes epidemic. Glob Public Health 2019; 14:1044-1057. [DOI: 10.1080/17441692.2019.1596292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Amy Moran-Thomas
- Anthropology, Massachusetts Institute of Technology, Cambridge, USA
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Bernays S, Paparini S, Namukwaya S, Seeley J. A Failed Method? Reflections on Using Audio Diaries in Uganda With Young People Growing Up With HIV in the BREATHER Trial. QUALITATIVE HEALTH RESEARCH 2019; 29:719-730. [PMID: 30499374 DOI: 10.1177/1049732318813534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this article, we present a case study in which we consider our use of the audio diary method with young people (aged 10-24) living with HIV in Uganda in a longitudinal qualitative study conducted in a clinical randomized control trial. Despite initial enthusiasm for the method among participants to capture accounts of participants' experiences outside of the confines of the HIV clinic, the constraints the young people encountered in accessing sufficient privacy to confidently make recordings meant that no one elected to use them again in the study. Despite the insights the use of the method generated, the lack of acceptability led to its relative failure. This demonstrates that despite the call for innovation, there is an unwavering necessity when selecting methods that they align with the needs and preferences of our participants and with an attentive assessment of the local context in which illness narratives are produced.
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Affiliation(s)
- Sarah Bernays
- 1 University of Sydney, Sydney, New South Wales, Australia
| | - Sara Paparini
- 2 Graduate Institute of International and Development Studies, Geneva, Switzerland
| | | | - Janet Seeley
- 3 Uganda Virus Research Institute, Entebbe, Uganda
- 4 London School of Hygiene & Tropical Medicine, London, United Kingdom
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Abstract
Since the turn of the millennium, conceptual and practice-oriented shifts in global
health have increasingly given emphasis to health indicator production over research and interventions
that emerge out of local social practices, environments and concerns. In this special
issue of Anthropology in Action, we ask whether such globalised contexts allow for, recognise
and sufficiently value the research contributions of our discipline. We question how global
health research, ostensibly inter- or multi-disciplinary, generates knowledge. We query ‘not-knowing’
practices that inform and shape global health evidence as influenced by funders’
and collaborators’ expectations. The articles published here provide analyses of historical and
ethnographic field experiences that show how sidelining anthropological contributions results
in poorer research outcomes for the public. Citing experiences in Latin America, Angola, Senegal,
Nigeria and the domain of global health evaluation, the authors consider anthropology’s
roles in global health.
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Brown H, Nading AM. Introduction: Human Animal Health in Medical Anthropology. Med Anthropol Q 2019; 33:5-23. [PMID: 30811674 PMCID: PMC6492111 DOI: 10.1111/maq.12488] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 11/30/2022]
Abstract
This introductory article maps out the parameters of an emerging field of medical anthropology, human animal health, and its potential for reorienting the discipline. Ethnographic explorations of how animals are implicated in health, well-being, and pathogenicity allow us to revisit theorizations of central topics in medical anthropology, notably ecology, biopolitics, and care. Meanwhile, the conditions of the Anthropocene force us to develop new tools to think about human animal entanglement. Anthropogenic change reorients debates around health and disease, but it also requires us to move beyond what some consider the traditional boundaries of the discipline. Zoonotic diseases, veterinary medicine, animal therapeutics, and food and farming are examples of topics that force such movement.
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Affiliation(s)
| | - Alex M. Nading
- Watson Institute for International and Public AffairsBrown University
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Duclos D, Faye SL, Ndoye T, Penn-Kekana L. Envisioning, Evaluating and Co-Enacting Performance in Global Health Interventions. ANTHROPOLOGY IN ACTION 2019. [DOI: 10.3167/aia.2019.260103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The notion of performance has become dominant in health programming, whether
being embodied through pay-for-performance schemes or through other incentive-based
interventions. In this article, we seek to unpack the idea of performance and performing in a
dialogical fashion between field-based evaluation findings and methodological considerations.
We draw on episodes where methodological reflections on performing ethnography
in the field of global health intersect with findings from the everyday practices of working
under performance-based contracts in the Senegalese supply chain for family planning. While
process evaluations can be used to understand contextual factors influencing the implementation
of an intervention, we as anthropologists in and of contemporary global health have an
imperative to explore and challenge categories of knowledge and practice. Making room for
new spaces of possibilities to emerge means locating anthropology within qualitative global
health research.
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