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Bell SE. Bringing the Global into Medical Sociology: Medicalization, Narrative, and Global Health. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465241249701. [PMID: 38738467 DOI: 10.1177/00221465241249701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Medical sociologists have much to gain by bringing in global health. In this article, I make the case for expanding our field by furthering sociological perspectives on global health. I reflect on my career, the influence of scholar-activist mentors, and my contributions to the development of scholarship about medicalization, narrative, and global health in medical sociology. First, I focus on medicalization, its relationship to biomedicalization and pharmaceuticalization, and critiques of the medicalization of global health. Second, I analyze the narrative turn in studies of illness experiences and the inclusion of visual materials as an integral part of narrative studies of illness. Third, I explore global health and show examples of bodies of knowledge that medical sociologists are building. Although I present each as a distinct area, my discussion illustrates how the three areas are intertwined and how my contributions to each traverse and build connections among them.
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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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Perez-Brumer A, Hill D, Parker R. Latin America at the margins? Implications of the geographic and epistemic narrowing of 'global' health. Glob Public Health 2024; 19:2295443. [PMID: 38147567 DOI: 10.1080/17441692.2023.2295443] [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: 06/23/2023] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Abstract
To explore the narrowing of the concept of 'global' in global health, this article traces how Latin America has held a place of both privilege and power as well as marginalisation in the field. We employ a modified extended case method to examine how Latin America has been 'seen' and 'heard' in understandings of global health, underscoring the region's shifting role as a key site for research and practice in 'tropical medicine' from the mid-nineteenth century through World War II, to a major player and recipient of development assistance throughout the 'international health' era after World War II until the late twentieth century, to a region progressively marginalised within 'global health' since the mid-1980s/1990s. We argue that the progressive marginalisation of Latin America and Southern theory has not only hurt health equity and services, but also demonstrates the fundamental flaws in contemporary 'global' thinking. The narrowing of global health constitutes coloniality of power, with Northern institutions largely defining priority regions and epistemic approaches to health globally, thus impoverishing the field from the intellectual resources, political experience, and wisdom of Latin America's long traditions of social medicine and collective health.
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Affiliation(s)
- Amaya Perez-Brumer
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Center for Interdisciplinary Research in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Hill
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Richard Parker
- Associação Brasileira Interdisciplinar de AIDS (ABIA), Rio de Janeiro, Brazil
- Sexuality Policy Watch (SPW), Rio de Janeiro, Brazil
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
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Wispelwey B, Osuagwu C, Mills D, Goronga T, Morse M. Towards a bidirectional decoloniality in academic global health: insights from settler colonialism and racial capitalism. Lancet Glob Health 2023; 11:e1469-e1474. [PMID: 37591594 DOI: 10.1016/s2214-109x(23)00307-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 08/19/2023]
Abstract
This Viewpoint considers the implications of incorporating two interdisciplinary and burgeoning fields of study, settler colonialism and racial capitalism, as prominent frameworks within academic global health. We describe these two modes of domination and their historical and ongoing roles in creating accumulated advantage for some groups and disadvantage for others, highlighting their relevance for decolonial health approaches. We argue that widespread epistemic and material injustice, long noted by marginalised communities, is more apparent and challengeable with the consistent application of these two frameworks. With examples from the USA, Brazil, and Zimbabwe, we describe the health effects of settler colonial erasure and racial capitalist exploitation, also revealing the rich legacies of resistance that highlight potential paths towards health equity. Because much of the global health knowledge production is constructed from unregenerate contexts of settler colonialism and racial capitalism and yet focused transnationally, we offer instead an approach of bidirectional decoloniality. Recognising the broader colonial world system at work, bidirectional decoloniality entails a truly global health community that confronts Global North settler colonialism and racial injustice as forcefully as the various colonialisms perpetrated in the Global South.
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Affiliation(s)
- Bram Wispelwey
- FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA; Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Chidinma Osuagwu
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - David Mills
- FXB Center for Health and Human Rights, Harvard University, Boston, MA, USA; Global Health Program, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Tinashe Goronga
- Centre for Health Equity Zimbabwe, Equal Health Global Campaign Against Racism, Harare, Harare, Zimbabwe
| | - Michelle Morse
- Department of Medicine, Harvard Medical School, Boston, MA, USA; New York City Department of Public Health and Mental Hygiene, New York, NY, USA
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Bhopal A, Getnet F, Manga S. Caught in the crossfires: the Virchow Prize, its inaugural winner, and the quest to decolonise global health. BMJ Glob Health 2023; 8:e013272. [PMID: 37479501 PMCID: PMC10364150 DOI: 10.1136/bmjgh-2023-013272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023] Open
Affiliation(s)
- Anand Bhopal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Takemi Program in International Health, Harvard University, Cambridge, Massachusetts, USA
| | - Fentabil Getnet
- Takemi Program in International Health, Harvard University, Cambridge, Massachusetts, USA
- National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Selene Manga
- Takemi Program in International Health, Harvard University, Cambridge, Massachusetts, USA
- Director, Tuberculosis Department, Latin American Society of Thoracic Diseases, Lima, Peru
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Krugman DW. Global health and the elite capture of decolonization: On reformism and the possibilities of alternate paths. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002103. [PMID: 37384634 DOI: 10.1371/journal.pgph.0002103] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Global Health is experiencing a moment of reckoning over the field's legacy and current structuring in a world facing multiple, intersecting challenges to health. While "decolonization" has emerged as the dominant frame to imagine change in the field, what the concept refers to and entails has become increasingly unclear. Despite warnings, the concept is now being used by elite Global North institutions and organization to imagine their reformation. In this article, I attempt to provide clarity to the issue of conceptualizing change in Global Health. By first outlining a brief history of decolonial thought and then exploring the current state of the decolonizing global health literature, I show a profound disjuncture between popularized calls for decolonization in Global Health and other theorizations of the term. I then argue that the diluting of "decolonization" into a depoliticized vision of reforming the inherently colonial and capitalistic institutions and organizations of Global Health is an example of "elite capture"-the coopting and reconfiguration of radical, liberatory theories and concepts then used by elites for their own gain. Showing how this elite capture has facilitated harm within the field and beyond, I conclude by calling for resistance to elite capture in all its forms.
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Affiliation(s)
- Daniel W Krugman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Perkins S, Nishimura H, Olatunde PF, Kalbarczyk A. Educational approaches to teach students to address colonialism in global health: a scoping review. BMJ Glob Health 2023; 8:bmjgh-2022-011610. [PMID: 37055173 PMCID: PMC10106004 DOI: 10.1136/bmjgh-2022-011610] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/18/2023] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION The enduring legacy of colonisation on global health education, research and practice is receiving increased attention and has led to calls for the 'decolonisation of global health'. There is little evidence on effective educational approaches to teach students to critically examine and dismantle structures that perpetuate colonial legacies and neocolonialist control that influence in global health. METHODS We conducted a scoping review of the published literature to provide a synthesis of guidelines for, and evaluations of educational approaches focused on anticolonial education in global health. We searched five databases using terms generated to capture three concepts, 'global health', 'education' and 'colonialism'. Pairs of study team members conducted each step of the review, following Preferred Reporting Items for Systematic reviews and Meta-Analyse guidelines; any conflicts were resolved by a third reviewer. RESULTS This search retrieved 1153 unique references; 28 articles were included in the final analysis. The articles centred North American students; their training, their evaluations of educational experiences, their individual awareness and their experiential learning. Few references discussed pedagogical approaches or education theory in guidelines and descriptions of educational approaches. There was limited emphasis on alternative ways of knowing, prioritisation of partners' experiences, and affecting systemic change. CONCLUSION Explicit incorporation of anticolonial curricula in global health education, informed by antioppressive pedagogy and meaningful collaboration with Indigenous and low-income and middle-income country partners, is needed in both classroom and global health learning experiences.
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Affiliation(s)
- Sylvie Perkins
- Center for Indigenous Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Holly Nishimura
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Praise F Olatunde
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anna Kalbarczyk
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Dada S, Wylie K, Marshall J, Rochus D, Bampoe JO. The importance of SDG 17 and equitable partnerships in maximising participation of persons with communication disabilities and their families. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:183-187. [PMID: 36511819 DOI: 10.1080/17549507.2022.2150310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Equitable partnerships across borders, sectors and communities are integral in creating shared understanding, novel solutions and sustainable development. Sustainable development goal (SDG) 17: Partnerships for goals, focuses on strengthening global partnerships. This highlights the importance of partnership as a tool to support the achievement of all SDGs. Partnerships are particularly vital to creating sustainable and appropriate services to support people who experience communication or swallowing disability and their families, in under-served communities, where services and expert personnel may be limited and where innovative strategies are required for working with families and communities to improve service accessibility. PURPOSE To reflect on key principles underpinning the creation of a speech-language pathologists' (SLPs') community of practice, designed to support SLPs from high-, low- and middle-income countries to develop equitable partnerships, aimed at supporting people who experience communication or swallowing disability their families. RESULT We draw on the authors' experiences of building partnerships to enhance participation for people who experience communication or swallowing disability. We discuss the need for global partnerships and challenges with current funding mechanisms. CONCLUSION We use the principles of the speech-language pathology community of practice and concepts from the Partnership Accelerator 2030 Agenda to frame reflections and recommendations. This commentary paper focuses on partnerships for the goals (SDG 17).
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Karen Wylie
- School of Allied Health, Curtin University, Perth, Australia
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Julie Marshall
- Health Professions Department, Manchester Metropolitan University, Manchester, UK
- University of KwaZulu Natal, Durban, South Africa
| | - David Rochus
- Yellow House Children's Services, Kisumu, Kenya, and
| | - Josephine Ohenewa Bampoe
- School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
- Faculty of Science and Health, Charles Sturt University, Albury, Australia
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Shawar YR, Neill R, Kunnuji M, Manoj M, Shiffman J. Understanding resilience, self-reliance and increasing country voice: a clash of ideologies in global health. BMJ Glob Health 2023; 8:bmjgh-2022-010895. [PMID: 36634980 PMCID: PMC9843176 DOI: 10.1136/bmjgh-2022-010895] [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: 10/06/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND 'Resilience', 'self-reliance' and 'increasing country voice' are widely used terms in global health. However, the terms are understood in diverse ways by various global health actors. We analyse how these terms are understood and why differences in understanding exist. METHODS Drawing on scholarship concerning ideology, framing and power, we employ a case study of a USAID-sponsored suite of awards called MOMENTUM. Applying a meta-ethnographic approach, we triangulate data from peer-reviewed and grey literature, as well as 27 key informant interviews with actors at the forefront of shaping these discourses and those associated with MOMENTUM, working in development agencies, implementing organisations, low-income and middle-income country governments, and academia. RESULTS The lack of common understanding of these three terms is in part a result of differences in two perspectives in global health-reformist and transformational-which are animated by fundamentally different ideologies. Reformists, reflecting neoliberal and liberal democratic ideologies, largely take a technocratic approach to understanding health problems and advance incremental solutions, working within existing global and local health systems to effect change. Transformationalists, reflecting threads of neo-Marxist ideology, see the problems as inherently political and seek to overhaul national and global systems and power relations. These ideologies shape differences in how actors define the problem, its solutions and attribute responsibility, resulting in nuanced differences among global health actors in their understanding of resilience, self-reliance and increasing country voice. CONCLUSIONS Differences in how these terms are employed and framed are not just linguistic; the language that is used is reflective of underlying ideological differences among global health actors, with implications for the way programmes are designed and implemented, the knowledge that is produced and engagement with stakeholders. Laying these distinct ideologies bare may be crucial for managing actor differences and advancing more productive discussions and actions towards achieving global health equity.
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Affiliation(s)
- Yusra Ribhi Shawar
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA .,Johns Hopkins University Paul H. Nitze School of Advanced International Studies, Washington, DC, USA
| | - Rachel Neill
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Kunnuji
- Department of Sociology, University of Lagos, Akoka, Lagos, Nigeria
| | - Malvikha Manoj
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeremy Shiffman
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA,Johns Hopkins University Paul H. Nitze School of Advanced International Studies, Washington, DC, USA
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Hindmarch S, Hillier S. Reimagining global health: From decolonisation to indigenization. Glob Public Health 2023; 18:2092183. [PMID: 35770706 DOI: 10.1080/17441692.2022.2092183] [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: 01/05/2022] [Accepted: 05/22/2022] [Indexed: 11/04/2022]
Abstract
In the wake of global racial justice and Indigenous sovereignty movements, there have been calls to decolonise global health as an academic discipline and set of policies, programmes, and practices. Identifying these calls for decolonisation of global health as both promising but limited, we argue that global health needs to engage in deeper critical reassessment of its ontological foundations in Western thought and that Indigenous ontologies have an important role to play in deconstructing and reimagining global health. We identify four Western ontological assumptions that are particularly relevant to global health and demonstrate how Indigenous ontologies assist in thinking outside of and beyond these assumptions, offering a path toward a reconstructed Indigenized imagining of global health.
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Affiliation(s)
- Suzanne Hindmarch
- Department of Political Science, University of New Brunswick, Fredericton, Canada
| | - Sean Hillier
- School of Health Policy & Management, York University, Toronto, Canada
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Abouzeid M, Muthanna A, Nuwayhid I, El-Jardali F, Connors P, Habib RR, Akbarzadeh S, Jabbour S. Barriers to sustainable health research leadership in the Global South: Time for a Grand Bargain on localization of research leadership? Health Res Policy Syst 2022; 20:136. [PMID: 36536392 PMCID: PMC9761652 DOI: 10.1186/s12961-022-00910-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Strong Global South (GS) health research leadership, itself both dependent on and a requisite for strong health research systems, is essential to generate locally relevant research and ensure that evidence is translated into policy and practice. Strong GS health research systems and leadership are important for health development and in turn for strong health systems. However, many GS countries struggle to produce research and to improve performance on widely used research metrics measuring productivity and reflecting leadership. Drawing on literature from a rapid review, this viewpoint paper considers the barriers to GS health research leadership and proposes strategies to address these challenges. FINDINGS GS researchers and institutions face numerous barriers that undermine health research leadership potential. Barriers internal to the GS include researcher-level barriers such as insufficient mentorship, limited financial incentives and time constraints. Institutional barriers include limited availability of resources, restrictive and poorly developed research infrastructures, weak collaboration and obstructive policies and procedures. Structural barriers include political will, politicization of research and political instability. External barriers relate to the nature and extent of Global North (GN) activities and systems and include allocation and distribution of funding and resources, characteristics and focus of GN-GS research collaborations, and publication and information dissemination challenges. CONCLUSIONS Strengthening GS health research leadership requires acknowledgement of the many barriers, and adoption of mitigating measures by a range of actors at the institutional, national, regional and global levels. Particularly important are leadership capacity development integrating researcher, institutional and systems initiatives; new GN-GS partnership models emphasizing capacity exchange and shared leadership; supporting GS research communities to set, own and drive their research agendas; addressing biases against GS researchers; ensuring that GS institutions address their internal challenges; enhancing South-South collaborations; diversifying research funding flow to the GS; and learning from models that work. The time has come for a firm commitment to improving localization of research leadership, supported by adequate funding flow, to ensure strong and sustainable research systems and leadership in and from the GS. Just as the humanitarian donor and aid community adopted the Grand Bargain commitment to improve funding flow through local and national responders in times of crisis, we strongly urge the global health research community to adopt a Grand Bargain for research leadership.
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Affiliation(s)
- Marian Abouzeid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia ,grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Ahlam Muthanna
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Iman Nuwayhid
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Phil Connors
- grid.1021.20000 0001 0526 7079Centre for Humanitarian Leadership, School of Humanities and Social Sciences, Deakin University, Burwood, VIC Australia
| | - Rima R. Habib
- grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Shahram Akbarzadeh
- grid.1021.20000 0001 0526 7079Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC Australia
| | - Samer Jabbour
- grid.22903.3a0000 0004 1936 9801The Lancet-American University of Beirut Commission on Syria, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon ,grid.22903.3a0000 0004 1936 9801Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Bartels SM, Haider S, Williams CR, Mazumder Y, Ibisomi L, Alonge O, Theobald S, Bärnighausen T, Escallon JV, Vahedi M, Ramaswamy R, Sarker M. Diversifying Implementation Science: A Global Perspective. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00757. [PMID: 36041849 PMCID: PMC9426981 DOI: 10.9745/ghsp-d-21-00757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
We present a joint global perspective about the urgent need to diversify the loci of knowledge creation and sharing in global implementation science. We underscore the imperative of addressing implementation research questions relevant to practitioners, policy makers, and researchers from low- and middle-income countries.
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Affiliation(s)
- Sophia M Bartels
- Department of Health Behavior, The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Shabab Haider
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Caitlin R Williams
- Department of Maternal and Child Health, The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Yameen Mazumder
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Olakunle Alonge
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sally Theobald
- Social Science and International Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg, Germany
| | | | | | - Rohit Ramaswamy
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Malabika Sarker
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg, Germany
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James MV, Lees SS. "Are You Sure It's Not the Corona Vaccine?" An Ebola Vaccine Trial During COVID-19 in DRC. Med Anthropol 2022; 41:503-517. [PMID: 35838298 DOI: 10.1080/01459740.2022.2097908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The COVID-19 pandemic began as an Ebola epidemic was unfolding in the Democratic Republic of the Congo. In this article, we examine how COVID-19 influenced experiences of an Ebola vaccine trial and attitudes towards medical research in Goma. First, critical debates about vaccine research became a forum in which to contest ineffective local governance and global inequality. Second, discussions about new COVID-19 therapeutics reignited critique of Western biomedical colonialism. Third, rumors were made powerful through everyday observations of the unexpected adaption of Ebola trial procedures in the pandemic. This illustrates the difficulties of maintaining participants' trust, when circumstances dictate protocol alterations mid-trial.
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Affiliation(s)
- Myfanwy Vaughan James
- London School of Hygiene & Tropical Medicine, Department of Global Health and Development, London, London, UK.,Department of International Development, Oxford University, Oxford, UK
| | - Shelley Susan Lees
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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14
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Rivera-Segarra E, Mascayano F, Alnasser L, van der Ven E, Martínez-Alés G, Durand-Arias S, Moro MF, Karam E, Hernández-Torres R, Alarcón S, Ramos-Pibernus A, Alvarado R, Susser E. Global mental health research and practice: a decolonial approach. Lancet Psychiatry 2022; 9:595-600. [PMID: 35397800 DOI: 10.1016/s2215-0366(22)00043-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/16/2022]
Abstract
The global health movement is having a paradigm crisis-a period characterised by a questioning of one's values, goals, and sense of identity. Despite important advances in population health worldwide, global health and global mental health often produce and reproduce power imbalances and patterns of oppression and exploitation that perpetuate the current modern world system (ie, Eurocentric, capitalist, and patriarchal) and its entangled global hierarchies (eg, gender, economic, epistemic, and linguistic). A consensus is emerging to decolonise global mental health, but it is not clear how to move from rhetoric to action. In this Personal View, we aim to share our experiences and the practices developed in the context of the COVID-19 health care workers (HEROES) Study. To do so, we present our HEROES decolonial team approach, which comprises three underlying principles: epistemic justice, pragmatic solidarity, and sovereign acts. We have developed decolonial team practices such as co-creating communication spaces to foster horizontal and equitable dialogue, locating and managing the study database in Chile, and ensuring local teams' rights and access to the data without barriers.
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Affiliation(s)
- Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.
| | - Franco Mascayano
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Lubna Alnasser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; La Paz Hospital Institute for Health Research (IdiPAZ), University Hospital La Paz, Madrid, Spain; Mental Health Network Biomedical Research Center (CIBERSAM), Madrid, Spain; Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Sol Durand-Arias
- Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Maria Francesca Moro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology St Georges Hospital University Medical Center, University of Balamad, Beirut, Lebanon; Head Institute for Development, Research, Advocacy & Applied Care, Beirut, Lebanon
| | - Ruthmarie Hernández-Torres
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico; Clinical and Translational Science Institute, University of Rochester Medical Center, University of Rochester, New York, NY, USA
| | - Sebastián Alarcón
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Alíxida Ramos-Pibernus
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Rubén Alvarado
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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15
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Khan SA. Decolonising global health by decolonising academic publishing. BMJ Glob Health 2022; 7:bmjgh-2021-007811. [PMID: 35301234 PMCID: PMC8931802 DOI: 10.1136/bmjgh-2021-007811] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/15/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Shahzad Amjad Khan
- Department of Surgery, Independent Medical College, Faisalabad, Pakistan
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16
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Polidano K, Parton L, Agampodi SB, Agampodi TC, Haileselassie BH, Lalani JMG, Mota C, Price HP, Rodrigues S, Tafere GR, Trad LAB, Zerihun Z, Dikomitis L. Community Engagement in Cutaneous Leishmaniasis Research in Brazil, Ethiopia, and Sri Lanka: A Decolonial Approach for Global Health. Front Public Health 2022; 10:823844. [PMID: 35242734 PMCID: PMC8885625 DOI: 10.3389/fpubh.2022.823844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often “neglected” public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE. Our decolonial approach implies that the model for community engagement will be different in Brazil, Ethiopia and Sri Lanka. Indeed, we adopt a critical anthropological approach to engaging with community members and it is precisely this approach we evaluate in this paper. The data and material we draw on were collected through qualitative research methods during community engagement activities. We established 13 Community Advisory Groups (CAGs): in Brazil (n = 4), Ethiopia (n = 6), and Sri Lanka (n = 3). We identified four overarching themes during a thematic analysis of the data set: (1) Establishing community advisory groups, (2) CAG membership and community representation, (3) Culturally appropriate and context-bespoke engagement, and (4) Relationships between researchers and community members. During our first period of ECLIPSE community engagement, we have debunked myths (for instance about communities being “disempowered”), critiqued our own practices (changing approaches in bringing together CAG members) and celebrated successes (notably fruitful online engagement during a challenging COVID-19 pandemic context). Our evaluation revealed a gap between the exemplary community engagement frameworks available in the literature and the messy, everyday reality of working in communities. In the ECLIPSE program, we have translated ideal(istic) principles espoused by such community engagement guidance into the practical realities of “doing engagement” in low-resourced communities. Our community engagement was underpinned by such ideal principles, but adapted to local sociocultural contexts, working within certain funding and regulatory constraints imposed on researchers. We conclude with a set of lessons learned and recommendations for the conduct of decolonial community engagement in global health research.
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Affiliation(s)
- Kay Polidano
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Linda Parton
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Suneth B. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Thilini C. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | | | - Clarice Mota
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Helen P. Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Steffane Rodrigues
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | | | - Leny A. B. Trad
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Zenawi Zerihun
- Department of Psychology, Mekelle University, Mekelle, Ethiopia
| | - Lisa Dikomitis
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, United Kingdom
- *Correspondence: Lisa Dikomitis
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17
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Staples J, Marsland R. Grappling with Diversification. Med Anthropol 2022; 41:1-3. [PMID: 35119314 DOI: 10.1080/01459740.2021.2015592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- James Staples
- Department of Social and Political Sciences, Brunel University London, UK
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18
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Hellowell M, Nayna Schwerdtle P. Powerful ideas? Decolonisation and the future of global health. BMJ Glob Health 2022; 7:bmjgh-2021-006924. [PMID: 35064046 PMCID: PMC8785167 DOI: 10.1136/bmjgh-2021-006924] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/30/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mark Hellowell
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Patricia Nayna Schwerdtle
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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19
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Kulesa J, Brantuo NA. Barriers to decolonising educational partnerships in global health. BMJ Glob Health 2021; 6:e006964. [PMID: 34789513 PMCID: PMC8601064 DOI: 10.1136/bmjgh-2021-006964] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/01/2021] [Indexed: 12/22/2022] Open
Abstract
Global health partnerships between high-income countries and low/middle-income countries can mirror colonial relationships. The growing call to advance global health equity therefore involves decolonising global health partnerships and outreach. Through decolonisation, local and international global health partners recognise non-western forms of knowledge and authority, acknowledge discrimination and disrupt colonial structures and legacies that influence access to healthcare.Despite these well-described aims, the ideal implementation process for decolonising global health remains ill-defined. This ambiguity exists, in part, because partners face barriers to adopting a decolonised perspective. Such barriers include overemphasis on intercountry relationships, implicit hierarchies perpetuated by educational interventions and ethical dilemmas in global health work.In this article, we explore the historical entanglement of education, health and colonialism. We then use this history as context to identify barriers that arise when decolonising contemporary educational global health partnerships. Finally, we offer global health partners strategies to address these challenges.
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Affiliation(s)
- John Kulesa
- Graduate School of Education and Human Development, George Washington University, Washington, DC, USA
- Department of Hospital Medicine, Children's National Hospital, Washington, DC, USA
| | - Nana Afua Brantuo
- Graduate School of Education and Human Development, George Washington University, Washington, DC, USA
- Department of Education, University of Maryland at College Park, College Park, Maryland, USA
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20
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Liwanag HJ, Rhule E. Dialogical reflexivity towards collective action to transform global health. BMJ Glob Health 2021; 6:e006825. [PMID: 34417275 PMCID: PMC8381326 DOI: 10.1136/bmjgh-2021-006825] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Harvy Joy Liwanag
- United Nations University International Institute for Global Health, Cheras, Federal Territory of Kuala Lumpur, Malaysia
| | - Emma Rhule
- United Nations University International Institute for Global Health, Cheras, Federal Territory of Kuala Lumpur, Malaysia
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